The Principle of Cooperation in Confidential Withholdings of HIV Status from Partners of Sexually Active Patients Who Do Not Intend to Disclose: A Role for Organizational Moral Agency

Abstract

An increasingly blurred understanding of the legitimate conditions under which clinicians may legitimately withhold HIV seropositive status from partners of patients who are sexually active and who do not intend to disclose suggests a critical need to revisit the relationship shared between the notion of confidentiality, the moral and legal duties to warn at-risk third parties, and the organizational ethics surrounding licit cooperation with wrongdoing in the effort uphold professional moral responsibility. This essay grounds its argument in two, straightforward premises: (i) the ethical principle of cooperation is an indispensable measure of the moral licitness of most, if not all, instances of complicity with wrongdoing; (ii) some instances of material organizational complicity vis-a-vis confidential withholdings of HIV seropositive status from partners of sexually active patients both meet and employ successfully the standards of the ethical principle of cooperation. Drawing from this syllogism, the aim and proposal of this essay posits the argument that, in Type II cases, health care organizations may (initially and on certain conditions) materially cooperate in withholding the HIV seropositive status of patients from partners with whom patients are sexually active and to whom patients do not intend to disclose HIV seropositive status in the effort to honor the (prima facie) professional obligations of privacy, confidentiality, and fidelity in a manner that is both legally licit and morally justifiable.