Ethical issues in relation to HIV care in the UK

Abstract 

Despite the universal applicability of generic codes of ethical and professional conduct in medical practice HIV remains a stigmatizing condition and certain aspects of care require particular consideration. Confidentiality is of particular concern for patients who may be anxious about others being made aware of an HIV diagnosis. At the same time, safe clinical care may require information to be shared amongst professionals, highlighting issues concerning medical record-keeping. Tensions between patient confidentiality and the wider public health may occur. Eligibility for free NHS care for HIV is dependent on immigration status, which may add to the difficulties of providing appropriate clinical care to some patients. The use of the criminal law in prosecuting people with HIV for reckless transmission has raised further complex questions for clinicians and patients. Reproductive decision-making, ways of assisting safe conception and prevention of mother-to-child transmission, together with the availability of fertility services for people with HIV raise particular ethical issues. Consideration is given to the particular issues facing healthcare professionals living with HIV.

Keywords: confidentiality, disclosure, ethics, healthcare worker, HIV, reckless transmission, reproduction