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Johnetta J. v. Municipal Court for San Francisco Judicial District3/20/1990
sistance in allaying the patient's fears.
"Allaying the fears of a patient can be a significant factor in treating that patient. Anxiety itself can cause or complicate medical problems and it can impede recovery. Where a fatal disease is involved, having access to all information bearing on the question of possible exposure can be of great assistance in relieving a patient's anxiety.
"Having all relevant information about potential exposure to HIV also assists a patient in determining the extent to which that patient wishes to make changes in his or her lifestyle to take into account the potential exposure, such as changes in diet and exercise, as well as whether it is necessary to take precautions in intimate relationships." The test of the bitten person is not immediately dispositive of HIV status since the HIV antibodies take up to six months to form, but " test of the potential
source of the infection can provide information to the person exposed during this time period."
Dr. Drew's expert opinions on the foregoing points were essentially echoed by real party's other experts, Drs. Maring, Luce, Sande and Gerberding. (Dr. Sande is Dr. Volberding's supervisor at the AIDS program at San Francisco General Hospital, and is chairman of University of California at San Francisco's AIDS Task Force.) Dr. Maring added the observation that there is a "growing concern" of contracting AIDS among the numerous peace officers and other public safety employees he treats in the course of his practice.
Dr. Gerberding noted there is some evidence of an experimental treatment possibility involving the drug zidovudine, commonly known as AZT. Doses of AZT taken by the victim within a short period of time after a bite might prevent infection. The drug is costly and the treatment "has severe side effects." "The condition of the blood of the biter could be an important factor for the employee to consider in deciding whether to subject his or her body to this prophylactic treatment."
Dr. Luce, the chief of staff at San Francisco General Hospital, stressed that "medical science is still unravelling the mysteries of this new disease. . . . Not enough data has been gathered to date to enable the medical community to advise patients or the public that transmission could never occur through a bite. . . . The question of whether such transmission is possible is still a matter of continuing inquiry. In light of the fatal nature of the disease, it is prudent to err on the side of caution until there are sufficient data to enable the medical community to conclude that there is no cause for concern."
Dr. Luce also opined that a negative test of the biter, while not dispositive, "serves several useful purposes: . . . It informs the patient that the risk of infection is decreased even further. It assists the physician's ability to assess the risk of infection, which will affect the degree of monitoring and other precautions the physician will prescribe for his patient. It also assists the physician in diagnosing and understanding the causes of medical problems that may arise. Information of a negative test result significantly reduces the anxiety of the bite victim. Allaying the fears of a patient can be an important factor in a treatment program. Anxiety itself can cause or complicate medical problems and can impede recovery. Where a fatal disease is involved, having access to all information bearing on the question of possible exposure can be of great assistance in relieving a patient's anxiety."
Real party's and petitioner's experts were essentially in agreement that the risk of HIV saliva transmission was, as variously phrased, "extremel
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