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I agree with Mr Stryker that confidentiality is the preferred line of defense against the harms of disclosure, and I applaud efforts to make it effective. The thrust of the article was not to advocate antidiscrimination laws "instead, " but to argue that efforts to shore up confidentiality face severe legal obstacles and in themselves are not enough. Dr Natale is incorrect in the view that I was "ascribing AIDS discrimination to a set of legal principles" that aim to preserve free communication and advocating a "disease-specific statutory codification." Discrimination against AIDS was not presented as being induced or justified by the law. Dr Natale fails to address the courts' growing acceptance not just of limitations on confidentiality in the public interest but of a duty to warn individuals at risk that outweighs patients' interests in privacy. The Supreme Court, in School Board of Nassau County, Florida v Arline
Dickens BM. The Legal Limits of AIDS Confidentiality-Reply. JAMA. 1988;260(22):3274. doi:10.1001/jama.1988.03410220057013