Posted on 09/20/2002 8:08:02 AM PDT by LurkedLongEnough
People getting medical help after an accident, fire or other emergency in Missouri now may be tested for contagious diseases such as hepatitis -- whether they want the test or not.
The law, a surprise to the American Civil Liberties Union and to some hospitals, assumes patient consent to be tested if a patient's blood or other bodily fluids are exposed to emergency care providers.
Missouri firefighters, hoping to reduce their chances of catching a disease in the line of duty, quietly persuaded the Missouri General Assembly to pass the law in May.
At least two Kansas City firefighters have died of hepatitis in recent years, one in 2001. Their families and colleagues think they contracted the disease while helping injured persons.
Knowing that a victim has a communicable disease would allow an emergency care provider to get treatment and would help prove that the illness -- if eventually contracted -- was work-related, supporters said.
"Emergency medical workers have never been entitled to know what condition someone has, nor has the law recognized the presumption that if we had a disease, we were exposed in the line of duty," said Louie Wright, president of Local 42 of the International Association of Fire Fighters. "We've sort of been in the worst of both worlds."
Firefighters have already attempted to use the law, which took effect Aug. 28. Someone recently vomited into the eye of Kansas City firefighter, but the hospital declined a request to test the unconscious patient, Wright said.
The hospital was initially unaware of the new law, Wright said. The patient eventually consented to the test, resolving the issue, Wright said.
Under the law, hospitals do not have to conduct the tests. But the law enables them to do the tests, if requested, and grants immunity from civil or criminal liability whether they do the tests or not. The cost of a test would be borne by the employer of the emergency care provider.
Missouri's ACLU lobbyist, Marsha Richeson, said she had not been aware of the new law, slipped in as an amendment to a large bill on emergency care services. The ACLU thinks patients should give consent before any testing is done.
"The test is invasive," said Dick Kurtenbach, executive director of the ACLU of Kansas and Western Missouri. "You are taking something from me, and I have not had the opportunity to argue about it."
Richeson said the blood tests would not prove that a patient had transmitted a disease to the provider.
"An employer will say: There are a lot of other ways you could have gotten it," she said. "You are still going to have a fight on your hands."
Richeson said tests are not always accurate in the first place.
"You are not safe just because a test is negative," Richeson said. "The only way to protect yourself is to get yourself tested."
John Corbett, president of the Missouri State Council of Firefighters, said the law to test patients is useful and that the health of providers outweighs privacy concerns of victims. The law is written to protect the identity of patients from the emergency care provider.
"Firefighters have to start worrying about themselves," Corbett said. "We have to take care of others; but you have to take care of yourself, too."
No one testified against the legislation in committee, Corbett said, even though Richeson said the ACLU had opposed it in the past. "They weren't on the ball, and we were," Corbett said. "It was a pleasant surprise."
Kurtenbach said the ACLU's national office knew of no other state with such a law, but Corbett said it was patterned after one in Iowa. Kansas law does not require emergency care patients to be tested, officials said.
The Missouri Hospital Association did not take a position on the legislation and has just started to inform hospitals about it, said Daniel Landon, an association vice president.
Because the law does not require hospitals to do the test, some patients might persuade a hospital not to test them, Richeson said.
"It could lead to all kinds of discrimination," Richeson said. "A hospital could play favorites." She said patients with a lawyer or other advocates could resist the test, while others may be less able to.
But the law is important in giving hospitals legal leeway to do the tests, said Jason White, assistant to the director of Municipal Ambulance Services Trust in Kansas City. Ambulance interests backed the law.
White said emergency care workers take precautions against exposure to blood and other fluids, and when there is exposure, patients almost always allow themselves to be tested. In other cases, though, he said the law will be helpful.
The law exempts testing for HIV or AIDS, which Kurtenbach said can be construed as violating the Constitution because it is not giving people with other diseases equal protection.
AIDS and HIV were exempted because other state laws address those diseases, said one of the bill's sponsors, Rep. Jenee Lowe, a Kansas City Democrat.
Clinics are required to submit to the Missouri Department of Health and Senior Services the names of people who test positive for HIV or AIDS. Those names would be available to an exposed health care worker, although that would not be of use if the patient they cared for had never been tested.
To reach Kevin Murphy, call (816) 234-4464 or send e-mail to kmurphy@kcstar.com.
Disclaimer: Opinions posted on Free Republic are those of the individual posters and do not necessarily represent the opinion of Free Republic or its management. All materials posted herein are protected by copyright law and the exemption for fair use of copyrighted works.