AIDS and ethics. An overview.

AIDS has generated a host of ethical questions that are urgent, poignant, and sometimes unprecedented. These questions fall into several familiar categories of ethical problems, including civil liberties vs. public health, distribution of scarce resources, "truth telling," confidentiality, and discrimination, among others. Established ethical principles apply in each of these areas, but certain features of this epidemic require new considerations. Factors such as our current uncertainty about the natural history of infection with HIV, the lack of evidence for transmission through casual contact, the social status of the groups at high risk, the unavailability of any definitive treatment, the tendency of AIDS to affect the central nervous system, and the availability of psychiatric evidence about the effects of hearing the diagnosis should affect the calculation of competing values. In general, there is little ethical justification at this time except in specific and limited situations for infringing on individual civil rights, for permitting discrimination against AIDS patients or those at risk, or for violating confidentiality.