AIDS and the physician's duty to warn (Part I)

The protective privilege ends where the public peril begins: Tarasoff v Regents of the University of California. The risk reasonably to be perceived defines the duty to be obeyed: Palsgraf v Long Island Railroad Co. This article analyzes the conflicting obligations (to maintain patient confidentiality and to warn those at risk) that a physician faces when confronted with an HIV-infected patient who is unable, or unwilling, to notify close contacts that they may have been, or will be, exposed to the AIDS virus. The ethical basis, the common law development, and the statutory establishment of each of these duties are examined, first in general, and then specifically, in regard to AIDS and HIV infection. The focus is placed on the patient's sexual partners (as persons at risk) although it is important to realize that this issue also applies to many other categories of close, and not so close, contacts.