CASE: BEST FRIENDS
Bill Prohaska was from Milwaukee. Jack Corrigan was from Portland, Maine. Both were sons of dentists, and both had found more interesting things to do in high school than hit the books. Jack had focused on playing his guitar and on the people who appreciated his playing and the marijuana they smoked together. Bill had played football and baseball for four years, had made the minimum grade requirement to stay on the teams by the skin of his teeth, and had filled the rest of his time with a busy social life and a goodly amount of beer.
It was no coincidence that neither young man was interested in college when high school was over. It was quite a coincidence that the two young men with such similar backgrounds should find themselves working side by side, and thinking about what they had done so far with their lives, on a U.S. Navy cruiser in the South China Sea somewhere off Da Nang, Vietnam, in the summer of 1969. A friendship blossomed that supported both men until their Navy hitches were over and helped each to put together a plan for what would follow.
Both men realized that they wanted to give dentistry a try, and they decided to plan their undergraduate applications so they would have a chance of studying at the same school. They were both admitted to Notre Dame, roomed together for four years, graduated cum laude as the reward for their hard work, and made their applications to dental school, hoping again to be studying somewhere near each other.
Jack was married the summer after college, with Bill as his best man of course, and Bill was engaged that same summer. Jack went to the dental school of the University of Illinois at Chicago, and Bill was accepted at Loyola University’s dental school a few miles down the road. Their spouses became good friends, and both men showed as much ability and worked as hard in dental school as they had as undergraduates. The only difference between them was that Jack’s car was struck by a hit-and-run driver in the summer after his first year. His leg was pinned in the twisted metal and had to be freed by fire department blowtorches. He lost a lot of blood before he reached the University of Illinois Hospital Emergency Room. Apart from his leg, however, his injuries were nor serious, and his two months in the hospital did nor set him back significantly in his studies. But the accident left him with an obvious limp that he would have for the rest of his life.
In May 1978, Dr. John Corrigan and Dr. William Prohaska held a joint graduation party in Chicago for both of their families. Both of their fathers had entertained hopes that their sons would join them in practice, but the two had long dreamed of practicing together. They stayed in Chicago, and in 1984 were able to buy the large practice of a retiring dentist in a Chicago suburb. They were fine men and good dentists, and their joint practice thrived. Their friendship was strong enough that they could disagree and work through it, and they and their families were still able to have fun together when their white coats had been hung up for the day.
But during a gray day in November 1993, Jack called Bill into his office with a serious look on his face. Jack had decided to be tested for the HIV virus. The two men had discussed their obligation to treat HIV-positive patients a number of times and had agreed that they would not turn any patient away because of their HIV status. Like most dentists they had by then established the Universal Precautions as the routine for themselves and their staff in the office. But to the best of their knowledge, none of their patients so far had been HIV-positive. Jack wasn’t quite sure why he had asked his physician to include the test for HIV in the blood work for a routine physical. Perhaps he intended it to be a baseline for comparison if they ever started seeing HIV-positive patients, he said. But he really couldn’t remember why his request had seemed right to him at that moment. His physician, he later learned, thought he was doing it because of contact with HIV-positive patients in his dental practice, but decided not to ask about the reason unless Jack brought it up in case it was something more personal.
The results of the test were positive. While there was no way to be sure, it seemed likely that the source of infection was tainted blood he received during his treatment for the car accident. In any case, he was an HIV-positive dentist now, and the question was what they should do about it. Should he quit practicing, Jack asked his colleague, or should he keep on? If he continued in the practice, were they obligated to inform his patients of his HIV status? What was the right thing to do, Jack asked his best friend and partner, now that he was an HIV-positive dentist? If a patient asks, does he have a duty to disclose?