An ethical dilemma in clinical practice: confidentiality, HIV positive status and disclosure to third parties

Abstract

Keeping information a patient has given in confidence to his or her doctor is a fundamental value in each individual doctorpatient relationship. However, when a medical professional is faced with disclosing confidential information in the face of competing public interests (or other ethically compelling reasons) he or she faces an ethical dilemma. In the context of the HIV/AIDS epidemic in South Africa, the dilemma to keep medical confidences or to disclose information to identifiable third parties is frequently faced by doctors and other healthcare professionals. This research report highlights the duty of medical confidentiality identifying its importance both as an ‘absolute’ principle in healthcare practice as well as suggesting that there are contexts in which it should be considered as a relative duty. In keeping, this format of this research report will present current data concerning the HIV/AIDS epidemic, interrogate the idea of medical confidentiality, explore some professional guidelines associated with HIV/AIDS disclosure, as well as raise some ethical– legal considerations concerning healthcare professionals and the problem of disclosure of their patient’s HIV positive status to identifiable third parties.