Editorials

Discrimination, informed consent, and the HIV infected clinician

BMJ 1997; 314 doi: http://dx.doi.org/10.1136/bmj.314.7085.915 (Published 29 March 1997) Cite this as: BMJ 1997;314:915

We must ask whether patients' rights to avoid the remotest of risks should override clinicians' rights to practise as long as their skills remain unimpaired

  1. Ronald Bayer, Professora
  1. a Division of Sociomedical Sciences, Columbia School of Public Health, New York, NY 10032, USA

    In the middle 1980s a central ethical challenge posed by the AIDS epidemic entailed the issue of whether doctors were obliged to care for patients infected with HIV regardless of the small but ineliminable risk that they might become infected as a result. Without exception, those who considered the issue from an ethical perspective concluded that doctors were morally obliged to provide care even in the face of risk; that professional duty took precedence over personal fear or preference.

    It was within that context that a small closed meeting was convened in 1988 at the Hastings Center, a research institute just north of New York, devoted to the study of medical ethics. The aim of the meeting was to examine a related but quite different issue: whether patients have a right to avoid contact with doctors infected with HIV. Two leading advocates of the rights of people with HIV, who were at the same time well known for their defence of patients' rights, were asked to address this issue. To the surprise of many at the session, both concluded, with great difficulty, that clinicians who engaged in invasive procedures had a duty to avoid exposing their patients to even the remotest of risks and should …

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