AIDS: responding to the crisis. Legal implications for health care providers

In the future, health care providers will not be able to avoid the legal problems that the AIDS epidemic presents. They can find guidance in the long-standing legal principles of privacy and confidentiality and of fair employment. Many laws contain confidentiality principles that focus on the right of patients to determine who has access to their confidential health care information. Dissemination of such information to those who have no legal or rational requirement to know it may result in the provider's criminal and/or civil liability. The HTLV-III blood test brings additional pressures to bear on patients' and employees' confidentiality rights. Since the test indicates only that the subject has been infected by the virus--not whether the person has or will develop AIDS--widespread mandatory screening is inadvisable because it could lead to unjustified discrimination. Under principles of handicap-discrimination law, health care providers may not terminate or discriminate against an employee with HTLV-III infection unless the employee cannot perform the job or poses a danger to the health and safety of himself or others. An employee who refuses to treat AIDS patients may be lawfully disciplined. Under health and safety laws, however, employers who discipline employees for wearing extra protective gear risk liability.