Violating confidentiality to warn of a risk of HIV infection: ethical work in progress

The old literature on whether medical confidentiality may be breached to warn a spouse of a risk of contracting syphilis from his/her partner - a deep and rich literature - has become relevant once again in the context of HIV infection and AIDS. This paper examines the reasoning and method employed in: the Catholic approach centered around the patient's (property) right to the secret; a (generic) model of justice, utilizing minimal principles of non-aggression and restitution; and an approach involving the elimination of unstable alternatives: the view that public health officials, but not the spouse, may/must be notified; and, that maintaining that the physician is at liberty to disclose but is not obliged to do so. The theory and method behind confidentiality turns out to be deeper than you might have anticipated.