HIV transmission: ethical and legal considerations in psychotherapy

Psychiatrists, particularly psychotherapists, have access to the most intimate details of patients' lives. As a result, psychiatrists may face a number of ethical dilemmas, particularly when the issue of potential human immunovirus (HIV) transmission is involved. This paper examines the principle and the limits of confidentiality, and outlines various ways to resolve situations in which there is a conflict between the risk of HIV being transmitted to the unsuspecting public and the principle of confidentiality. Psychiatrists should not assume that patients engaged in high risk behaviour that may be self-destructive fully understand the risks involved. An educational approach may be warranted with these patients, even though such an approach would not be consistent with non directive therapy.