# Doctor confidentiality, HIV, and what feels right **URL:** \ **Category:** Great Debates\ **Created:** [July 21, 2012, 3:20pm UTC](https://boards.straightdope.com/t/doctor-confidentiality-hiv-and-what-feels-right/628959 "2012-07-21T15:20:04Z")\ **Posts on this page:** 20\ **Page:** 2
**Author:** ![Stratocaster](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/stratocaster/32/16393_2.png) [@Stratocaster](https://boards.straightdope.com/u/Stratocaster)\ **Post date:** [July 22, 2012, 1:38am UTC](https://boards.straightdope.com/t/doctor-confidentiality-hiv-and-what-feels-right/628959/21 "2012-07-22T01:38:10Z")
Yep, I assumed that. My point is in reaction to the several people in this thread who thought the first case offered no reason for the doctor to make any sort of disclosure, since “the damage is done.” I would argue it’s at least a moral concern (why would one assume this guy won’t continue this behavior with other partners?), and in some instances, it’s a criminal matter (and as such, should be reported). ETA: Responding to RNATB ---
**Author:** ![Farmer\_Jane](https://avatars.discourse-cdn.com/v4/letter/f/bbe5ce/32.png) [@Farmer\_Jane](https://boards.straightdope.com/u/Farmer_Jane)\ **Post date:** [July 22, 2012, 1:38am UTC](https://boards.straightdope.com/t/doctor-confidentiality-hiv-and-what-feels-right/628959/22 "2012-07-22T01:38:20Z")
> [@Iggy](#): > > HIV is treated differently for disclosure purposes than any other illness in emergency services. > > I work in a 9-1-1 center outside the US (so HIPPA does not apply) and routinely ask about “any other medical conditions the ambulance crew should know about.” I can relay any information to the medical crew _except_ HIV status, even if the patient explicitly instructs me to inform the ambulance crew. > > Of course the EMTs should always use universal precautions. That isn’t really the issue in my mind. The problem is that this non-disclosure policy sets HIV apart from all other illnesses. It’s something not to be talked about. And as the old slogan says, Silence = Death. That sounds so…strange. ---
**Author:** ![Bricker](https://avatars.discourse-cdn.com/v4/letter/b/977dab/32.png) [@Bricker](https://boards.straightdope.com/u/Bricker)\ **Post date:** [July 22, 2012, 1:42am UTC](https://boards.straightdope.com/t/doctor-confidentiality-hiv-and-what-feels-right/628959/23 "2012-07-22T01:42:36Z")
> [@Really\_Not\_All\_That\_Bright](#): > > Depends on the state. It’s not a crime everywhere. Not a crime in DC, where presumably this doctor’s experience lies. It is a crime in nearby Maryland and Virginia. ---
**Author:** ![humblebumble](https://avatars.discourse-cdn.com/v4/letter/h/b5e925/32.png) [@humblebumble](https://boards.straightdope.com/u/humblebumble)\ **Post date:** [July 22, 2012, 1:44am UTC](https://boards.straightdope.com/t/doctor-confidentiality-hiv-and-what-feels-right/628959/24 "2012-07-22T01:44:21Z")
Do you think people with HIV treat themselves as subhuman? Would you treat someone with HIV as subhuman? ---
**Author:** ![Bricker](https://avatars.discourse-cdn.com/v4/letter/b/977dab/32.png) [@Bricker](https://boards.straightdope.com/u/Bricker)\ **Post date:** [July 22, 2012, 1:50am UTC](https://boards.straightdope.com/t/doctor-confidentiality-hiv-and-what-feels-right/628959/25 "2012-07-22T01:50:30Z")
> [@humblebumble](#): > > Do you think people with HIV treat themselves as subhuman? > > Would you treat someone with HIV as subhuman? No, to both questions, but nothing in this thread until now has suggested “subhuman” treatment is at issue. ---
**Author:** ![humblebumble](https://avatars.discourse-cdn.com/v4/letter/h/b5e925/32.png) [@humblebumble](https://boards.straightdope.com/u/humblebumble)\ **Post date:** [July 22, 2012, 1:57am UTC](https://boards.straightdope.com/t/doctor-confidentiality-hiv-and-what-feels-right/628959/26 "2012-07-22T01:57:15Z")
> [@Bricker](#): > > No, to both questions, but nothing in this thread until now has suggested “subhuman” treatment is at issue. What do you think would be a motive for unwillingness to disclose such information? It’s not exactly something that is easy to tell someone, especially someone in a relationship. How did it become a stigma in the first place? ---
**Author:** ![Bricker](https://avatars.discourse-cdn.com/v4/letter/b/977dab/32.png) [@Bricker](https://boards.straightdope.com/u/Bricker)\ **Post date:** [July 22, 2012, 2:03am UTC](https://boards.straightdope.com/t/doctor-confidentiality-hiv-and-what-feels-right/628959/27 "2012-07-22T02:03:19Z")
> [@humblebumble](#): > > What do you think would be a motive for unwillingness to disclose such information? It’s not exactly something that is easy to tell someone, especially someone in a relationship. The infected person doesn’t want to risk the possibility that his or her partner will decline to risk his or her health, and break off the relationship. Or the infected person likes unprotected sex and doesn’t want to risk the possibility that his or her partner will insist on protected sex. Neither outcome is fairly described as being treated as subhuman. ---
**Author:** ![Ambivalid](https://avatars.discourse-cdn.com/v4/letter/a/a5b964/32.png) [@Ambivalid](https://boards.straightdope.com/u/Ambivalid)\ **Post date:** [July 22, 2012, 2:08am UTC](https://boards.straightdope.com/t/doctor-confidentiality-hiv-and-what-feels-right/628959/28 "2012-07-22T02:08:46Z")
> [@Bricker](#): > > The infected person doesn’t want to risk the possibility that his or her partner will decline to risk his or her health, and break off the relationship. Or the infected person likes unprotected sex and doesn’t want to risk the possibility that his or her partner will insist on protected sex. > > Neither outcome is fairly described as being treated as subhuman. Quite the opposite in fact; I think not disclosing one’s HIV/AIDS status to one’s partner is treating that _partner_ as sub-human. ---
**Author:** ![Vlad\_Igor](https://avatars.discourse-cdn.com/v4/letter/v/7feea3/32.png) [@Vlad\_Igor](https://boards.straightdope.com/u/Vlad_Igor)\ **Post date:** [July 22, 2012, 2:11am UTC](https://boards.straightdope.com/t/doctor-confidentiality-hiv-and-what-feels-right/628959/29 "2012-07-22T02:11:52Z")
If HIV/AIDS had been treated as an STD and a public health issue from the beginning, instead of a gay disease (and by extension punishment for being gay), the line between the right to privacy and public health policy would be much clearer. In both cases in the OP, I see that line being crossed and protection of others through public health policy trumping a right to individual privacy. While it may not appropriate for the MD to disclose what she knows, she should be able to notify a public health official who can intervene and make sure all parties are fully informed, and further exposure stopped. ---
**Author:** ![ZPG\_Zealot](https://avatars.discourse-cdn.com/v4/letter/z/e47c2d/32.png) [@ZPG\_Zealot](https://boards.straightdope.com/u/ZPG_Zealot)\ **Post date:** [July 22, 2012, 2:53am UTC](https://boards.straightdope.com/t/doctor-confidentiality-hiv-and-what-feels-right/628959/30 "2012-07-22T02:53:45Z")
> [@humblebumble](#): > > Do you think people with HIV treat themselves as subhuman? > > Would you treat someone with HIV as subhuman? If the person with HIV is having sex with another person without informing that person of the risk, yes I would consider the HIV carrier subhuman. ---
**Author:** ![Ferret\_Herder](https://avatars.discourse-cdn.com/v4/letter/f/e47774/32.png) [@Ferret\_Herder](https://boards.straightdope.com/u/Ferret_Herder)\ **Post date:** [July 22, 2012, 3:00am UTC](https://boards.straightdope.com/t/doctor-confidentiality-hiv-and-what-feels-right/628959/31 "2012-07-22T03:00:07Z")
> [@kayaker](#): > > HIV is a reportable disease. The physician should report the results to the department of health. The ball is then in their court. Along with tons of other infectious diseases, for what it’s worth. HIV isn’t singled out for special treatment here. And **humblebumble** , I don’t give a shit if it’s early in a relationship and “hard” to disclose - someone should tell their potential sex partner **before** they hop into bed with them about **any** STDs. Yes, this includes genital herpes even if you’re not breaking out right now, because you can transmit that even if you don’t have active sores and are wearing a condom. (I know about 25% of the population has it - you should still disclose.) People who are barebacking when they know they’re HIV-positive are assholes. ---
**Author:** ![humblebumble](https://avatars.discourse-cdn.com/v4/letter/h/b5e925/32.png) [@humblebumble](https://boards.straightdope.com/u/humblebumble)\ **Post date:** [July 22, 2012, 3:22am UTC](https://boards.straightdope.com/t/doctor-confidentiality-hiv-and-what-feels-right/628959/32 "2012-07-22T03:22:08Z")
It should be the obligation of a person to disclose such information to his or her partner. Here, I define such information as being HIV positive. However, it might be better for the doctor to disclose such information to the partner of the patient. If your partner was HIV positive, would you rather here it from him or her or the doctor? ---
**Author:** ![Anduril](https://avatars.discourse-cdn.com/v4/letter/a/c0e974/32.png) [@Anduril](https://boards.straightdope.com/u/Anduril)\ **Post date:** [July 22, 2012, 3:33am UTC](https://boards.straightdope.com/t/doctor-confidentiality-hiv-and-what-feels-right/628959/33 "2012-07-22T03:33:24Z")
On the one hand, any future harm should be prevented by the physician so I think they should report on patients who disclose their plans of endangering another person. On the other hand, from a practical point of view, if you begin to break confidentiality on HIV cases, it might lead people to not report their status/plans with their physicians. The only reason the doctor was able to find out about the patients’ plans at all was that the patients were quite open about them. I don’t know… ---
**Author:** ![Bricker](https://avatars.discourse-cdn.com/v4/letter/b/977dab/32.png) [@Bricker](https://boards.straightdope.com/u/Bricker)\ **Post date:** [July 22, 2012, 7:52pm UTC](https://boards.straightdope.com/t/doctor-confidentiality-hiv-and-what-feels-right/628959/34 "2012-07-22T19:52:39Z")
> [@Anduril](#): > > On the one hand, any future harm should be prevented by the physician so I think they should report on patients who disclose their plans of endangering another person. On the other hand, from a practical point of view, if you begin to break confidentiality on HIV cases, it might lead people to not report their status/plans with their physicians. The only reason the doctor was able to find out about the patients’ plans at all was that the patients were quite open about them. I don’t know… No. In the first case, the patient was diagnosed with AIDS and only then did the doctor learn the partner was the source – and then not forthrightly, but because he disclosed a previous medication which the doctor recognized as part of a since-deprecated cocktail regimen. ---
**Author:** ![UltraVires](https://avatars.discourse-cdn.com/v4/letter/u/ecccb3/32.png) [@UltraVires](https://boards.straightdope.com/u/UltraVires)\ **Post date:** [July 22, 2012, 11:19pm UTC](https://boards.straightdope.com/t/doctor-confidentiality-hiv-and-what-feels-right/628959/35 "2012-07-22T23:19:05Z")
> [@Stratocaster](#): > > I’m not so sure. Was a crime committed? Why shouldn’t it be reported? If a physician saw evidence of sexual abuse, he wouldn’t say, “Well, the damage is done, let’s move on.” Is this different (in that sense)? That’s different. In that case, the patient is the abused child, and not her abuser. The doctor has no confidentiality/protected relationship to the abuser to be violated. Even if the abuser was his patient as well, he didn’t learn of the abuse because of that relationship, and no confidence is violated. If the abuser said, “Yeah, I’ve been fucking my daughter, but I promise it will never happen again,” then mandatory reporting statutes are in place to overcome this nook in the law. I supposed that a person who knowingly infected a partner with HIV might do it to the next partner, no statute has made the “might” part of this one a mandatory reporting. Now, if the doctor finds out that the HIV positive patient has broken up with his girlfriend and having sex with an unprotected partner, then the ethical “future” damage comes into play. ---
**Author:** ![Farmer\_Jane](https://avatars.discourse-cdn.com/v4/letter/f/bbe5ce/32.png) [@Farmer\_Jane](https://boards.straightdope.com/u/Farmer_Jane)\ **Post date:** [July 22, 2012, 11:41pm UTC](https://boards.straightdope.com/t/doctor-confidentiality-hiv-and-what-feels-right/628959/36 "2012-07-22T23:41:11Z")
> [@humblebumble](#): > > It should be the obligation of a person to disclose such information to his or her partner. Here, I define such information as being HIV positive. > > However, it might be better for the doctor to disclose such information to the partner of the patient. > \*\* > If your partner was HIV positive, would you rather here it from him or her or the doctor?\*\* Who cares? I’d just like to know so I can punch the appropriate person in the face for not telling me. ---
**Author:** ![panache45](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/panache45/32/64_2.png) [@panache45](https://boards.straightdope.com/u/panache45)\ **Post date:** [July 23, 2012, 6:16am UTC](https://boards.straightdope.com/t/doctor-confidentiality-hiv-and-what-feels-right/628959/37 "2012-07-23T06:16:27Z")
I’m not going to read this thread, because I’ve already seen this issue in real life, from every angle, more times than I can remember. To knowingly expose someone to a possibly life-threatening virus is no different than pointing a loaded gun at their head and pulling the trigger. Anyone who can intervene, should. The doctor has sworn to “above all, do no harm.” Confidentiality is irrelevant when a human life is at stake. ---
**Author:** ![bengangmo](https://avatars.discourse-cdn.com/v4/letter/b/50afbb/32.png) [@bengangmo](https://boards.straightdope.com/u/bengangmo)\ **Post date:** [July 23, 2012, 7:22am UTC](https://boards.straightdope.com/t/doctor-confidentiality-hiv-and-what-feels-right/628959/38 "2012-07-23T07:22:37Z")
Here it’s illegal to knowingly expose someone to AIDS. How they plays into a doctor reporting I don’t know. BUT I think that reporting illegality should trump any sort of confidentiality oaths. ---
**Author:** ![Quartz](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/quartz/32/267_2.png) [@Quartz](https://boards.straightdope.com/u/Quartz)\ **Post date:** [July 23, 2012, 9:07am UTC](https://boards.straightdope.com/t/doctor-confidentiality-hiv-and-what-feels-right/628959/39 "2012-07-23T09:07:57Z")
HIV infection is a [criminal matter](http://www.gmfa.org.uk/sex/hivandaids/hiv-and-the-law) in the U.K. [This document](http://www.nat.org.uk/Media%20library/Files/Policy/Living%20with%20HIV/Confidentiality/Confidentiality%20in%20healthcare.pdf) (pdf) from NATS states that doctors may disclose HIV status if it’s in the public interest. ---
**Author:** ![kob09](https://avatars.discourse-cdn.com/v4/letter/k/ebca7d/32.png) [@kob09](https://boards.straightdope.com/u/kob09)\ **Post date:** [July 23, 2012, 9:46am UTC](https://boards.straightdope.com/t/doctor-confidentiality-hiv-and-what-feels-right/628959/40 "2012-07-23T09:46:03Z")
infecting someone knowingly or not inform a person you live with about the risk is illegal here as well recently I visited a friend I hadn’t seen for a while and he told me that he is HIV positive but he doesn’t want to reveal it to his daughter who lives with him. I think it’s irrespobsible from him to not tell his 15-year old daughter what’s going on as accidental infection is not 100% excluded if she doesn’t have a chance to be careful … I am not sure if I should talk to him again about the issue and try to get him to tell her. i think he has experienced a lot of rejection from people who do know and that is part of the reason he doesn’t want to tell his daughter. He does live his bi-sexuality openly, so I think the daughter is reasonable enough to hear the truth. [Previous page](https://boards.straightdope.com/t/doctor-confidentiality-hiv-and-what-feels-right/628959.md?page=1) [Next page](https://boards.straightdope.com/t/doctor-confidentiality-hiv-and-what-feels-right/628959.md?page=3)