The Delhi AIDS Control Society and National AIDS Control Organisation argue that patient's status should be revealed to his/her partner with or without the patient's consent. Social organisations working among AIDS patients believe it is unethical and will prompt more and more HIV positive people to go ``into hiding.''

The DACS letter suggests the Supreme Court judgment on the issue be circulated among all clinicians with a view to facilitate a ``decision'' conforming to the Supreme Court judgment. The Supreme Court ruling in September 1998 on a petition filed by an AIDS patient said that his doctor was justified in telling his fiancee that he was HIV positive. (see box)Says Dr. Ashok Kumar of the All India Institute of Medical Sciences (AIIMS): ``Whether you should seek the consent of a patient while informing the spouse varies from patient to patient. So far there was no policy regarding this and it was left to the doctor's discretion.'' The NGOs fear that this situation may change after the DACS letter.

C.S. Khariwal, Director, DACS says the ruling was being circulated to keep the doctors informed. ``The national policy was for informing relatives with the patient's consent. But for telling a partner, the ruling does not insist on consent,'' he adds.

While some lawyers described the Delhi AIDS Control Society letter as unconstitutional, NGOs working in the field are threatening to move court against it. Many are consoling themselves over the fact that the DACS has not asked the doctors to follow the Supreme Court judgment, it has only asked them to refer to it while handling such situations.

According to AIDS activist Anjali Gopalan, the Government is moving against its own efforts to ensure confidentiality to HIV patients by giving doctors the green signal to reveal their medical status to their partners. Says Gopalan who runs the NGO Naz Foundation: ``Once there is no confidentiality, patients will go into hiding rather than risk betrayal by doctors,'' she says.

Some legal experts agree. ``The letter asking for circulation of the court ruling among doctors sets doctors at liberty to inform the patient's sexual partners. But nowhere does it say that the patient should be informed about this or his consent taken,'' says Aurobindo Ghosh, a lawyer. He said that the ruling, if made universally applicable, will also mean violation of Article 14 which guarantees the fundamental right to equality. If in all other medical cases, confidentiality and consent of patient are the law, then the HIV patient cannot be denied this right, he said.

George Pulikan, another lawyer, says that any Supreme Court ruling should be treated as law. ``But it is appropriate in only situations that are identical to the case that prompted the ruling,'' he adds.

The DACS initiative has the full support of NACO. In fact, its letter to IMA says it is accompanied by a copy of a letter from the NACO chief J.V.R. Prasada Rao. Rao told Express Newsline that that it was part of the national AIDS policy to reveal the patient's status to the partner even without the patient's consent. For partner notification, consent is not necessary, he said.

As for the DACS letter, he said NACO had been calling for partner notification after the Supreme Court ruling. Dr Chinkolal Thansing, who has been working for AIDS patients here, says that doctors should inform a patient's partner or any relative only with his or her consent or counsel him and make him inform the spouse. He adds that already many doctors were abruptly informing relatives without proper counseling and scaring off the patient.