HIV consent bill may face tougher challenge in House

By Tara Jayakar, Cape Cod Times

BOSTON – Physicians and AIDS advocates are debating whether a proposed bill that would allow doctors to test patients for HIV with a simple verbal consent needs other changes that would make it easier for health providers to see such records.

“It’s a good step that it went from written to verbal but it needs to go further,” says Dr. Lynda Young, president of the Massachusetts Medical Society. “The other part to this is that this proposed legislation has separate written informed consent for each release of the information.”

The Senate passed a bill March 2 changing the existing law requiring “written” consent for HIV testing to “spoken” consent.

Supporters say the change will remove a barrier for doctors to get patients screened for HIV.

“We want people to get tested,” says Joe Carleo, executive director of the AIDS Support Group of Cape Cod. “We want people to know their status.”

According to the Massachusetts Medical Society blog, the number of people with HIV-AIDS has increased 35 percent from 2000 to 2009.

“Nationally, the Centers for Disease Control estimates that more than 1 million people

live with HIV, with 56,000 new infections occurring annually. Many don’t know they’re infected.”

Advocates of the change say it will remove a barrier for doctors screening for HIV, but some lawmakers have their doubts the change is needed, an indication the legislation may face a tougher test in the House.

“We have a lot of written consent on many matters concerning health care,” says Rep. Demetrius Atsalis, D-Barnstable. “If it comes to the House, I don’t think I’d support the changes.”

Atsalis said that, while he doesn’t know the nuances of the bill, he would have to be convinced by a health care provider that the change was necessary.

“With written consent there’s documentation that consent has been given,” says Atsalis.

But Young said the spread of HIV could be slowed in the long run if it was easier for doctors to share critical test results with their colleagues. By identifying the disease earlier, doctors would be able to prevent the spread of HIV to others, particularly newborns.

“Patients with HIV often see a number of providers, and it’s crucial those providers know the status of where (the patients) are in their illness or the fact that they even have it,” she says. “So if they forget to mention to this particular person it’s OK for them to send them that data, it’s just a barrier for very critical patient information.”

Young said one solution would be to make HIV testing part of a routine checkup. According to Young, having a test for HIV alongside standard cholesterol and blood sugar tests would make that information part of the record, and available to any doctor with that patient’s record.

“A separate system for all HIV-related information makes it really difficult and maybe even impossible when you have electronic medical records that don’t talk to each other,” she says. “It’s just very difficult to keep this information in an electronic record where it belongs so that you can share it with other providers, and then have to carve out, so to speak, that specific information related to HIV because you’re not allowed to share it unless the patient gives written or verbal consent.”

Carleo, however, says he thinks that changing privacy laws to release medical records is not a good idea.

“We would not be supportive of that,” says Carleo.

The bill now moves to the House for debate.

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