Clinical ethics and HIV-related illnesses: issues in treatment and health services research.

Bernard Lo, M.D. is Associate Professor in the Divisions of General Internal Medicine and Medical Ethics, and is affiliated with the Center for AIDS Prevention Studies, and the Robert Wood Johnson Clinical Scholars Program, University of California at San Francisco. This work is supported in part by Center Grant MH42459 from the National Institutes of Mental Health and Drug Abuse, by Grant HS 05791 from the National Center for Health Services Research, and by The Robert Wood Johnson Foundation. The acquired immune deficiency syndrome (AIDS) epidemic has forced physicians and public officials to grapple with longstanding clinical and policy dilemmas (Mangione and Lo 1989; Walters 1988). The epidemic has dramatized perennial problems such as access to medical care, the cost of care, and the allocation of resources. While these dilemmas also occur with other diseases, the sudden harsh reality of the human immunodeficiency virus (HIV) epidemic has added even more urgency to the need for solutions. On other issues, AIDS has required a reevaluation of existing policies; for example, in decisions