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HIV-testing of health care workers: unethical request or moral obligation?

Transmission of HIV from physician to patient is possible. Physicians should help the public understand the low level of this risk and put it in the perspective of other medical risks, while acknowledging public concern. Nevertheless, there is a clear need for national guidelines which give unambiguous, practicable guidance about HIV-testing of health care workers performing invasive procedures and consequences of positive results. It is an ethical obligation of us physicians to come forward with such distinct recommendations and clearly have identified "exposure-prone" procedures which might necessitate HIV-screening. Infection with HIV does not in itself justify restrictions on the practice of an otherwise competent health care worker, but seropositive physicians should place themselves under the guidance of an expert review panel, which should determine whether practice restrictions are appropriate.