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January 3, 1996

Clinical Crossroads: Alcoholism and HIV Infection-Reply

Author Affiliations

Massachusetts General Hospital East Charlestown, Mass

JAMA. 1996;275(1):32-33. doi:10.1001/jama.1996.03530250036016

In Reply.  —The letter by Drs Zenilman, Rompalo, and Jadack highlights several important issues that were discussed in our Clinical Crossroads article. Zenilman and colleagues raise the issue of a physician's "duty to warn" potential victims of future harm, a duty enshrined in the Tarasoff case.1 The problem with respect to the patient under discussion is that to warn potential victims, the clinician must know their identities. In this case, we cannot predict who the patient's future sexual partners will be. Short of successful treatment, the clinician cannot protect or warn society at large, except by incarcerating the patient or perhaps forcing him to wear a warning label. Such measures have not been adopted by American society. Indeed, American society has, by and large, limited the paternalistic powers that physicians have. Only in limited circumstances, such as the mentally ill individual who poses an immediate risk to self or