In its first attempt to influence public policy on containing the AIDS epidemic, the American Medical Association yesterday issued a report rejecting wide use of mandatory testing and called for tough new laws to protect the civil liberties of all who test positive for the AIDS virus.
The report, written by the AMA's Board of Trustees, urges the immediate formation of a national policy to confront the disease, noting that the epidemic "is now more than six years old and the growing magnitude of the problem has been apparent for nearly that long."
The board said Reagan administration plans to spend $1 billion to fight AIDS next year "will not be enough" and endorsed legislation introduced by Rep. Henry A. Waxman (D-Calif.) to increase resources for voluntary testing and counseling.
The strong position for the nation's largest and most powerful medical organization implicitly challenges the direction of administration policy on acquired immune deficiency syndrome. While the administration intends to appoint an advisory body on AIDS, the AMA is seeking a commission with strong powers to develop and help implement a national policy acceptable to federal, state and local governments and private industry.
"What we are saying is that we need to do much more," said Dr. Lonnie Bristow, a board member who helped draft the policy that the AMA House of Delegates will vote on this week. "If there is any real criticism of our system, it is simply that we have not devoted the necessary resources to fight this disease."
White House spokesman Dan Howard said administration officials had not seen the report and declined to comment.
Earlier this month, in his first major speech on AIDS, President Reagan called on the states to institute routine testing for marriage-license applicants, inmates in state prisons and local jails, and persons seeking treatment for drug abuse or sexually transmitted diseases.
While the AMA trustees recommended mandatory testing of prisoners, immigrants and the military, as well as blood and organ donors, they stopped short of other stated Reagan administration goals.
"Testing should not be extended to all individuals anywhere who are considering marriage or to all persons in hospitals," the report said.
"Public health authorities have advanced a plausible premise for their opposition to mandatory testing" for certain groups, the report continued. "Until those premises are shown . . . to be incorrect, a policy rejected by the vast majority of public health officials, including the Centers for Disease Control and the surgeon general, cannot be recommended."
The U.S. Public Health Service has projected that by 1991 there will be more than 300,000 reported cases of AIDS in this country, with 200,000 deaths.
About 1.5 million Americans are now believed to be infected by the virus that causes AIDS, and many of them do not know it. Many state laws and a recent Supreme Court decision, School Board of Nassau County v. Arline, protect AIDS patients against discrimination. But the court left open the question of whether healthy people who test positive for the AIDS virus are protected by federal law.
"The whole fear about testing positive is the stigma it brings," said one person who helped prepare the report. "When you test positive and do not have AIDS, you are able to function in virtually all respects. These people should not be the subject of discrimination."
Although the trustees emphasized that "mandatory national testing, at present should not be broadly extended," they also called for routine voluntary testing at drug and sexually transmitted disease clinics. They added that such testing should be performed only with the informed consent of the subject, who should have the right to refuse.
The report also seeks a much wider education program for the public and for health-care professionals. The report urges that more money be devoted to counseling those who test positive and to training physicians properly for the task.
The Department of Health and Human Services, while endorsing education programs on AIDS, has been reluctant to endorse mass-media commercials that advocate the use of condoms or discuss homosexuality. On Friday, the agency said it was releasing ads that would mention neither.
The AMA trustees rejected that approach, writing that "preventative messages must necessarily deal with controversial subject matter."
The trustees also said that in cases where a person was found to be infected with the AIDS virus, whether the person was sick or not, the information should be reported to public health officials "on an anonymous or confidential basis."
They stressed, however, that such a plan could work only if proper statutes to protect confidentiality and civil liberties were enacted.