In contrast to the demand to inform patients about the health condition of their surgeon, stands the doctor’s right to privacy, personal dignity, and freedom.

Background:

This position paper was developed in light of a severe case that led to a criminal lawsuit and conviction of a doctor who, while working as an anesthesiology intern, was a carrier of the Hepatitis C virus (likely without his knowledge). During the trial, it emerged that the doctor was addicted to narcotic drugs and used to inject himself with these drugs during his work, using a single syringe for both himself and his patients. As a result, he infected approximately 30 patients under his care.

Although this case is extremely unusual and does not reflect a common reality in medicine in Israel, it, along with the case of the heart surgeon who was infected with AIDS, has sparked a lively public debate. The questions raised are whether a hospital can employ a doctor, particularly in operating rooms, when it is known that the doctor has a contagious disease, and whether the public should be informed about the doctor’s illness.

The Patient Rights Law states that medical treatment shall not be provided to patients unless they have given informed consent, after being presented with the chances and risks of the proposed treatment. Some believe that the surgeon’s health status must be included in this information to allow patients to decide whether to consent to a specific doctor treating them. Proponents of this view also argue that even if the patient was not infected by the sick doctor, knowing afterward that the doctor had a contagious disease, and the need for the patient to undergo periodic medical tests to check his or her health status, could cause emotional pressure and psychological harm that should be prevented by proper disclosure. They believe that only this way full transparency and trust between doctors and patients can be maintained.

On the other hand, there is the sick doctor’s right to privacy, personal dignity, and freedom of occupation as any other patient.

The Physicians' Ordinance (New Version-1976) states that "If the Director (the CEO General of the Ministry of Health) believes that a licensed doctor suffers from a disease that endangers the public, he may require the doctor to appear before a medical committee for examination." If the experts in that committee believe that the doctor’s medical condition does not pose a risk to his patients, that doctor is entitled to medical confidentiality like any other person, and cannot be required to disclose his health status to his patients. Imposing such a blanket disclosure obligation would be a disproportionate prejudice to the sick doctor. If the authorized authority has determined that a doctor is permitted to practice medicine without restriction, then details about the treating physician's medical condition are not considered "medical information" required by the Patient's Rights Law for the patient to make a decision.

Knowing that the sick doctor’s health status will remain confidential will encourage sick doctors to voluntarily report their health condition and seek treatment early and effectively. This will also help to maintain the broader public health interest.

Position Paper:

• A doctor with a contagious disease that endangers his patients should refrain from providing medical treatment or assuming medical responsibility for their health.
• A doctor with a contagious disease that does not endanger his patients is not required to disclose his health status to them.
• The decision on the level of risk posed by a specific doctor’s contagious disease to his patients will be made according to professional standards accepted domestically and internationally.
• This position maintains the balance between the public interest in receiving safe medical treatment and the doctor’s right to privacy, personal dignity, and freedom of occupation.