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December 1, 1993

Federal Ruling Reins In Liberal HIV Testing Law, Consensus Still Lacking on Controversial Issue

JAMA. 1993;270(21):2530-2531. doi:10.1001/jama.1993.03510210016004

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DESPITE ATTEMPTS in recent years to destigmatize AIDS by treating the illness like any other infectious disease, an Alabama court says it still isn't so.

In an October ruling, a federal judge in Montgomery, Ala, declared unconstitutional the portion of a state law that allowed HIV testing without written, informed consent if, based on a physician's "reasonable medical judgment," the patient is at high risk for infection.

Overall, the 2-year-old law requires HIV testing with written, informed consent. But it listed three exceptions. Still intact are provisions that state explicit consent is unnecessary for the protection of health care workers, or if knowledge of the patient's HIV status will change the course of medical care.

By upholding the two exceptions, advocates who believe that there is no substitute for explicit consent say the ruling doesn't go far enough. However, the decision appears to halt the pendulum pushed by some groups,