A nation of suspects: drug testing and the Fourth Amendment

AIDS phobia, public health warnings, and lawsuits: deterring harm or rewarding ignorance?

Courts in more than a dozen states have decided cases in which a person has claimed money damages for his or her fear of getting acquired immunodeficiency syndrome (AIDS). Although most courts have rejected such claims in the absence of actual exposure to the human immunodeficiency virus (HIV), their reasoning has varied slightly from state to state. This article argues that negligence law should not permit people who are HIV negative to recover damages for an unfounded fear of AIDS. Public health statements intended to educate the public about preventing HIV transmission may have encouraged some fear-of-AIDS lawsuits against health care practitioners. Although well intentioned, such statements have been used to justify inappropriate restrictions on medical practice and disclosure of a practitioner's HIV status. To avoid such misuse, such statements should be revised to make clear that the way in which procedures are performed, not who performs them, determines HIV transmission.

The role of physicians as medical review officers in workplace drug testing programs. In pursuit of the last nanogram

In discussing the role of physicians in workplace drug testing programs, I focus on the recent Department of Transportation regulations that require drug testing in such regulated industries as interstate trucking, air transportation, mass transit, and the railroads. These regulations require that applicable drug testing programs employ physicians as medical review officers to evaluate positive tests that have been screened and confirmed by different techniques to determine if there is a legal medical explanation for the result. The drug testing program tests for the presence of amphetamine, cocaine, tetrahydrocannabinol, opiates, and phencyclidine. If an employee testing positive has an acceptable medical explanation, the result is to be reported as negative. Little practical advice exists for medical review officers, and they must be aware of key elements of the regulations and potential trouble spots.