HIV-Infected Professionals, Patient Rights, and the "Switching Dilemma"
JAMA. 1992 Mar 11; 267(10): 1368-1371.
The ethical issues surrounding the Centers for Disease Control and American Medical Association guidelines for health professionals infected with the human immunodeficiency virus are examined and discussed. Although human immunodeficiency virus transmission risks during surgery are lower than many risks we routinely face, it is not irrational for a patient to want to switch from an infected professional to an uninfected one. The American Medical Association claim that physicians have a duty to avoid imposing any identifiable risks is implausible. Knowing the Centers for Disease Control estimate of risks gives us no way to decide whether the rights of patients or those of handicapped (infected) workers should be given priority. Granting priority to patient rights, either by giving patients the opportunity to know the risks they face and to switch to another provider, or by removing infected providers (compulsory switching), makes us all worse off. This gives us reason to reject these guidelines and emphasize other infection control measures.
Aids; Common Good; Consent; Decision Making; Dentistry; Disclosure; Disease; Government; Guidelines; Health; Health Personnel; HIV Seropositivity; Informed Consent; Moral Obligations; Organizations; Patient Care; Patients; Patients' Rights; Physician Patient Relationship; Physicians; Policy Analysis; Professional Organizations; Rights; Risk; Surgery;
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Daniels, Norman (1992)I shall examine what we know about the probability of HIV transmission from infected professionals, and then compare it with the other probabilities of death we face in everyday and medical contexts. One way to discount ...