AIDS and a Duty to Protect ?

Steve sswift at umbc.edu
Sat Feb 4 14:45:20 EST 1995


Oscar Barriuso (barriuso at ux4.cso.uiuc.edu) wrote:

: Mr. B, age 28 reported to the community health center of a large city teaching hospital
: for counseling after being confidentially informed that his blood test 
: was positive for antibodies to the HIV virus that causes AIDS.  The patient has
: no symptons.
: 	Dr. T. informed Mr. B that although he did not have AIDS, there
: was between a 5 -30 % probability that he would develop the disease
: w/ in the next 5 years.  He was also told he can infect others through
: sexual contact and other bodily fluid contact.  He was consoled not to 
: donate blood, and to practice "safe-sex". that, is sex which does not involve
: the exchnage of bodily fluids such as semen.
: 	Mr. B then revealed that he was bisexual, and that he believed 
: that he had contracted the infection during one of his homosexual
: encounters.  He also said he was engaged.  Dr. T advised him to inform
: his fiancee of his Dx.  But Mr. B refused to do so, saying that it would ruin 
: his marriage plans.

: SHOOULD Dr. T inform her of his patient's test results, or should
: he protect the confidentiality of the therapeutic relationship ?

	If he informs this woman he risks losing his license, lawsuit, etc.
If he doesn't inform this woman, she could get HIV, AIDS, and die.
I don't know what most doctors would do in this situation. However to put a
twist on your scenario, knowingly transmitting HIV in some states is 
considered attempted murder. If said patient did transmit his HIV infection
to his fiancee, even after engaging in safe sex, but without informing her
of his infection. Would that still be considered attempted murder, 
accidental homocide? 

Baring a false positive, this is a case where society is protecting 
the criminal and not the victim. What crime? The patient intends to 
engage in an extreme fraud. 
Its something like subjecting someone to an experimental drug without
their knowledge or permission, and the drug causes side effects that 
could kill. (Just a rough analogy) 


What would happen ......
If this patient had herpes?  Fiancee takes her chances.
If this patient had TB contagious?  Quarentine patient.
If this patient had leperosy?	??? Not something to casually risk.

	I believe that some states now require a blood test for HIV before
marriage, though I'm not completely certain.

Now if I were said doctor, I would send an unsigned letter to said fiancee
suggesting that she get both herself and her fiancee tested for HIV. 
If done properly it probably would not land back on my doorstep, and most
people IMO would probably get tested under those circumstances. This also 
protects the patient if he had a false positive. 

--




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