Positive practice
BMJ 2006; 333 doi: https://doi.org/10.1136/sbmj.0612470 (Published 01 December 2006) Cite this as: BMJ 2006;333:0612470
- James M N Duffy, medical student1,
- Simon Rackstraw, consultant HIV physician2
- 1University of Manchester Medical School
- 2St Bartholomew's, Royal London, and Mildmay Hospital, London
No one knows how many doctors practising in the United Kingdom are HIV positive. The professional ramifications of being HIV positive become clear only when seen through an historical lens, because the medical profession has been notoriously bad at supporting ill doctors in the past.
The Department of Health and the General Medical Council's policy is to support disclosure with confidentiality and acceptance, allowing HIV positive doctors to continue their professional practice. Indeed, these rights are protected in British law, through the Disability Discrimination Act 2005. But the reality of ensuring that employers and colleagues do not discriminate against HIV positive doctors remains a challenge in medical practice.
Dangers of disclosure
The General Medical Council considers HIV infection to be a serious communicable disease because it can be transmitted from human to human and results in a serious life threatening illness. HIV positive doctors must, therefore, follow the council's guidance, as outlined in its Serious Communicable Disease publication.1 The guidelines say that doctors must seek appropriate help and advice from a consultant specialising in occupational health, infectious diseases, or public health. They must not rely on their own assessment of risk.
Advice should be sought on how professional practice should be changed, and if current, previous, or future employers should be told. The situation has gained further complexity recently because disclosure to an employer is now mandatory to receive legal protection under the Disability Discrimination Act. Reaching the decision to make a disclosure to an employer can be emotionally challenging and is confounded by the scarcity of practical guidance for either the mechanism of the disclosure or the consequences. …
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