PROTECTING PATIENTS FROM HIV INFECTION: IS ISOLATION AN OPTION?
To the Editor:
Your review of the present day status of HIV and AIDS infections in children, as written in the July 1990 issue of Pediatrie Annals (1990;19(7):407-408) deserves commending. However, certain statements require further discussion. Your final conclusion that "we do not have any effective means of preventing HlV infections save isolating non-infected from infected persons " explains itself! You go on to say that "we cannot do this because we have no legal means of identifying all infected persons without violating all principles of human rights. " This is confusing.
Protection of human rights principles demands inclusion of non-infected as well as infected persons. Hence, possible changes in legal means are necessary to attain this principle. Should isolation of HIVinfected victims be considered necessary for the human rights needs of non- infected persons? As physicians, our Hippocratic Oath requires primum rum nocere - first do no harm - for all patients, noninfected as well as infected. Past epidemics and pandemics were controlled only by means of isolation as indicated at the time. Are individual and constitutional rights more significant than the saving of millions - yes millions - of pediatrie lives now predicted to be lost by the year 2000? Similar statements are not meant to indicate inhuman understanding of feelings, but rather are an attempt to consider all aspects for all individuals at this crucial time of a final solution for a deadly disease!
The medical profession must become the basic advocate for the logical use of all medical principles involving oïl members of a society, not only treatment of tragically affected victims. The political control of this menace, with only individual and constitutional rights as a goal, is contrary to all democratic thinking! This does not require re-education. Yes, we must await the "discovery of drugs that will cure HIV infections and of a vaccine that will prevent them." While waiting, in my opinion, we as pediatricians should do our best "to help affected children and their families cope" and also accept responsibility and leadership in applying possible epidemiologie methods of preventing further spread and control, beyond mere education, of this horrendous medical threat to our society!
Juíes Í. Klein, MD
Dr Klein is entitled to his opinion, and we must all consider it seriously as we address the needs of our HIV-infected and non-Hi V- infected patients, and the application of the principles of human rights and the law.
Robert A. Hoekelmon, MD