SHOULD PHYSICIANS INFECTED WITH HUMAN-IMMUNODEFICIENCY-VIRUS BE ALLOWED TO PERFORM SURGERY

Practice restrictions on physicians who have the human immunodeficienc y virus can significantly interfere with their freedom to practice. Th ree main ethical views have been advocated concerning such restriction s: (1) Infected physicians should be required either to refrain from p erforming procedures posing any risk of transmission or to reveal thei r seropositivity to the patient and proceed if consent is obtained; (2 ) they should not be restricted; (3) they should be restricted from so me subset of invasive procedures posing higher risks of transmission. However, the first view overlooks the adverse effects of restrictions and the second view disregards consequences of patient exposure. A sho rtcoming of the third view is its focus on risks of transmission rathe r than exposure, An ethical view avoiding these difficulties is the fo llowing: Physicians infected with human immunodeficiency virus should be restricted from procedures involving risks of patient exposure grea t enough to require informed consent. Given current risk estimates, th is implies restrictions, at the least, on procedures involving an open wound.