Dentistry and the ethics of infection.
Currently, any dentist in the UK who is HIV-seropositive must stop treating patients. This is despite the fact that hepatitis B-infected dentists with a low viral load can continue to practise, and the fact that HIV is 100 times less infectious than hepatitis B. Dentists are obliged to treat HIV-positive patients, but are obliged not to treat any patients if they themselves are HIV-positive. Furthermore, prospective dental students are now screened for hepatitis B and C and HIV, and are not allowed to enrol on Bachelor of Dental Surgery degrees if they are infectious carriers of these diseases. This paper will argue that: (i) the current restriction on HIV-positive dentists is unethical, and unfair; (ii) dentists are more likely to contract HIV from patients than vice versa, and this is not reflected by the current system; (iii) the screening of dental students for HIV is also unethical; (iv) the fact that dentists can continue to practise despite hepatitis B infection, but infected prospective students are denied matriculation, is unethical; and (v) that the current Department of Health protocols, as well as being intrinsically unfair, have further unethical effects, such as the waste of valuable resources on 'lookback' exercises and the even more damaging loss of present and future dentists. Regulation in this area seems to have been driven by institutional fear of public fear of infection, rather than any scientific evidence or ethical reasoning.
Shaw
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Dental School, Faculty of Medicine, University of Glasgow, 378 Sauchiehall Street, Glasgow, G2 3JZ. d.shaw@dental.gla.ac.uk
D000293:Adolescent; D000328:Adult; D002321:Career Choice; D003219:Confidentiality / Q000941:ethics; D006679:HIV Seropositivity / Q000635:transmission* / Q000821:virology; D006287:Health Planning Guidelines; D006509:Hepatitis B / Q000635:transmission*; D006801:Humans; D019552:Infection Control, Dental / Q000331:legislation & jurisprudence / Q000592:standards*; D017757:Infectious Disease Transmission, Professional-to-Patient / Q000941:ethics* / Q000331:legislation & jurisprudence / Q000517:prevention & control*; D007258:Informed Consent / Q000941:ethics; D008403:Mass Screening / Q000941:ethics; D018570:Risk Assessment; D012570:School Admission Criteria; D013335:Students, Dental; D014342:Truth Disclosure / Q000941:ethics; D006113:United Kingdom; D019562:Viral Load