[Legal and ethical aspects related to AIDS]. 1990

R Bayer, and L Gostin
Universidad de Columbia, Fundación Norteamericana de Investigaciones sobre el SIDA.

Ethics, law, and politics converge in three areas relating to AIDS: discrimination against HIV-infected persons, confidentiality of diagnosis, and exercise of the coercive powers of the State. An analysis is made of these areas, with particular emphasis on experience in the United States. Discrimination against HIV-infected persons is objectionable for moral reasons and may be counterproductive to public health. Irrational beliefs regarding the ease of contracting HIV infection are not uncommon and lead to the exclusion of infected persons from workplaces and schools. Such discrimination could lead to resistance to voluntary testing and to all contact with health care services, and could, in the final analysis, produce harmful effects. Confidentiality with regard to medical diagnosis of AIDS was considered very important in the United States during the first years of the epidemic, but health authorities subsequently began to require notification of the names of infected persons for inclusion in a confidential registry. In September 1985 the State of Colorado made it compulsory to notify the health authorities of positive results of HIV antibodies tests, and 18 states have followed suit. Notification of third parties poses complex problems. Generally speaking, it is considered that health personnel have the right, but not the obligation, to inform those who are exposed to risk. The notion of coercion with regard to AIDS has been favored by disapproval of behavior linked to transmission of the infection. Isolation policies that have been put into effect in certain countries have been vigorously debated. In several nations certain behavior entailing risk of transmitting the infection has been penalized.

UI MeSH Term Description Entries
D007883 Legislation, Medical Laws and regulations, pertaining to the field of medicine, proposed for enactment or enacted by a legislative body. Medical Legislation
D010356 Patient Isolation The segregation of patients with communicable or other diseases for a specified time. Isolation may be strict, in which movement and social contacts are limited; modified, where an effort to control specified aspects of care is made in order to prevent cross infection; or reverse, where the patient is secluded in a controlled or germ-free environment in order to protect him or her from cross infection. Home Isolation,Isolation, Home,Isolation, Patient,Negative Pressure Isolation,Negative Pressure Patient Isolation
D011287 Prejudice A preconceived judgment made without factual basis. Anti-Semitism,Islamophobia,Anti Semitism,Anti-Semitisms,Islamophobias,Prejudices
D003068 Coercion The use of force or intimidation to obtain compliance.
D003219 Confidentiality The privacy of information and its protection against unauthorized disclosure. Patient Data Privacy,Privacy of Patient Data,Privileged Communication,Confidential Information,Secrecy,Communication, Privileged,Communications, Privileged,Data Privacy, Patient,Information, Confidential,Privacy, Patient Data,Privileged Communications
D004992 Ethics, Medical The principles of professional conduct concerning the rights and duties of the physician, relations with patients and fellow practitioners, as well as actions of the physician in patient care and interpersonal relations with patient families. Medical Ethics
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000163 Acquired Immunodeficiency Syndrome An acquired defect of cellular immunity associated with infection by the human immunodeficiency virus (HIV), a CD4-positive T-lymphocyte count under 200 cells/microliter or less than 14% of total lymphocytes, and increased susceptibility to opportunistic infections and malignant neoplasms. Clinical manifestations also include emaciation (wasting) and dementia. These elements reflect criteria for AIDS as defined by the CDC in 1993. AIDS,Immunodeficiency Syndrome, Acquired,Immunologic Deficiency Syndrome, Acquired,Acquired Immune Deficiency Syndrome,Acquired Immuno-Deficiency Syndrome,Acquired Immuno Deficiency Syndrome,Acquired Immuno-Deficiency Syndromes,Acquired Immunodeficiency Syndromes,Immuno-Deficiency Syndrome, Acquired,Immuno-Deficiency Syndromes, Acquired,Immunodeficiency Syndromes, Acquired,Syndrome, Acquired Immuno-Deficiency,Syndrome, Acquired Immunodeficiency,Syndromes, Acquired Immuno-Deficiency,Syndromes, Acquired Immunodeficiency
D014342 Truth Disclosure Truthful revelation of information, specifically when the information disclosed is likely to be psychologically painful ("bad news") to the recipient (e.g., revelation to a patient or a patient's family of the patient's DIAGNOSIS or PROGNOSIS) or embarrassing to the teller (e.g., revelation of medical errors). Disclosure, Truth,Disclosure, Error,Disclosures, Error,Disclosures, Truth,Error Disclosure,Error Disclosures,Truth Disclosures
D014481 United States A country in NORTH AMERICA between CANADA and MEXICO.

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