Case Studies: AIDS and a Duty to Protect

Abstract

A case study is presented in which a bisexual man tests positive for antibodies to the human immune deficiency virus (HIV), a virus associated with AIDS. The patient, who is asymptomatic, is urged to tell his fiancée of the diagnosis. When he refuses, his physician must decide whether to inform the woman himself or to protect the confidentiality of his patient. Winston and Landesman comment on the physician's moral and legal obligations. Winston recommends that the doctor try to persuade the patient to inform his fiancée. If this fails, the doctor should consider breaking confidentiality after consulting legal, public health, and ethical authorities. Landesman emphasizes the possible negative consequences of violating confidentiality, and argues that abiding by the patient's wishes ought to have priority in most cases.