The right to know. Ethical issues related to mandatory testing of healthcare workers for HIV

To prevent transmission of human immunodeficiency virus (HIV) from patient to healthcare professional, in 1987 the Centers for Disease Control (CDC) put forth guidelines requiring the use of gloves and sometimes masks when treating all patients in exposure-prone situations. Recently, however, the spotlight has shifted as a result of tragic events in Florida when patients of a dentist who died of AIDS were found to be infected with the virus. The question now is whether patients have a need and right to know if a health-care professional is HIV positive. In July 1991 the CDC called for voluntary testing of dentists and physicians who perform "exposure-prone procedures." Also in that month, a proposal in the Senate called for testing all healthcare professionals who perform infection-prone procedures and incarceration of HIV-positive professionals who do not reveal their condition. Later, a similar bill was introduced in the House. Neither of these bills passed, but a joint action by the Senate and House did result in legislation that suggests, but does not require, testing of care givers, following the CDC guidelines or a substitute measure. Professional societies have opposed the CDC guidelines because making a list of exposure-prone procedures would heighten fears, when the risk of transmission is actually small. Also, the guidelines might drive HIV-positive professionals to hide their conditions. Finally, the testing would not be totally effective because of the time lapse between infection and the ability to detect it.(ABSTRACT TRUNCATED AT 250 WORDS)