Confidentiality and HIV

James, a 25-year-old white man with no symptoms, attends the genitourinary medicine clinic. He reports that Tom, his boyfriend of 2 years, has advised him to attend. He says Tom was diagnosed and treated for syphilis the week before at the same clinic. James has had no other partners since his last negative tests 2 years ago and says Tom had a negative HIV test last year. James consents to all tests including an HIV test. While the patient is waiting for his tests, the doctor pulls out Tom’s file. She confirms that Tom was diagnosed with syphilis last week but also notices that Tom is HIV-positive and has attended this center for the past 4 years for HIV care. Tom’s next appointment is in 2 days.

• How should the doctor proceed with this consultation? What should she say to James?
• Does the fact that both patients are under the care of the same clinic affect the doctor’s decision?
• What should be said to Tom at his next appointment?
• Would the doctor be liable if she breached Tom’s confidentiality or if she did not inform James of his ongoing risk?

Apply Theory (Specific Professional Healthcare Competencies + Clinical Medical Ethical Principles) to Practice in order to provide Optimal Patient-Centered Care (OPCC)

Source – Ethics Case Studies from Clinical Ethics and Law (Second Edition), Carolyn Johnston Penelope Bradbury