Is confidentiality between doctors and patients sacrosanct?
The law which entitles patients to confidentiality applies to HIV/AIDS and any other sexually transmitted disease as a general rule in the United Kingdom. Under the Disability Discrimination Act, employers have no rights to discriminate against HIV positive people. However, when it comes to the possibility that some of those infected by the virus could be transmitting it to others whether unconsciously or deliberately, could the law of confidentiality be a possible key to the spread?
Medical professionals have access to patients’ private information. This means that they are often the first to know that a person is HIV positive. But they cannot reveal the health status of their patient to family members or any organisation.
James Chalmers, a senior lecturer at the University of Edinburgh in the School of Law, wrote a recently published book ‘Legal Responses to HIV and AIDS’. He said: “Confidentiality in the UK is not an absolute obligation. And if a doctor believes that one of their patients is potentially putting somebody else at risk of serious harm, then they have the right to breach confidentiality. In fact they may even be legally advised to do that.”
Section 22 of the General Medical Practice reads: “Personal information may be disclosed in the public interest, without the patient’s consent, where the benefits to an individual or to society of the disclosure outweigh the public and the patient’s interest in keeping the information confidential.”
Dr Mario Longondgo, an emergency medicine registrar from London, said: “That’s an area of controversy. As a medical doctor, I would protect the confidentiality of my patients because the cornerstone of my job is basically confidentiality. However, there can be situations where we need to question a few things. For instance, if you know someone who is HIV positive and he is behaving in a way to could endanger the society. What do you do?”
According to Dr Longondgo, although he has never found himself in such situation, he admitted that medical professionals are aware of rules and regulations set up to report a suspicious patient. However, because the process to deal with such matters can be long, it is up to individual doctors to decide whether or not to proceed.
Prosecution: ‘recklessly causing serious harms to others’
Although the criminalisation of HIV has been affecting people globally for some times, experts say that it is only in the past few years that the UK has started to see prosecutions.
Mr Chalmers, who is also a co-ordinator of the new MSc in Global Crime, Justice and Security starting in September 2009 at the University of Edinburgh, said: “Prosecutors are entitled to prosecute in courts to convict people who have transmitted HIV to their sexual partners when they’ve been criminally reckless and they haven’t disclosed the fact that there are HIV positive to their partners and have engaged into unprotected sex, which has resulted in HIV being distributed.”
So, in terms of justice for HIV positive people, is the UK’s law efficient? Mr Chalmers insisted: “I’m not sure. It depends on what you think the job of the law is. I certainly don’t think that the law is going to help prevent the spread of HIV. The law is unlikely to be successful in that sense, that’s a public health problem.”