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Ethics briefings
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  1. Veronica English,
  2. Rebecca Mussell,
  3. Julian Sheather,
  4. Ann Sommerville
  1. BMA Ethics Department; ethics@bma.org.uk

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    Mandatory disclosure of HIV status

    In 2002, the Scottish Police Federation called attention to the growing number of assaults on police officers by drug addicts and people infected with bloodborne viruses, including HIV, hepatitis B, or C. In cases where officers were deliberately exposed to attackers’ bodily fluids, the federation argued that they should be able to find out the infection status of the assailant.1 In February 2005, the Scottish Executive published a consultation, setting out new legal proposals to achieve this.2 Going further than the police federation’s petition,1 the consultation proposed that any victim of assault or rape involving bodily fluids should be able to apply to a sheriff to allow disclosure of the assailant’s infection status.2 The proposal required that voluntary consent to disclosure be sought from alleged perpetrators and, in the absence of any relevant results in their medical record, it allows them to be asked to have a voluntary blood test. There would be pressure to agree since refusal could result in a large fine but it was emphasised that no blood sample would be forcibly taken.

    The advantages of mandatory disclosure were claimed to be reduced anxiety for assault victims and an opportunity for them to make an informed choice about whether to discontinue postexposure prophylaxis (PEP) for HIV and hepatitis B. There is no PEP for hepatitis C but for HIV, prophylaxis is stressful and unpleasant and people would generally prefer to stop if enough information about their actual risk were promptly available.

    In Scotland, procurators fiscal can already apply for a warrant to access the medical records of accused people or require a blood sample to be provided for testing for bloodborne diseases but they do not disclose those results to victims. The new proposals would permit disclosure if judged to be warranted and …

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