KIRKUS REVIEW
Using as his case in point the well-known Kimberly Bergalis incident--in which a dentist was suspected of having infected Bergalis and several other patients with the AIDS virus--Rom probes deeply into the question of how public health policy is made. As the principal investigator of the Government Accounting Office's inquiry into the federal Centers for Disease Control's handling of this case, Rom expected to find that the CDC had made major mistakes. Instead, he found the the agency to have been both competent and thorough. The author (Government and Public Policy/Georgetown Univ.) explores the reasons for criticism of the CDC's role by the media and by advocates of both patients' and health-care workers' interests. While finding that the HIV-positive dentist, David Acer, had indeed infected Bergalis and other patients, the CDC admitted that it was unable to determine how, and without this knowledge, it was hard-pressed to develop a policy aimed at preventing future incidents. After looking at the CDC's consideration of such issues as mandatory testing of health-care workers, practice restrictions, and patient notification, and its eventual development of some rather nebulous guidelines, Rom turns to the response of Congress and the actions by state legislatures, regulators, and courts. Their actions, he finds, have produced a mixture of ambiguous and contradictory rulings. The CDC, he concludes, is the proper agency for making health policy regarding HIV and medical personnel. However, it should have brought together advocates on all sides--patients, health-care workers, medical experts--and engaged them in seeking a common interest. Rom skillfully points out what that common interest is--improving the safety of both patients and health-care providers--and how focusing on competence rather than HIV status benefits both sides. Despite the provocative title, there's no sensationalism here- -just solid research and the calm and persuasive voice of reason.