September 28, 2011
The Massachusetts Medical Society, a group representing state health care providers, is warning lawmakers and health officials that a proposed HIV testing bill's language on consent and privacy could do more harm than good.
Massachusetts and Nebraska are the only states that have not fully adopted CDC's 2006 guidelines for HIV testing, which specifically recommend against obtaining separate consent and suggest incorporating permission into a general consent that patients ages 13-64 would give for any type of diagnostic test. Current Massachusetts law states that no doctor or health care provider can test for HIV or release information about results without obtaining a patient's written informed consent.
The proposed bill replaces written consent with "verbal informed consent," which must be noted in a patient's records. It also states that a patient's HIV-related medical information cannot be shared without the patient's written consent.
"A general medical consent form should suffice," said Dr. Lynda Young, president of MMS. "Verbal consent that is specific for one kind of testing, no matter what that testing is ... doesn't need to happen." Adding the requirements only place more roadblocks in the way of routine HIV testing, she said.
"Right now we have systems in place that protect patients' confidentiality," said Dr. Stephen Boswell, president of Fenway Health, which provides health care to Boston's LGBT community. "They are very significant and far-reaching rules that govern who we can talk to, how we can talk to them, when we need their permission, how we have to get permission."
Boswell and Rebecca Haag of AIDS Action Committee (AAC) oppose the bill. However, "I think we all share the goal of expanded testing," said Haag, who has proposed a compromise solution that lawmakers eliminate the disclosure and information-sharing provisions.
Young said MMS is open to discussions with AAC, but added that doctors remain strongly opposed to the bill and would prefer instead to have the current law repealed.