AIDS Concern Spawns Social Policy Questions

Panic spread at two New York City schools last summer when parents refused to send their children to class because one child with AIDS was allowed to continue his studies at a public school. The two local schools eventually sued the New York Board of Education, which permitted the AIDS-stricken child to attend class.

Prior to that event, New York schools began drafting guidelines on to how to handle cases of AIDS in the system. The new policy, which in part called for a team of physicians to examine any child with AIDS, was established to allay growing fears over this devastating disease and its methods of transmission, which are not fully understood.

No longer just a medical issue, AIDS has raised a number of public policy questions in the past few months--ranging from admission to the armed forces to testing high-risk groups for insurance purposes.

Many cities and towns, for example, have devised procedures to deal with public employees with AIDS. Most of the guidelines are based upon recommendations from various state and federal health agencies. The federal Centers for Disease Control found that AIDS cannot be transmitted by "casual contact" and that precautions in the workplace are rarely needed.

Last month Cambridge established a policy for all its public employees who have AIDS or who have been infected by the AIDS-related virus, HTLV-III. Although the measure states that employees "should be treated the same as with any other chronic illness," it calls for a special team of physicians to monitor AIDS cases.

Any Cambridge employee with the disease may remain at his job, but must inform his superior of his condition. The employee's supervisor then notifies the city manager and the health commissioner, both of whom are charged with providing "medical review and advice."

"We wanted to try to point out that the people who have [AIDS] were able to work," says Cambridge Health Commissioner Melvin H. Chalfen '55.

City Hall's guidelines are modeled closely on those established last fall by the Cambridge School Department for its employees. The school system's policy also permits children with AIDS to attend classes without any formal review as long as the child does not have open wounds or exhibit "unnatural" behavior such as biting.

But the policies, which Cambridge officials admit are still evolving, are coming under increasing attack by medical authorities and gay activists for being unnecessary, if not discriminatory.

"If someone is walking around with hepatitis [B], they're not required to report it," says Dr. Warren E.C. Wacker, director of Harvard's University Health Services. "And [that disease] is far more likely to be transmitted."

Wacker says that Harvard has set up no special guidelines to handle AIDS patients in the university community. The director of the university's health services says that since AIDS does not spread in public settings or workplaces, there is no need to treat the disease differently or have the victim notify his employer.

Several gay activists claim that policies like the one adopted by Cambridge are discriminatory, creating a special category for employees with AIDS and a panel to review their right to work. The guidelines, they say, violate city and state civil rights laws which forbid discrimination on the basis of handicap.

"It is our position that [the Cambridge policy] is illegal," says Kevin M. Cathcart, a lawyer for Gay and Lesbian Advocates and Defenders, a public interest legal group involved in gay issues.

"Right from the very start they are treating AIDS differently than any other disease. Any policy that treats people differently with this disease than with any other disease is against state law," Cathcart says.

The Massachusetts Commission Against Discrimination (MCAD), an agency which enforces the state's civil rights laws, will determine in the next month whether the Cambridge AIDS policy is discriminatory, MCAD will review the guidelines to see if they discriminate on the basis of handicap.

Meanwhile, the state legislature will consider a bill soon which would allow insurance companies to require prospective policy holders to provide a blood sample as a test for AIDS.