Health Education AIDS Liaison, Toronto


Blood-test bill a violation of privacy, Radwanski says

By CAMPBELL CLARK
The Globe and Mail Friday, February 22, 2002

OTTAWA -- Canadians would suffer a "massive violation of privacy" from a bill that would force people to take blood tests for viruses such as HIV if it is suspected they infected a police officer or health-care worker, federal Privacy Commissioner George Radwanski warned yesterday.

Mr. Radwanski said the bill would give the state broad authority to force an invasive procedure on law-abiding people, with little promise it would be effective and no proof it addresses a large-scale problem.

"This proposed bill would violate privacy in the most profound way possible because it would take away that right to control access not only to the most sensitive private information about ourselves, but even to our physical selves as well," he told the Commons justice committee.

The bill, introduced by Tory-DRC MP Chuck Strahl and backed in initial votes by a majority in the Commons, is designed to let emergency workers such as paramedics and police know whether they have been infected by viruses like hepatitis or HIV when they deal with suspects or accident victims.

Many AIDS workers and civil-rights advocates oppose the bill.

However, organizations representing police officers and health-care workers are in favour of it. They cite the case of Ottawa police Constable Isobel Anderson, who was jabbed with a bloody syringe as she searched the pockets of an armed-robbery suspect.

Worried about HIV infection, she began treatments with a drug cocktail that causes serious side effects but can prevent the virus from taking hold. But she stopped the drugs in part because the robber tested negative for HIV.

Mr. Radwanski told the committee that protecting health-care workers is laudable, but the bill's provisions would be an ineffective and unwarranted reduction of rights.

He said that a negative test does not guarantee there's no HIV infection, for example, because the virus might not be detected for several months after a person is infected.

He also said there has been only one confirmed case in Canada, and two possible cases, of someone being infected with HIV on the job, so it is not clear that the problem is big enough to warrant a large reduction in rights.

When Mr. Strahl raised the possibility that police officers could be assaulted with needles or bitten, Mr. Radwanski said he would be less concerned if the bill applied only to assault suspects, rather than accident victims.

"Maybe you surrender an element of your right to privacy when you bite someone," he said. "I'm not sure you surrender it when you collapse bleeding on a sidewalk."

Mr. Strahl's Tory-DRC coalition and the Canadian Alliance said they believe the balance of rights should favour people who fear they have been infected, and might choose to take toxic drugs.

COMMENTARY:

Serious problems with postexposure prophylaxis PEP treatment have been evident for some time. In one study published in the Annals of Hematology in 1994 (Ann Hematol. 1994 Sep;69(3):135-8) AZT was given to 14 health care workers who were exposed to HIV-contaminated blood through needle sticks and similar accidents. Fully half of the 14 workers had to quit the drug because of severe toxic side effects, and the study was stopped early before more damage was done. Only 11 of the 14 people could continue to take the drug for more than four weeks. Neutropenia developed in 36% (4 of 11) of the people who completed 4 weeks of AZT treatment. The three people who could not make it to four weeks dropped out due to "severe subjective symptoms". One worker had to be stopped prematurely because his neutropenia was so severe that he developed an upper respiratory tract infection.

This recent report also urges caution:

Serious Adverse Events Attributed to Nevirapine Regimens for Postexposure Prophylaxis After HIV Exposures --- Worldwide, 1997--2000"
CDC MMWR January 05, 2001 / 49(51);1153-6

For more information on postexposure prophylaxis go here.

Can HIV Be Transmitted Through Needle Sticks?


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