Mr. Busey

Your patient, Mr. Busey, is a 77-year-old man who has been on a treatment for AIDS known as HAART, highly active antiretroviral therapy. However, because he has not been taking his medication daily, the HIV has become resistant to the combination of HAART. He has missed many of his regular check ups with you. One day he showed up and informed you that he does not want to pursue any more treatment. He plans to live the rest of his life without any concerns about his health. However, he also informed you that he has a new girlfriend, Ms. Cleary, that he met at the senior home. He also informs you that he has not told Ms. Cleary about his AIDS. You feel a little uncomfortable, but you ask him if he is sexually active. To your surprise, he responds that he is. You begin to talk to him about safe sex practices, but he interrupts saying “we’re just a couple of old geezers. “It doesn’t matter anyways because we aren’t planning to have children.” He shrugs it off and says that he just wants to enjoy himself for the rest of his life. “Anyways, Ms. Cleary has a lot of other medical problems to worry about. She does not need this on her mind, and it would not affect her health much.” You are concerned of the patient spreading the AIDS, but you also know that informing the girlfriend about his AIDS breaches confidentiality. Also, you research a little more about the medical conditions that Ms. Cleary has, and you realize that the even if she did contract AIDS, it would not affect her lifestyle much. However, you also feel a little uneasy because you realize that she may want to know as a precautionary measure. You do not want to breach your patient’s confidentiality, and you are unsure whether or not there would be a benefit of informing Ms. Cleary of her boyfriend’s condition. What should you, as the physician, do?

--Written by Kiran Singh