Confidentiality Limits with Clients Who Have the AIDS Virus

Abstract

Limits of confidentiality have not been defined for the life‐threatening dilemma of a client who has the AIDS virus and who continues to be sexually active without informing her or his partners. The authors review the medical background of acquired immunodeficiency syndrome, legal limits, and ethical tenets of confidentiality. A position supporting breach of confidentiality is taken, and specific suggestions for counseling the client are offered.

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

“…With the ever-increasing prevalence of AIDS, mental health professionals almost inevitably will encounter HIV-infected individuals in their psychotherapy practice (Upadhya & Bluestone, 1994). 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).…”

Counseling to End an Epidemic: Revisiting the Ethics of HIV/AIDS

“…This declaration was used to both support and challenge confidentiality breaches and to substantiate the requirement that consent for disclosure be given without force or coercion. Similar to Gray and Harding's () position, Cohen's model rule held that a counselor must breach confidentiality by disclosing a client's HIV‐positive status to a relevant third party provided that (a) medical evidence establishes the client's serostatus, (b) the client places the third party at high risk through a special (e.g., sexual) relationship, and (c) the client neither previously planned nor currently plans to disclose this information to said third party.…”

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.…”