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The Dartmouth
March 29, 2024 | Latest Issue
The Dartmouth

Panelists discuss ethical dilemmas of AIDS virus

Lee Works created a moment of palpable emotion among the more than 80 students who attended a panel discussion on AIDS Friday afternoon when he told them of the day he found out he was infected with the HIV virus.

Seven years ago, Works had just moved into a new apartment, but he never unpacked, he said.

"When I found out I was infected I spent four days sitting in the middle of a hardwood floor just thinking about what I was going to do with my life," Works said.

Works and four other doctors presented a variety of clinical and ethical issues related to AIDS, but did not offer any easy answers during a panel held in 105 Dartmouth Hall.

Mark Siegler, director of the department of clinical ethics at the University of Chicago Hospital, led the discussion.

Also participating were Jim Bernat, professor of medicine and director of clinical ethics at the Dartmouth-Hitchcock Medical Center; Jeff Parsonnet, an infectious disease specialist at DHMC; and Ethics Professor Bernie Gert.

Parsonnet said DHMC has seven staff members who deal mostly with people infected with HIV.

"We tend to think that in this quiet little part of the world this is not that big of a problem, but we are currently following 100 to 150 cases," of HIV positive patients, Parsonnet said.

The panel also discussed the problems of treatment drugs and their prices. Parsonnet said patients need to discuss with doctors whether to take drugs for treatment.

"Up until this past year, physicians have been fairly dogmatic about the requirement to take these drugs," Parsonnet said.

But because all the drugs used to treat people infected with HIV have serious side-effects, Parsonnet said more people now feel it is the patient's right to decide whether or not to take medication.

"In the past year though there have been a number of articles and debates about this and it's really something that has to be sat down and decided between the physician and the patient," he said.

The panel dealt with a number of other topics, such as mandatory testing of the population for HIV and a patient's right to confidentiality.

"The duty of confidentiality may have to be balanced in some way to protect non-informed people who may be at risk of getting the virus," Bernat said.

The panel raised the question, as an example, of whether or not it is a physician's right to override a patient's desire for confidentiality if partners may have been exposed to the HIV virus through unprotected sexual contact with the HIV-infected patient.

The discussion, which was sponsored by Amarna undergraduate society, lasted almost two hours and then participants and audience members went to a reception at Kappa Kappa Gamma sorority.