Physicians can and should expect their workplace to provide appropriate means to limit occupational exposure through rigorous application of infection control methods. The denial of appropriate care to a class of patients for any reason is unethical. Whether physicians should disclose their condition depends on the likelihood of risk to the patient and relevant law or regulations in their locales. Physicians should remove themselves from care if it becomes clear that the risk associated with contact or with a procedure is significant even if appropriate preventive measures are taken. Physicians are also obligated to disclose their condition after the fact if a clinically significant exposure has taken place.
Physicians have several obligations concerning the risk of infection.
They should help the public to understand the low level of this risk and put it in the perspective of other medical risks while acknowledging public concern. Physicians provide medical care to health care workers and part of this care is discussing with health care workers their ethical obligation to know their risk for such diseases as HIV or viral hepatitis, to voluntarily seek testing if they are at risk and to take reasonable steps to protect patients. The physician who provides care for a seropositive health care worker must determine the health care worker's fitness to work. In some cases, seropositive health care workers cannot be persuaded to comply with accepted infection control guidelines or impaired physicians cannot be persuaded to restrict their practice. In such exceptional cases, the treating physician may need to breach confidentiality and report the incident to the appropriate authorities in order to protect patients and maintain public trust in the profession, even though such actions may have legal consequences.