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December 9, 1988

The Legal Limits of AIDS Confidentiality

Author Affiliations

University of Michigan School of Public Health Ann Arbor

University of Michigan School of Public Health Ann Arbor

JAMA. 1988;260(22):3273. doi:10.1001/jama.1988.03410220057011

To the Editor.—  When information regarding a diagnosis of human immunodeficiency virus (HIV) infection falls into the wrong hands the result may be the loss of employment, housing, and insurance coverage and the disruption of relationships with family and friends. Legal protections of confidentiality are the first line of defense in the fight against HIV-related discrimination. Because there are occasional situations in which confidentiality can be breached with moral and legal impunity, Dr Dickens1 would have us instead fall back on the protections provided by antidiscrimination laws—once the damage is done and the horse is out the barn door and down the road a piece.Dr Dickens beats too hasty a retreat. If the legal protections of confidentiality are "illusory," they should be shored up, not abandoned. It is difficult, but not impossible, to balance duties owed to patients and to third parties and to define in advance the