HIV-Infected Health Care Professionals: Public Threat or Public Sacrifice?
Milbank Quarterly. 1992; 70(1): 3-42.
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 the appeal to patient rights would be to insist that patient fears of HIV transmission are irrational. I resist this suggestion, noting that the strong paternalism required to make such a judgment is not justifiable; in fact, even if patients' fears are exaggerated or even phobic, it will nevertheless be rational for patients to reduce their fear by the "low cost" effort (to them) of switching from infected professionals. I will examine the suggestions, however, that if professionals have moral obligations to inform their patients or to refrain from imposing risks on them, obligations that can be derived independently of claims about patient rights to knowledge or protection, then we might short-circuit the controversy by appealing to those professional obligations. I will then discuss in more detail the difficulties underlying the conflict between the rights of patients and handicapped workers, explaining why resolution of this dispute seems intractable. I argue that we have good reason not to allow the full exercise of patient rights because this would make each of us worse off. Limiting patient rights leaves the rights of handicapped workers intact and leads us to expand our efforts to control infection. I will conclude by discussing the policy implications of this argument as well as the recent revisions of the AMA and CDC guidelines.
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Daniels, Norman (1992-03-11)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 ...