Israel's Health Ministry May Discipline Dentists Who Refuse to Treat HIV Patients

More than a fifth − 22 percent of the 633 dentists interviewed for a survey, conducted for the Israel AIDS Task Force − said they refuse to treat HIV carriers.

The Health Ministry has started holding hearings for dentists who refuse to treat people positive for HIV, after a recent survey showed that almost half of Israeli dentists refuse to treat HIV patients, or put off treating them to the end of the day. Such practices run contrary to ministry regulations.

More than a fifth − 22 percent of the 633 dentists interviewed for the survey, conducted for the Israel AIDS Task Force − said they refuse to treat HIV carriers. This appears to be an infraction of the patients’ rights law of 1996. In addition, 20 percent of the dentists said they put off treating HIV carriers to the end of the day, contrary to Health Ministry regulations forbidding this kind of discrimination.

“For the procedure to be flouted by so many dentists requires that ministry take a firm stand against it," said AIDS Task Force CEO Dr. Yuval Livnat.

AIDS Task Force volunteers participating in the survey called dentists and made an appointment. Then the callers told the respective clinic staff they were HIV carriers. No less than 137 dentists ‏(22 percent‏) immediately cancelled the appointment while 125 others said they would see the patient only at the end of the day.

The rate of dentists who generally refuse to treat HIV carriers was especially high in Petah Tikva ‏(50 percent − 22 out of 44‏), Jerusalem ‏(32 percent, 21 out of 66‏) and Haifa ‏(32 percent − 54 out of 171‏).

Health Ministry director-general Prof. Ronni Gamzu this week summoned six dentists who, according to complaints to the HIV Task Force, reportedly refused to treat HIV carriers or discriminated against them.

Gamzu told the dentists that if the complaint against them proves true, “I see this as inappropriate behavior.”

The ministry’s procedure stipulates that dentists must treat every patient as an HIV carrier as far as preventing passing infections from one patient to another is concerned. Dentists were instructed in July 2009 to treat HIV carriers like any other patient and not to see them only at the end of the day.

“HIV carriers are entitled to receive medical treatment like any other patient, under the same cautionary measures. The ministry’s routine sterilization procedures provide doctors and patients with adequate protection to prevent contagion of infectious diseases, including HIV,” Livnat said.

Some dentists said in the survey that they refuse to treat HIV carriers because they had to sterilize instruments in a special way afterward, even though medical equipment must be sterilized after every patient anyway.

One dentist said that if he had to treat an HIV carrier, he would have to sterilize all the instruments for an entire day and this would prevent him from doing any other work.

“These arguments show that the dentists are either unfamiliar with the sterilization procedures, or they’re not telling the truth,” Livnat said.

The Israel Dental Association chairman, Dr. Yitzhak Chen, said he would hold meetings to explain the situation to dentists and solve the problem.

“Like anyone else, when a dentist doesn’t know enough, he may develop fears. Dentists don’t treat HIV carriers on a daily basis and we’ll have to familiarize them with treating patients with infectious diseases,” he said.

In January, Haaretz reported that the Israel Medical Association’s ethics committee balked at issuing across-the-board instructions to doctors to treat HIV carriers. A survey released in December 2012 among medical students showed a reluctance on their part to treat HIV carriers and patients.

In the wake of the angry reactions to the report, the ethics committee reconsidered and issued instructions to doctors to treat every patient, including HIV carriers.

Lior Mizrahi