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Commentary: A Call for Authoritative CDC Guidelines for HIV-Infected Health Care Workers

Published online by Cambridge University Press:  01 January 2021

Extract

Recent court decisions imposing liability on physicians who fail to inform patients that they carry the human immunodeficiency virus (HIV) before performing invasive procedures create an urgent need for the Centers for Disease Control and Prevention (formerly the Centers for Disease Control) to reopen the issuance of guidelines and to address authoritatively the question of the appropriate limits within which HIV-infected health care providers can treat patients.

Public fear of HIV-infected physicians (polls show 80 to 90 percent of patients surveyed want to know if their physicians are HIV-infected) were kindled by reports, beginning in 1990, that Dr. David Acer, an HIV-infected dentist, had infected a number of his patients. However, great skepticism has arisen as to whether Dr. Acer’s patients were infected as a result of procedures conducted in accordance with universal precautions against transmission. Moreover, look back studies have failed to identify even one patient, among the thousands who have undergone procedures administered by HIV-infected physicians, who contracted the virus directly from his/her physician.

Type
Article
Copyright
Copyright © American Society of Law, Medicine and Ethics 1994

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References

Behringer v. The Medical Center at Princeton, 592 A.2d 1251 (N.J. Super. L. 1991); Faya v. Almaraz, 620 A.2d 327 (Md. 1993); and Kerins v. Hartley, 17 Cal. App. 4th 713 (1993).Google Scholar
See Centers for Disease Control, “Recommendations for Preventing Transmission of Human Immunodeficiency Virus and Hepatitis B Virus to Patients During Exposure-Prone Invasive Procedures,” Morbidity and Mortality Weekly Report, 40, no. RR-8 (1991): 5.Google Scholar
Daniels, N., “HIV-infected Professionals, Patient Rights, and the ‘Switching Dilemma’,” JAMA, 267 (1992): 1368–71; and Gerbert, B. et al., “Physician and Acquired Immunodeficiency Syndrome: What Patients Think About Human Immunodeficiency Virus in Medical Practice,” JAMA, 262 (1989): 1969-72.CrossRefGoogle Scholar
Centers for Disease Control, “Possible Transmission of Human Immunodeficiency Virus to a Patient During an Invasive Procedure,” Morbidity and Mortality Weekly Report, 39 (1990): 489; Centers for Disease Control, “Update: Transmission of HIV Infection During an Invasive Dental Procedure—Florida,” Morbidity and Mortality Weekly Report, 40 (1991): 21; and Centers for Disease Control, “Update: Transmission of HIV Infection During Invasive Dental Procedures—Florida,” Morbidity and Mortality Weekly Report, 40 (1991): 376.Google Scholar
See Hostetler, A.J., “How Dentist Spreads AIDS Still Unclear,” Phoenix Gazette, May 15, 1992, sec. A11.Google Scholar
See Rogers, A.S. et al., “Investigation of Potential HIV Transmission to the Patients of an HIV-infected Surgeon,” JAMA, 269 (1993): 1795–801; Mishu, B. et al., “A Surgeon with AIDS: Lack of Evidence of Transmission to Patients,” JAMA, 264 (1990): 467-70; Dickinson, G.M. et al., “Absence of HIV Transmission from an Infected Dentist to His Patients: An Epidemiologic and DNA Sequence Analysis,” JAMA, 269 (1993): 1802-06; Armstrong, E.P. et al., “Investigations of a Health Care Worker with Symptomatic Human Immunodeficiency Virus Infection: An Epidemiological Approach,” Mil. Med., 152 (1987): 414-18;; and Porter, J.D. et al., “Management of Patients Treated by a Surgeon with HIV Infection,” Lancet, 335 (1990): 113-14.CrossRefGoogle Scholar
Centers for Disease Control, “Recommendations for Preventing Transmission of Human Immunodeficiency Virus and Hepatitis B to Patients During Exposure-Prone Invasive Procedures,” Morbidity and Mortality Weekly Report, 40, no. RR–8 (1991): 5.Google Scholar
See Cimons, Marlene, “Plan to Ease Curbs on AIDS-Infected Doctors is Scrapped,” Los Angeles Times, June 14, 1992, sec. A13.Google Scholar
Behringer v. The Medical Center at Princeton, supra note 1.Google Scholar
Faya v. Almaraz, supra note 1.Google Scholar
Kerins v. Hartley, supra note 1.Google Scholar
See E. McCray and the Cooperative Needlestick Surveillance Group, “Occupational Risk of Acquired Immunodeficiency Syndrome Among Health Care Workers,” N. Engl. J. Med., 314 (1986): 1127–32.Google Scholar
Centers for Disease Control, “Draft: Estimates of Endemic Transmission of HBV and HIV to Patients by the Percutaneous Route During Invasive Surgical and Dental Procedures,” Jan. 10, 1991. See also “CDC Sparks Debate With Release of HIV Estimates,” Amer. Health Consultants, 2 (Feb. 1991): Special Bulletin 2.Google Scholar
See, e.g., Ray v. School Dist. of DeSoto County, 666 F. Supp. 1524 (M.D. Fla. 1987).Google Scholar
See, e.g., Chalk v. United States Dist. Court, 840 F.2d 701 (9th Cir. 1988).Google Scholar
Ray v. School Dist. of DeSoto County, supra note 15.Google Scholar