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confidentiality issues in regards to HIV positive school students
Apr 19, 1999

I am a Senior Biology Major at XXXXXXX in XXX. I am taking a Social Ethics course that involves writing a paper on the topic of choice. Mine is in regards to a teacher's rights, responsibilities, and options if he/she was informed by a parent that his child has HIV and is in this teacher's class. Does this teacher have an ethical or legal responsibility to inform the other kindergarten students, teachers, principle, school personnel, etc.?

Thank you for your time and information.

Response from Ms. Breuer

When a teacher learns from a parent that a student in the school has HIV, the teacher has one clear legal responsibility: to keep that information confidential. Privacy law protects the student from a teacher's disclosure of medical information, and if the teacher does disclose, the teacher opens up the school district to legal liability if discrimination results.

An ethical responsibility is not so much a matter of law as a matter of respect for the rights of all persons involved. Here my response is an opinion, not a reflection of actions that would increase or decrease the school's liability. The rights of all persons involved are best respected when everyone involved is educated about HIV. The teacher's ethical responsibility, in my opinion, is to lobby for that education--for other teachers, the principal, school personnel, even other parents--before an unintentional disclosure leads to discriminatory behavior. People who are uneducated about HIV have been known to do some ugly things in response to disclosure that a child at their school has HIV. And a child who has HIV is carrying a secret that may be too much for the child to carry. The child may be the source of his or her own disclosure, despite whatever a parent has told the child about keeping the secret.

Telling school personnel about the one child known to have HIV avoids the real problem with ignorance about HIV in general: it solves or prevents nothing in respect to the child not known to have HIV, but HIV+ just the same. The most practical application for this information is first aid. Every adult in that school should know how to do first aid safely (avoiding direct contact with human blood), and every child should know that no one should touch a bleeding person or a blood spill without latex gloves. Anything less than that is a failure to protect the employees and the children from hepatitis B and hepatitis C, both far more infectious than HIV.

The key question to ask yourself about disclosing anyone's HIV status in any situation is "What would these people do differently if they knew?" If the answer is that they would protect themselves and the other children in the event of a first aid incident, then that protective behavior must become their standard. Almost any other answer I can think of would constitute discrimination. Can you think of anything else they would do differently if they knew? Is it legal? Is it discriminatory? What purpose would it serve?

Nancy Breuer



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