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"First, do no harm." Meeting this seemingly simple commandment of the Hippocratic oath has grown more difficult with the increased spread of the AIDS virus, as patients worry that they may catch the deadly disease from their doctors. Currently the U.S. House of Representatives is debating legislation that would prohibit health care workers from conducting invasive medical or dental procedures if they are infected with human immunodeficiency virus, or HIV. Medicine Professor Rob MacGregor, who specializes in infectious diseases at HUP, and his colleagues who oppose the mandatory testing said last night there is not sufficient data to prove that transmission through health care workers is a significant risk. There is one documented case of provider-to-patient transmission, and in that dental case, many records are missing, according to Assistant Infectious Disease Professor Patrick Brennan. "To make a national compulsory system in testing on the basis of one event seems to be an overreaction to the relatively minuscule," MacGregor said. "The case is very strongly disputed," Brennan added. "It is now believed that he may have had sexual contacts with his patients and that he may have infected them through poorly sterilized instruments." But Nursing sophomore Racquel Lowe said last night the legislation is positive and should be implemented. "The patients have a right to know if the doctor or nurse has AIDS," Lowe said. "If they make it known to the patient, some will discriminate and not go back -- others may have faith." Those who oppose the legislation, introduced by Rep. William Dannemeyer (R-Calif.), also argue that the cost of testing all health care workers is enormous and that it would divert limited funds away from research. "Do you test physicians once a year?" HUP infectious disease physician Ian Frank said. "That's a lot of money -- with not a lot of impact." Opponents to the legislation said that the test may not indicate positive infection immediately after receiving the virus and that testing would have to be continuous. "I don't think it is going to solve the problem," said Margaret Sovie, chief nursing officer at HUP. "It will only tell you about that moment in time -- not the rest of your career." The New York Times reported last week that it may cost up to $1 billion a year to carry out the program. The legislation would also allow physicians to test their patients for AIDS without the patient's consent. "If we are going to have testing on one side, we have to have it on the other side," Brennan said. "Very, very, very few people get infected by [the health care provider] and it is much more likely that a health care worker will be infected by a patient." One nursing student said she agreed with the legislation that health care workers should be required to be tested, but added that the results should not be made public. "I dont think it should be made public knowledge," Joy Lowe said. "The health care provider can know themselves and make responsible decisions." The Nursing freshman also said that she disagreed with the provision allowing for patient testing. "I think any test should be done only with the person's permission -- whether its an AIDS test or an EKG," Lowe said.

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