'Duty to warn' vs. 'patient confidentiality': the ethical dilemmas in caring for HIV-infected clients

An ethical dilemma that health professionals working with HIV-infected clients currently face is the issue of maintaining patient confidentiality vs. the professional's duty to warn persons at potential risk for acquiring the virus. Multiple factors are involved when trying to resolve what a health professional's obligations are when he or she becomes aware of a risk to another individual. Professional standards require that patient confidentiality be maintained in order to promote a helping relationship. Yet, the well-being of the one at risk must be considered. Legal precedents with other sexually transmitted diseases have been established that place the burden upon the clinician to warn in order to prevent litigation. Yet, an action on the part of the clinician should not be carried out just to prevent litigation. Actions that are taken should consider what is healthiest for all parties involved. Two cases are presented that cite specific instances in which a sexual partner was put at risk. A flow chart is presented that should assist in decision-making.