Breaching confidentiality to protect others

Peter has attended the genito-urinary(GU) specialist clinic at his local central hospital due to recurrent infection and ulceration of GU tract. He is seen by Dr Ang who informs him that he is HIV positive. Dr Ang counsels Peter to contact his sexual partners to inform them of his status.

After the counseling, Peter starts a course of treatment.

For the last 18 months Peter has been in a relationship with Linda. They are expecting a baby in 2 months time. Before this relationship Peter had a series of sexual partners.

On a subsequent visit to the clinic it becomes clear to Dr Ang that Peter has not told Linda of his HIV status. Dr Ang is aware of the impending arrival of their baby and tells Peter that steps should be taken to assess whether Linda is HIV positive and whether the baby is at risk so that if necessary treatment may be started.

Peter adamantly refuses to tell Linda and says that if she is told without his consent then he will stop his course of treatment no matter the harmful unpredictable consequences Dr Ang told him already.

What should Dr Ang do? Can / should he inform Linda, or Peter’s GP about Peter’s HIV status?