Moving away from rational medicine?

Abstract

The General Medical Council has taken a major step away from the concept of confidentiality in its guidelines on HIV and AIDS, which have recently gone to all doctors in Britain.* The GMC advises doctors to break this cornerstone of the doctor and patient relationship under certain circumstances. It states that “the doctor may consider it a duty to seek to ensure that any sexual partner is informed in order to safeguard persons from infection.” Furthermore, in the case of a health worker infected with HIV, the GMC now sees it as the duty of a doctor to inform the patient's employer, or head of service, usually another doctor, of the patient's HIV state, if the patient is thought not to have sought or followed advice to modify his or her professional behaviour. This may have profound effects, not only on the trust between patient and doctor, but also on the practising of rational medicine. The Lancet queried the wisdom of breaking confidentiality by informing a patient's partner. We question the wisdom of informing the employer of a patient who is a health professional. While the GMC acknowledges that there is only one proved case of infection of a patient by a health professional—a dentist in the United States—the guidelines place …