Subject: AMA Calls for a Mostly Voluntary Approach on AIDS Tests
Date: Published: 6/24/87 77 lines
Source:  WALL STREET JOURNAL. Copyright Dow Jones & Co. Inc. 

   AMA, Issuing Guidelines on AIDS Tests,
   Calls for a Mostly Voluntary Approach
    ---
   By Frank E. James
   Staff Reporter of The Wall Street Journal

   CHICAGO -- The American Medical Association issued
recommendations on who should be tested for the AIDS virus,
emphasizing voluntary over mandatory testing.  It said it
expects the guidelines will be widely followed.
   As the voice of organized medicine, the AMA also urged
that the Reagan administration provide more national
leadership and create a commission to study the epidemic.
   The AMA advocated three categories of testing.  For certain
groups, such as prison inmates and immigrants, it recommended
 mandatory testing.  Routine but voluntary testing should be
done on patients at venereal-disease and drug-abuse clinics,
the group said.  And where a patient's medical history or
clinical status indicates, the AMA recommends testing if the
examining physician thinks it is warranted.
    The recommendations are part of the AMA's first major
policy statement on AIDS, or acquired immune deficiency
syndrome.  The policy, contained in a report to the AMA's
house of delegates at the annual meeting here, was approved
by that body's 406 members.  About half of the nation's
552,716 doctors are AMA members.  Traditionally conservative,
the AMA took longer than some of its members would have liked
to formulate its position as it carefully weighed its
response to the crisis.
    By advocating mandatory testing of state and federal
prisoners and immigrants, the AMA places itself in line with
the Reagan administration, which plans to test immigrants and
federal prisoners.
   AIDS, an incurable and usually fatal disease that destroys
the body's ability to fend off infections, has infected more
than 36,000 people in the U. S. More than 20,000 have died
from the disease.  AIDS is known to be transmitted through
unprotected sexual intercourse with an infected person,
transfusions of contaminated blood or use of contaminated
 needles.
   The AMA's recommendations are just that, as the
organization hasn't any power to enforce them.  But it expects
that they will have broad impact.  "The medical community and
legislators have been waiting for the day when there'd be
some direction here.  Well, today's the day," said James H. 
Sammons, the AMA's executive vice president.
   Where routine voluntary testing is concerned however, the
AMA differed with the administration.  President Reagan has
stated that applicants for marriage licenses should be tested
and some states are considering legislation to that end.  But
the AMA said that, based on the medical evidence, routine
testing of marriage-license applicants isn't necessary.
   Besides submitting users of VD and drug clinics to routine
and voluntary testing, the AMA also approved of such testing
for certain individuals in "high-risk" communities:  pregnant
women in their first trimester, individuals seeking family
planning and patients needing surgery or other invasive
procedures.  Under routine and voluntary testing a patient
would have to specifically object to a test for it not to be
conducted.
   Cory SerVaas, editor and publisher of the Saturday Evening
Post and an AMA member, didn't think the AMA's testing policy
went far enough.  "We should test all pregnant women, not only
those from high-risk areas," said Dr. SerVaas.  "Teenagers are
promiscuous today.  We should push free and voluntary testing
and get industry to support it.  Why are we so hung up about
this?  "

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