Confidentiality Limits With Clients Who Have HIV: A Review of Ethical and Legal Guidelines and Professional Policies

Abstract

The publication of the first counseling articles addressing confidentiality limits of clients who have HIV (human immunodeficiency virus) and continue to be sexually active with an uninformed partner occurred 4 years ago. Since that time, dialogue about whether a helping professional may ethically and legally breach confidentiality has not resolved the dilemma but instead has created more questions and controversy for counselors. In this article the authors highlight the barrage of ethical issues regarding HIV and Acquired Immune Deficiency Syndrome (AlDS), review ethical and legal guidelines pertaining to HIV and AIDS and confidentiality, summarize HIV and AIDS confidentiality policies of the major helping professional organizations, articulate questions that contribute to the confidentiality dilemmas, and challenge the American Counseling Association (ACA), formerly the American Association for Counseling and Development (AACD), to develop specific guidelines for counselors.

Psychologists' perceptions of their duty to protect uninformed sex partners of HIV‐positive clients‡

“…As a result, mental health professionals must inform themselves about the complex medical, legal and social issues provoked by the epidemic of HIV disease (Gray & Harding, 1988;VandeCreek & Knapp, 1989). Perhaps the most perplexing issues in AIDS-related literature involve the legal and ethical extent of the duty to protect third parties and the dif®culty of balancing the rights of HIV-infected patients versus the right of society to be protected from the spread of AIDS (Harding, Gray, & Neal, 1993;Erickson, 1993).…”

Divergent Ethical Perspectives on the Duty-to-Warn Principle With HIV Patients

“…Other opinions have also been offered on whether to violate an HIV-positive patient's confidentiality when she or he is potentially infecting an unknowing partner (Gray & Harding, 1988;Harding, Gray, & Neal, 1993;Kain, 1988;Landesman, 1987;Melton, 1988;Winston, 1987). Many of these invoke ethical principles or frameworks when making a case for breaking (or not breaking) confidentiality.…”

Techniques for Teaching HIV Counseling: An Intensive Experiential Model

“…The complexity and nuances of the ethical issues, as they relate to HIV disease, makes this a complicated part of the course. We review the literature on confidentiality, duty to warn, competency, and rational suicide (e.g., Erickson, 1990;Harding, Gray, & Neal, 1993;Kain, 1996;Rogers & Britton, 1994;Werth, 1992). However, due to the relative newness of these issues and the lack of agreement between profes-sionals, case law, state interpretations, and professional organizations (Allers & Katrin, 1988;Werth, 1993), we are left giving students a somewhat vaporous message.…”