The HIV-positive dentist: balancing the rights of the health care worker and the patient

It would seem that perhaps there may be evidence of light at the end of the ‘HIV/AIDS tunnel’ after all. There are signs (however late) of a return to sanity in the application of public health measures. The article regarding a ‘hypothetical dentist’ (Gardam M A, Flannagan W F & Salit I E CMAJ 2001; 164(12) : 1715-8) suggests that in Canada’s largest province HIV infection is notifiable. That this situation does not apply in certain provinces says a great deal about the degree of procrastination to the forces of political correctness. The ‘waiving of the waiver’ by CMA executives at last years annual meeting was a further example of this. A signed waiver would have protected health care workers and also pointed a finger to the whereabouts of infection.

Eleanor Caplan’s recent legislation advising the HIV screening of refugees and immigrants is also welcome news. This is not directed at exclusion but rather at ascertaining the whereabouts of infection. This has also been a long time coming. Eleven years have passed since this writer was involved in a polemic in the CMAJ correspondence columns on this topic with a well known specialist in medical ethics ( CMAJ 1990 ; 142 (6) 524-6). HIV infection then as now was a major public health concern. It was not as suggested analagous to Huntingdon’s Chorea (Somerville M A The case against HIV antibody testing of refugees and immigrants CMAJ 1989: 141: 889-94 )

It is hoped that at the forthcoming annual meeting of CMA in Quebec these matters will again warrant appropriate debate.

James E Parker
Abbotsford B.C.