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unethical?
Feb 16, 2004

Dr. Bob

I was just on the hopkins site and Dr. gallant said that it was not unethical for somone who was hiv+ to perform oral on somone that is hiv- without informing them of their positive status. Do you think this is O.K?

Response from Dr. Frascino

Hello,

I can't really say this is a question of ethics. What we try to do is present scientific data, including the probability (estimated risk) of HIV transmission from various types of exposures. Current data indicate that the risk of HIV transmission in the situation you describe would be astronomically low. A theoretical risk due to unusual circumstance could be postulated, but the general probability risk remains so small as to be nearly nonexistent. Is it ethical for me to tell you that you will not get run over by a snowplow if you live on the beach in Bora Bora? It is theoretically possible for someone to mow you over with a snow plow, while you are lying on the beach, applying Coppertone to those hard-to-reach areas that you don't want to get sunburned and sipping an adult beverage out of a coconut with a little umbrella sticking out of it. But, the chances of that actually happening are so small that they become essentially nonexistent. So, once again, this is not really an ethical question. Mutually consensual adult sex assumes the risks that come along with the activity. HIV prevention is not solely the responsibility of those who know they are positive. Remember, there are lots of positive folks out there who don't know they are positive. Is it "ethical" for them to have unprotected sex without knowing for sure they are not at that moment HIV-negative? As you can see, one can carry this "ethics" question to extremes. I prefer to think of this issue as one of personal responsibility. We should all assume our sex partners could be HIV-positive and take the precautions we feel are needed to keep ourselves and our partners safe.

If you want to see "unethical," just look at:

1. Halliburton

2. The Bush Administration's environmental programs

3. 1.5 billion dollars proposed to strengthen "marriage," but at the same time supporting a constitutional amendment banning some folks wanting to get married.

Dr. Bob



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