A Grave Injustice
British Dental Journal January 27, 2007

HIV is an increasing global problem, and potentially affects every man, woman and child on the planet. No one can afford to ignore it. The number of diagnoses in the UK continues to increase, and with that increase comes an increase in risk to all of us, as dentists in our professional lives, and as ordinary people in our private lives.

As dentists we have to deal with blood and body fluids on a daily basis, and as we are told it is unethical to refuse to treat a patient on the basis of their being HIV positive, we are obliged to take the risks that go with that. As there are many times more HIV positive patients than HIV positive dentists, it must be obvious who is statistically more at risk from whom, in the event of a mishap during treatment. This occupational risk must be fully recognized and acknowledged, and it would be totally unethical, in my opinion, to deny a colleague anything less than the fullest possible support in the event of a positive diagnosis. Once diagnosed, a dentist becomes a patient: a patient who is just as entitled to dignified and sympathetic support from the healthcare system as any other taxpayer.

The author’s courage is to be admired in referring to the mode of infection, in this case, as a ‘personal misdemeanour’.

Certainly, HIV can be acquired through ignorance, carelessness, recklessness, folly, and poor judgement, of which we can all be guilty at times, but it can also be acquired through sheer bad luck. In any of these circumstances, a death sentence, however much postponed, is a very heavy price to pay.

As fallible, feeling human beings, dentists are as susceptible as anyone else to the traumas and misfortunes of life and the personal vulnerabilities that can result from them. They cannot make their lives risk-free any more than the rest of humanity and have as much right as anyone else to a private life and all that means. Even people in apparently stable, monogamous relationships can be at risk. Existing sexual partners can cheat, and new ones may not fully disclose a previous sexual history. This prospect was brought starkly home to me several years ago when my own marriage of 25 years failed, and I suddenly realised how the process of finding another relationship would take me into new ‘risk territory’. How many of us are prepared to avoid such risk altogether and become celibate hermits? Or are dentists expected to give up a normal personal life in order to safeguard their livelihood, or to supposedly protect patients whom evidence shows are not at risk and who, collectively, pose many more times the risk to us than we do to them? The idea is absurd.

This case brings into stark reality how little recognition, understanding or concern is given by the Establishment to the welfare of those in the caring professions, in the same way that combatant troops wounded or otherwise traumatised in battle are regarded simply as ‘cannon-fodder’ and abandoned by the MOD.

We have come to expect shabby treatment from the Establishment, but to realize that we now have elements of an inhuman, prejudiced, discriminatory, hypocritical, abusive, ruthless, narrow-minded, dog-eat-dog culture, devoid of empathy and compassion, pervading our own and other healthcare professions frankly disgusts me.

I sincerely hope that the author of this article will at last gain some measure of healing from publishing his story and fromany supportive correspondence that he richly deserves to receive for exposing this grave injustice for the benefits of us all.

G. Raven
Birmingham
doi: 10.1038/sj.bdj.2007.40