Should physicians infected with human immunodeficiency virus be allowed to perform surgery?
Practice restrictions on physicians who have the human immunodeficiency virus can significantly interfere with their freedom to practice. Three main ethical views have been advocated concerning such restrictions: (1) infected physicians should be required either to refrain from performing procedures posing any risk of transmission or to reveal their seropositivity to the patient and proceed if consent is obtained; (2) they should not be restricted; (3) they should be restricted from some subset of invasive procedures posing higher risks of transmission. However, the first view overlooks the adverse effects of restrictions and the second view disregards consequences of patient exposure. A shortcoming of the third view is its focus on risks of transmission rather than exposure. An ethical view avoiding these difficulties is the following: Physicians infected with human immunodeficiency virus should be restricted from procedures involving risks of patient exposure great enough to require informed consent. Given current risk estimates, this implies restrictions, at the least, on procedures involving an open wound.
Department of Human Values and Ethics, College of Medicine, University of Tennessee, Memphis.
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D000163:Acquired Immunodeficiency Syndrome / Q000635:transmission*; D002487:Centers for Disease Control and Prevention, U.S.; D030881:Disclosure; D004992:Ethics, Medical; D035082:Federal Government; D013502:General Surgery / Q000331:legislation & jurisprudence; D006801:Humans; D010361:Patients; D010820:Physicians / Q000331:legislation & jurisprudence; D012307:Risk Factors; D014481:United States