Patient Privacy

The answer is A. It was the discovery of the HIV/AIDS disease that started a serious dilemma about public health safety and patient rights.

The concept of protecting patient privacy has its roots in the ancient Hippocratic Oath, but public health surveillance has its own history too. Data collection about mortality and infectious diseases began in the United States as far back as in 1878. In the early twentieth century, health surveillance aiming to detect and control the spread of infectious diseases required physicians to give complete information about the patient together with the disease or "suspected disease," to state health authorities. But physicians under their Hippocratic Oath did not approve of this invasion on patient privacy.

When the AIDS pandemic emerged in the early 1980s, this tension between community safety and patient privacy became serious. Initially, when medical researchers were still trying to determine the pathogen of AIDS, the Center for Disease Control recommended tracking the cases of AIDS in the United States to determine the cause of the disease and prevent its spread. At that stage, due to the lack of knowledge about the disease, named reporting of AIDS generated no public controversy, in spite of privacy concerns. A few infected individuals did organize campaigns to protect their medical information. But it was only after the pathogen of AIDS was discovered in 1983 that privacy rights for AIDS patients became a matter of concern for bio-ethicists. Since then, it has been a major challenge for bio-ethicists to balance community safety with individual rights.

Resources:

The Historical Development of Reporting as a Public Health Practice, excerpted from: Lawrence O. Gostin and James G. Hodge, Jr., The "Names Debate": the Case for National HIV Reporting in the United States, 61 Alb. L. Rev. 679 - 743, 689-698 (1998).