Call for doctors to declare HIV status exaggerates risk of disease transmission
I am saddened by the call from a local concern group last month for the declaration of one's HIV status to be made mandatory in the health care profession.
The call was made in the wake of the suicide of a young HIV-infected doctor.
I am reminded of Hong Kong dentist Mike Sinclair, who declared his HIV-positive status in 1992, an incident that found its way to news headlines and exercised the public for months.
The recent debate reported in the media is testimony that we have again missed the focus. Internationally, mandatory testing and the declaration of one's HIV status are not the accepted strategy for protecting public health.
The decision to conduct 'look-back' investigations of patients treated by the late surgeon has, unfortunately, reinforced the public's perception of the exaggerated risk of HIV transmission in our medical service.
What, then, should the focus be? Naturally, society expects health professionals to behave in a way no different from others when it comes to HIV infection. An HIV-infected doctor is expected to seek medical advice and act upon it.
It is the responsibility of his or her attending physician to report the case anonymously to the director of health, who will then ask for an expert panel to be convened. The panel will assess the circumstances and advise on job modifications, if this is deemed necessary.
This mechanism was established in 1994, not because of the high risk of HIV transmission to patients but because of the need for a pragmatic means to allay the fears of the public on the one hand and to help the health professional on the other.
I am concerned that our medical training or health services have failed in such a way that the doctor or his attending physician was unaware of how one could be helped.
I feel sorry for friends and relatives of the deceased doctor. The unsympathetic attitude of people and reports is, to me, a cause for concern. Have we thought about why he jumped to his death?
In retrospect, he must have been in despair, thinking that once he admitted his HIV status, he would then be exposed to the irresponsible demands of the medical profession and the community.
The remarks of the concern group have sadly proved that his concern was genuine. To make things worse, one's dignity is easily ignored when one's life is gone.
S. S. Lee, professor of infectious diseases,Chinese University of Hong Kong