WINSTON-SALEM (AP) - A dispute over anonymous testing for AIDS has erupted into a caustic battle of letters between two doctors and into threats by the lieutenant governor to take the state health commission to task on the issue in the legislature this spring.
The dispute has Dr. James S. Fulghum III, a Raleigh brain surgeon, criticizing the work of the N.C. Commission for Health Services and Dr. Jesse H. Meredith, a surgeon at N.C. Baptist Hospital who has been the commission's chairman for 20 years.The commission, which makes health rules for the state, decided Nov. 9 to allow county health departments to continue anonymous testing for the AIDS virus.
Last year, Fulghum and Lt. Gov. Jim Gardner led a successful drive for a provision that made infection with the AIDS virus, known as the human immunodeficiency virus, or HIV, reportable to the state.
The word reportable always means names and addresses, Gardner said. ``The commission chose to ignore that. The matter will be brought up to the legislature.'
Advocates of anonymous testing say that protecting a person's identity will encourage him to get tested. But Fulghum, Gardner and other opponents of anonymous testing want AIDS treated like any other infectious disease.
Until the bill passed last year, a person's name and address and other information were reported to the state only after a doctor had diagnosed the condition as AIDS. The names of those carrying the virus but not ill did not have to be reported - although their age, sex, race and means of infection are filed with the state lab that does the test.
At its meeting in Asheville in November, the commission decided that as of Feb. 1, when the law takes effect, the names of people tested in private doctors's offices and hospitals will be reported.
But after hearing from experts on AIDS, the commission decided it is in the interest of public health to have free and anonymous testing available through county health departments. It decided that the current practice of sending in the age, sex and race - but not the name - of those tested for the virus at health departments will fulfill the requirements of the new law.
Dr. G. Earl Trevathan Jr., a commission member, said the commission made its decision based on evidence that fears of discrimination would keep people at risk for AIDS from being tested.
``It was just that the testimony of people with AIDS and the professionals who care for them ... was so overwhelming that the commission voted 100 percent in their favor.'
In a letter to Meredith, Fulghum says that testimony and information he and others gave at public hearings before the Asheville meeting were ignored by the commission. He did not attend the Asheville meeting, and he protested that the commission accepted public comment at it without advertising the meeting as a public hearing.
The letter ends: ``To have ... the wishes of the governor, lieutenant governor, secretary of natural resources and the state health director virtually ignored is an abuse of power in the worst sense. I can assure you these matters will be discussed in the next session of the legislature as well as in the Public Health Study Commission hearings.'
Fulghum is a member of that study commission, which the legislature formed last summer to review the state public health system and state AIDS policy. He also contributed $3,000 to Gardner's campaign.
On Dec. 4, Meredith sent Fulghum a letter saying that the representatives of the governor and lieutenant governor were not ignored, but that the commission's decision was based on testimony of scientific experts.
He noted that the commission always asks for public comment before it makes a final decision on health rules.
The letter ends: ``I assure you that your fulminations and threats are completely unwarranted and, speaking as a fellow surgeon, frankly most embarrassing to our profession.'