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News and Notes

April 1997

Temporary AIDS Czar | Reefer Research | Assisted Suicide | Mandatory Testing of Infants |

Without Pomp, Temporary AIDS Czar Takes Power

On Valentine's Day, February 14, Patricia S. Fleming left office as director of National AIDS Policy, and the White House press office quietly released a statement naming her temporary successor. The acting czar is not one of the individuals who were reported to be on the short list for the job a few months ago -- Phill Wilson, Pat Christen, Jim Graham and Mike Isbell -- but is instead Eric P. Goosby, a highly regarded physician who currently coordinates HIV activities at the Department of Health and Human Services (HHS). Active on the aids issue for the past 14 years, Dr. Goosby, an African-American, was formerly a primary care physician at San Francisco General Hospital where he was noted for his sensitive care of drug-using aids patients; he once told the San Francisco Examiner that addicts too often "are treated like criminals rather than as if they're sick."

His current work at HHS is the creation of guidelines for protease inhibitor treatment regimens and their financing, due for release in March. Opinion is divided over whether Goosby, a man who unnamed insiders call "a nice guy" but "not a very competent administrator," will ultimately be able to drop the "acting" from his title, a process for which there is precedent: Following the resignation in 1994 of the first czar, Kristine Gebbie, Patsy Fleming became interim director of the office. She acceded to the full office a couple of months later. Though respectful of Goosby's record, AIDS Action Council executive director Daniel Zingale and other advocates have called for the post to be elevated to cabinet level and filled with a prominent individual. "We urge that he [President Clinton] consider high-profile figures such as Henry Cisneros [former Secretary of Housing and Urban Development], Jesse Jackson, David Kessler [outgoing FDA Commissioner], Ann Richards [former Governor of Texas], or General John Shalikashvili [chair of the Joint Chiefs of Staff]," Zingale said.


It's Reefer Research Time, Government Scientist Say

In an effort to replace the political rhetoric with scientific reasoning, the National Institutes of Health (NIH) convened a panel charged with determining what is known and what needs to be studied regarding potential medical uses of marijuana for people with aids, glaucoma, cancer, and other serious illnesses. The panel is to report its findings in one month. Studies of marijuana are "complicated by political issues and strong prior beliefs," said Robert Temple of the Food and Drug Administration. "There is some experience but not a lot of controlled trials. Many claimed benefits of smoked marijuana are highly subjective. We need to find a way to do an objective study." The move by the NIH follows the January 29 editorial in the prestigious New England Journal of Medicine that blasted the federal government's policy on marijuana as "misguided, heavy-handed and inhumane," and called for its reclassification, a move that would allow doctors to prescribe it. Dr. Jerome Kassirer, editor-in-chief of the journal, scolded Secretary of Health and Human Services Donna Shalala, Attorney General Janet Reno, and drug czar Barry McCaffrey for their outspoken public stands against marijuana's medicinal use.

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Survey of AIDS Docs Reveals Highest-Ever Rate of Assisted Suicide

Half of the San Francisco Bay Area aids doctors who participated in a recent survey indicated they knowingly prescribed a lethal dose of narcotics to help a patient commit suicide -- the highest rate of doctor-assisted suicide documented -- reported the New England Journal of Medicine on February 5. Of the 118 doctors who responded anonymously to the survey, 53% admitted they prescribed a lethal dose of opiates at least once, though the study did not ascertain whether or not the patients used the drugs to end their lives. Previous studies have found between 7% and 9% of doctors helped terminally ill patients die. Though most of the surveyed doctors, all members of the 228-member Community Consortium, helped one or two patients to die, one doctor estimated prescribing lethal drug doses to 100 patients.

"The results show that physician-assisted suicide is clearly a reality. It reflects what physicians are really doing," said San Francisco psychologist Lee Slome, the study's author. "On the other hand, it is surprising that this large a proportion of physicians is willing to admit doing it at least one time." The survey also showed that doctors' attitudes toward assisted suicide are changing: 48% of those polled said they would help a hypothetical AIDS patient die; in 1990, 28% said they would do so. "The survey is a snapshot of what doctors in the community were doing, " said Dr. Donald Abrams of San Francisco General Hospital and director of the Community Consortium. "The question is, will it change when we look at this again in the future?"


Editor's note: According to Judith Rabkin, M.D., a member of Body Positive's Medical Advisory Committee, "all members of the Community Consortium were surveyed. Of 228 doctors, 137 (60%) responded; 19 no longer practiced, so 118 questionnaires were evaluated. The median number of direct requests for assisted suicide was two (that is, half the respondents had received two or fewer requests; half more than two)."


New York State Begins Mandatory HIV Testing of Infants

New York State's controversial mandatory testing of infants for HIV -- the first such program in the nation -- began quietly in hospitals in February. Technically, the state has been anonymously testing newborns for years, but the new policy requires the disclosure of the results to the mothers -- weeks after the test is conducted -- whether or not they would consent to be tested themselves. A positive test result for the infant means the mother is HIV-infected; the child itself has a 25% chance of being HIV-infected in the womb. According to a report in The New York Times on February 10, carrying out the tests has been mundane in light of the heated controversy that has surrounded mandatory testing for years. Of 10 hospitals polled by the Times, not one had patients who refused to undergo the test. "Certainly, this is a very charged issue and an extraordinary undertaking, politically and as a public health program," said New York State Health Commissioner Dr. Barbara DeBuono. "It is being watched closely by other states and the CDC [Centers for Disease Control and Prevention] to see if it has any significant impact."


Back to the April 97 Issue of Body Positive Magazine.




  
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