In 1987, the CDC recognized that there was a theoretical risk that HIV could be spread from surgeon to patient, as has occurred with Hepatitis B - a far more contagious virus. Since no HIV transmission had been documented, the CDC had the opportunity to implement studies of people treated by surgeons who had died of AIDS to see if any patients had become infected.

Last year, when the first report of AIDS apparently transmitted from a Florida dentist to [Kimberly Bergalis], was received, the CDC decided to develop more explicit guidelines. Last August, the agency convened a meeting of AIDS specialists to discuss recommendations. At that meeting, which I attended, the absence of useful information was overwhelming. There was inadequate information about whether HIV-infected surgeons pose a risk.

Several weeks ago, the long-overdue CDC guidelines were issued. They are most notable for the questions they raise rather than the answers they provide. The agency's chief recommendation is that HIV-infected surgeons should avoid "exposure-prone" operations. It further advises that "medical, surgical and dental" organizations should decide which operations infected surgeons can safely perform.