Disease control and medical care: communicable diseases.
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AIDS is the first public health crisis in America to arise after the mid-century civil rights revolution. Reflecting the values of the civil rights movement, public health experts have drawn attention to the dangers of discrimination against individuals who are sick or at risk, and generally have expressed a preference for voluntary over compulsory measures to limit the spread of the illness. Remarkably, government officials--judges, legislators, and administrators--have largely acceded to the views of these experts. This perspective indicates a more sophisticated understanding of discrimination issues throughout society; experience with AIDS may itself help to transform and refine ideas about individual rights, especially the constitutional conception of "equal protection under the law."
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To ascertain the degree of patient risk for acquiring HIV from an infected health care worker, several key questions have arisen: Beyond a single dental practice, has there been doctor-to-patient HIV transmission; are some procedures inherently more dangerous to patients than others; can HIV be transmitted despite good technique and universal precautions; is hepatitis B virus (HBV) transmission from physician to patient a relevant model for HIV transmission; is operator skill and technique as much or more of a factor in the risk for transmission than the nature of the procedure itself? The Centers for Disease Control (CDC) released recommendations about HIV-infected health care workers last year....The CDC proposed that sufficient data existed to declare that certain procedures were "exposure-prone," that is, that transmission of HIV to a patient could occur despite good technique and proper precautions.... Because of the major concerns expressed by many medical specialty societies, the CDC has indicated plans to review and revise the recommendations.