Ethical issues in the psychiatry of HIV disease

Abstract

The psychiatric care of persons with HIV disease often entails ethical dilemmas. These include questions regarding the limits of confidentiality, concerns over HIV-related cognitive dysfunction, debate over the degree to which patients should be involved in clinical decision-making, and controversies about the ‘right to die’ whether of natural causes, suicide, assisted suicide, or euthanasia. There are, in addition, special problems related to the HIV-infected health care provider which have received attention over the last months. These dilemmas, as they arise in the practice of psychiatry, constitute the focus of this paper. These issues are explored through review of the current literature, the law, the popular press, and by means of clinical vignettes.