Criminal transmission of an infectious disease
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When a patient has a serious infection, they (as do all individuals) have a duty not to cause intentional injury or suffering to another party.
This has been most relevant in recent times with the prosecution of individuals for infecting others with HIV unintentionally when they haven't disclosed their status (even if the sexual encounter was consensual). Patients who are engaging in such behaviour should be warned that there is a risk that may be criminally liable if transmission were to occur.
There have been several successful prosecutions in UK, including those of:
A doctor might act defensibly to breach confidentiality in such situations and inform a partner at risk, or public health, or indeed the police. They would have to be able to demonstrate a significant risk, and a potentially serious consequence. A doctor does not have a duty to protect a third party against all possible harms, but warning a person at risk gives them useful choices about how to protect themselves. Whether breaching confidentiality in this way is a moral and/or legal duty, on the other hand, is more controversial.
Whether or not the infected individual has a moral duty not to infect others is also problematic, especially where this may impose severe limitations on their own freedoms. It could be argued that such a duty (to society) only exists where society fulfills its duty towards the individual (in terms of protection of rights, contribution to health care etc).
- BHIVA Discussion document about the limits of confidentiality, especially when there is a dilemma, i.e. when maintaining confidentiality might put others at risk, e.g. when a patient with HIV is believed to continue having unprotected sex without informing their partner(s).
- ↑ Crown Prosecution Service. Policy for prosecuting cases involving the intentional or reckless sexual transmission of infection. Last viewed 3 Jan 2009.
- ↑ Clare Dyer. BBC News Website. Last Updated: 14 October, 2003]
- ↑ Codere G, Goldberg D, Cameron S, Shaw L, Taylor A. The Stephen Kelly Case: Impact on HIV testing behaviour. International Conference on AIDS. 2002 Jul 7-12; 14: abstract no. WePeC6153.
- ↑ BBC News. HIV case man jailed for five years Last updated 16 March, 2001
- ↑ Court of Session Judgement. Giovanni Mola. 5 April, 2007. Last viewed 3 January, 2009.
- ↑ Dixon-Mueller R, Germain A. HIV testing: the mutual rights and responsibilities of partners. Lancet. 2007 Dec 1; 370(9602):1808-9.(Link to article – subscription may be required.)
- ↑ Harris J, Holm S. Is there a moral obligation not to infect others? BMJ (Clinical research ed.). 1995 Nov 4; 311(7014):1215-7.