Medical Ethics Today

A new edition of the BMA’s handbook of ethics and law, Medical Ethics Today will be published in December. Based on the large volume of enquiries to the BMA’s medical ethics department, the book offers practical advice and guidance on common ethical and medico-legal dilemmas. It also aims to stimulate debate on broader areas of public policy. For more information, see the BMA website www.bma.org.uk/ethics.

Confidentiality and HIV in Australia

The availability of skilled doctors is both a necessary and an incontrovertible public good.

The New South Wales Supreme Court has ruled that a woman can claim damages against doctors who failed to disclose her partner’s HIV status to her whilst she was under their care.¹ Disclosure of people’s HIV status to their sexual partners without their consent obviously raises important issues about duty of care, public interests, and confidentiality. In this case, at the woman’s insistence both partners agreed to be HIV tested before getting married. She tested negative but he was found to be HIV positive. Neither received the other’s test results from the medical centre because of confidentiality rules. The doctor who informed the man of his positive status failed to discuss specifically with him the importance of telling his future wife, assuming that this was obvious to “a neatly dressed man who appeared to be educated”. The man, however, when asked by his partner for his results, lied to her and said he had tested negative. After they married and had unprotected sex, the woman was diagnosed HIV positive.

In Australia, the Public Health Act 1991 permits disclosure of patients’ HIV status to their sexual partner if patients themselves refuse to do so. This provision is mirrored in the UK both in common law and guidance from the General Medical Council, which says that if doctors cannot persuade patients …