Politics and poker--two game plans shape up in AIDS-control strategy

A line from the song 'Politics and Poker,' from the Broadway musical Fiorello, goes: 'Neither game's for children, either game is rough. Decisions, decisions, like who to pick, how to bet, how to play, how to call a bluff.' Events in recent months, leading up to and following the release of CCD's recommendations for preventing transmission of HIV to patients by health care workers, can be characterized as a nation playing both games in trying to deal with undefinable or unexplainable risks of AIDS transmission. The nation seems split between those who favor politically astute (though not necessarily logically or ethically sound) solutions, and those who believe that HIV-infected practitioners must make decisions on testing, disclosure, and changes in practice based on a rational assessment of each individual case--factoring in the odds of viral transmission, the chance of losing a career, the interpretation of risk, adherence to stringent infection control technique, timing, patient confidence, and peer support. Ether one is a gamble. This special issue of Hospital Ethics takes a look at the politics and poker of AIDS testing and disclosure, with special attention to the kinds of advice being offered to hospitals as they develop policies on infected health care workers.