Bioethics Blogs

Privacy vs safety: should doctors disclose their infectious diseases?

Health-care workers who discover they are infected have an ethical obligation to seek professional advice about their work practise limitations stevendepolo

A drug-addicted Melbourne anaesthetist has been accused of infecting 56 of his patients with hepatitis C by injecting himself with opiate-filled syringes, before using them on his patients. While his gross misconduct is clearly the cause of their infection, the fact that patients can potentially acquire blood-borne illnesses from health-care practitioners prompts us to ask whether patients have a right to know the infectious disease status of their health-care providers.

The professional expectation of physicians is best summarised by the phrase do no harm. But physician behaviour (misconduct or malpractice) can cause harm; so can a physician’s health status. And, of course, the matter is not restricted to physicians: the health-care workforce comprises many professionals including dentists, midwives, podiatrists, physiotherapists, paramedics and nurses.

Australian health-care workers who are impaired by drug addiction, alcohol abuse or dependency and mental disorders can be restricted from practise by their registration board. The assessment is based on their clinical competency and the desire to protect patient safety. But what about health-care workers (including students, trainees and volunteers) who are infected with serious viruses such as hepatitis B, hepatitis C, or HIV?

Reducing the risk of infection

It’s important to note that the overall risk of transmission of HIV from infected clinicians to their patients is very low: about 2.4 to 24 per million procedures. The risk of transmission of HIV from a patient to a clinician through mishaps such as needle-stick injuries is much higher, at around 0.3%.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.