Newcastle Law School, 21-24 Windsor Terrace, Newcastle University, Newcastle upon Tyne, NE2 4HQ, UK.
North Cumbria Integrated Care NHSFT, Pillars Building, Cumberland Infirmary, Infirmary Street, Carlisle, CA2 7HY, UK.
Med Law Rev. 2021 Aug 11;29(2):284-305. doi: 10.1093/medlaw/fwab011.
This article examines the current BHIVA/BASHH guidelines on the disclosure of HIV+ status in the context of sexual activity. It assesses whether the guidance provided on how to avoid criminal prosecution accurately reflects the prevailing position in law. Given that aspects of the guidance related to non-disclosure of HIV infection in the context of low or negligible risk are as yet untested in UK law, it is argued that there is some uncertainty as to whether the professional body guidelines and the law can be reconciled with each other. The article also considers whether the BHIVA/BASHH guidelines stray beyond the boundaries of medical advice as normally understood (focused on the protection of health and the prevention of onward transmission), by posing both as legal advice on how to avoid prosecution and offering what could be viewed as a moral judgement as to when disclosure is required. While a bio-medical assessment of risk naturally shapes clinical guidelines and may also inform views as to appropriate sexual behaviour and risk-taking, it is unclear whether scientific assessment of risk should be the sole guide when it comes to determining the nature of any disclosure obligation or the medical advice to be given on this matter.
本文探讨了 BHIVA/BASHH 目前关于性行为中披露 HIV+ 状态的指南。评估了关于如何避免刑事起诉的指导是否准确反映了法律上的主流观点。鉴于该指南中与低风险或可忽略风险情况下不披露 HIV 感染相关的部分在英国法律中尚未得到检验,因此存在一些不确定性,即专业机构指南和法律是否可以相互协调。本文还考虑了 BHIVA/BASHH 指南是否超出了通常理解的医疗建议的范围(侧重于保护健康和防止传播),因为它既提出了如何避免起诉的法律建议,又对何时需要披露提出了可能被视为道德判断的观点。虽然对风险的生物医学评估自然会形成临床指南,并可能对适当的性行为和冒险行为提出看法,但当涉及确定任何披露义务的性质或就此问题提供的医疗建议时,科学评估风险是否应该是唯一的指导,这一点并不清楚。