The Duty to Protect a Patient’s Right to Confidentiality: Tarasoff, HIV, and Confusion

This paper sets out to discuss the legal complexities that arise when a clinician is faced with an HIV-positive patient who reveals an intention to engage in sexual activity with an unknowing partner. The landmark Tarasoff case and notion of a clinician’s duty to protect are reviewed. Actual courtroom decisions in cases involving similar issues of disease transmission are examined. The criminalization of HIV-positive individuals who are sexually active without making partners aware of their seropositivity is also discussed. Although no definitive guidelines exist for what to do in this specific situation, clinicians who know the legal landscape and practice defensive medicine are in the best position to fulfill legal and moral responsibilities in protecting third parties, patients, and themselves.