AIDS screening, confidentiality, and the duty to warn.

The authors evaluate current proposals for the compulsory screening of selected populations for antibodies to the human immunodeficiency virus (HIV) as a means of controlling the spread of AIDS. They argue that, in the absence of an effective vaccine or treatment, any public health benefit predicated on behavior modification among persons who test positive would be marginal or counterproductive and would be disproportionate to the invasion of privacy, discrimination, and economic costs incurred. The collection of sensitive health information in screening programs would raise ethical and legal conflicts for physicians and public health officials between their duty of confidentiality and their obligation to protect third parties from a foreseeable danger of infection.