Medical vectors: Surgical HIV transmission and the location of culpability

Abstract

This paper investigates the first documented case of non-transfusion-related surgical HIV transmission in a developed country, Australia. In 1989, four women were infected with HIV as a result of surgical procedures in a private clinic. A subsequent medical tribunal failed to establish medical negligence or a failure of infection control procedures on the part of the surgeon. We use this case to interrogate some of the assumptions about human culpability that feature in both HIV epidemiology and criminal law approaches to HIV transmission. We argue that these models for explaining viral spread overestimate the role of human agency and underestimate the importance of anonymous, contingent, material relations between viruses, bodies, and technologies. We suggest that the medical tribunal model, with its implicit recognition of viral agency and the impossibility of eliminating risk, offers an alternative model of justice to the criminal justice system, with its exclusive focus on human agency.