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Editor,—This ethical debate1 calls for comment.
Why did the clinicians only suspect AIDS? Surely at the second attendance the diagnosis was clinically obvious. As well as continuing treatment of candidiasis and starting prophylaxis of Pneumocystis carinii pneumonia, was not treatment for AIDS indicated? For fear of court proceedings a specimen of blood untested or surplus to routine haematological tests could have been stored to confirm, if necessary, the clinical diagnosis. A perspicacious defence lawyer could make much of this in terms of doctor thoroughness, cautiousness, and thoughtfulness—on behalf of his client.
In terms of contact tracing the word “disclosure” occurs repeatedly. Surely the first thing an index case is told when his/her cooperation is sought is that under no circumstances will their name be divulged. The contacts, when attending, will be refused any information regarding who has named them and immediately assured that the same confidentiality will be maintained if their cooperation is called for in the contact tracing process.
Only when it becomes widely known in a clinic that such confidentiality is thoroughly pursued will counterproductive fears be eliminated. With understanding and cooperation it can be done.
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