Letter from Gary B. MacDonald, AIDS Action Council to C. Everett Koop
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1986-10-22 (October 22, 1986)
MacDonald, Gary B.
AIDS Action Council
Koop, C. Everett
Reproduced with permission of the AIDS Action Council.
AIDS, the Surgeon General, and the Politics of Public Health
October 22, 1986
Dear Dr. Koop:
On behalf of the Council, I congratulate and commend you on the excellent report to the nation on AIDS that you released today.
Your press conference this morning, your extemporaneous answers to questions and the report itself were and are accurate,
timely and tuned to the long-term -- as they should be. The report will do much to combat fear and hysteria, and, we hope,
to encourage rational, scientifically-based responses to this crisis. I would especially commend your statement that, as a
nation, we are fighting a disease not people. Your sensitivity to the need that everyone must be concerned, and must unite
to fight AIDS together, will be very persuasive, I'm sure. The Council will certainly do everything it can to urge widespread
usage of your report and its findings.
One area of concern to us in the report -- one we believe may require further explanation from you to the press and public
-- is your statement on page 17 that those who suspect they may have been exposed to HIV virus "should have a blood test."
Such a blanket recommendation cannot be made, in our judgment, unless it is accompanied by extremely clear cautions about
the potentially very serious negative ramifications of obtaining a positive or a negative test result, the need for absolute
confidentiality (or better, anonymity) of test results, and the irreducible requirement for extensive, ongoing counselling
of individuals who choose to be tested. Simply to send people out to be tested without informing them in advance of these
complex factors is potentially to expose millions to unwarranted discrimination, loss of jobs and insurance or worse. We are
certain that, in the spirit of fairness and accuracy with which you have written an otherwise first-rate report, you will
want to clarify the issue of testing, confidentiality and counselling for the American public.
Thank you again for a fine report. Let us know if we can be helpful in any way in making certain that it is widely distributed.
We are grateful to have been included among the groups which advised you on the report's contents, and we look forward
to a continuing close association.