This is because none is mandatory. And none, with the possible exception of tuberculosis, involves routine and continuous screening of physicians or the suspension of their privileges. This is an extraordinary step, an infringement of the basic human right to dignity and privacy. The infringement is grave, because testing will neither be voluntary nor confidential. There are occasions when individuals suffer discrimination and disadvantage for the good of the public as a whole.
Society demands such sacrifices in the face of a serious threat to public health or safety.
There is no doubt that physicians can transmit serious viral infections to patients during surgical and other invasive procedures. 5 Hepatitis C has been transmitted during cardiothoracic surgery to 1 patient in the UK and to 5 in Spain. These estimates are as good as any, but they are still only estimates. 5 Transmission of HIV can occur but is distinctly rare. It is imperative that population-based studies of hepatitis B and C be done to make the Health Canada estimates more precise.