Protecting the patient already died does not make any sense! - page 2

My patients was HIV+ and he died during a central line insertion... It is tragic...but that is another story. What upset me the most is....his future wife came to the unit and she is pregnant. We... Read More

  1. by   barbyann
    Good thread. I thought that deceased individuals had no rights. That is what I remember from school. Has this changed with Hipaa?

    A dead person can't sue you or the MD. The mother/baby could sue you if they feel information was held and it caused undo harm.

    Maybe I am wrong?
  2. by   sirI
    Quote from barbyann
    The mother/baby could sue you if they feel information was held and it caused undo harm.

    Right now, all attempts to litigate an HIV case and prove the physician had a duty to protect a third-party have been unsuccessful.

    There will need to be clear and concise laws created with defining limitations on the boundaries of liability in regards to HIV status reporting.
  3. by   suzanne4
    What the physian does or does not is not the question here, the issue is that the nurse is unable to share this information with anyone per the confidentiality document that is signed when you were hired. And HIPAA laws are still in place while that patient is in that facility, breathing or not breathing.

    Same way as if they were a "no information" patient. If they expire, it does not remove that clause. Same situation.

    Department of Health employees follow their protocol. Again they are under a different employer and different rules.
  4. by   justme1972
    Quote from suzanne4
    What the physian does or does not is not the question here, the issue is that the nurse is unable to share this information with anyone per the confidentiality document that is signed when you were hired. And HIPAA laws are still in place while that patient is in that facility, breathing or not breathing.

    Same way as if they were a "no information" patient. If they expire, it does not remove that clause. Same situation.

    Department of Health employees follow their protocol. Again they are under a different employer and different rules.
    Thanks for clarifying that Suzanne. I'm of course, looking at this thread as a layperson with zero training, but it's breaking my heart just thinking about it.

    What you are saying about a nurse not being able to say anything, that the channel has to be sent through the physicians...that makes sense to me as well.

    Now, with what Siri said, especially where all attempts to get the HIV+ patient to disclose status has failed...wouldn't a patient's death fall into that catagory?

    Very, very interesting thread, and a good one.
  5. by   TrudyRN
    HIV is awfully political. Don't trouble yourself about something that is bigger than you, except to fight it by contacting the legislators who make the laws. DO NOT RISK YOUR LIVELIHOOD OVER THIS.

    Furthermore, don't pregnant women get routinely tested for HIV? I'm not sure.
  6. by   SuesquatchRN
    Why do you assume the fiancee doesn't know he was positive? I'm sure she suspected something during his lengthy decline. And why do you assume that she is "totally innocent"? What, he's guilty of something?
  7. by   kmoonshine
    Pregnant women don't get routinely tested for HIV. It's an option, but it seems like very few women take advantage of it.

    I'd suggest getting your hospital ethics committee involved. They should be the ones handeling this situation so you don't feel burdened by it.

    Does your hospital offer employee assistance? If so, perhaps you could talk to someone about the inner turmoil you are going through.
  8. by   sirI
    Quote from trudyrn

    furthermore, don't pregnant women get routinely tested for hiv? i'm not sure.
    revised recommendations for hiv testing of adults, adolescents, and pregnant women in health-care settings (from the cdc):

    for pregnant women
    • hiv screening should be included in the routine panel of prenatal screening tests for all pregnant women.
    • hiv screening is recommended after the patient is notified that testing will be performed unless the patient declines (opt-out screening).
    • separate written consent for hiv testing should not be required; general consent for medical care should be considered sufficient to encompass consent for hiv testing.
    • repeat screening in the third trimester is recommended in certain jurisdictions with elevated rates of hiv infection among pregnant women.
    [color=#0b3d91]http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5514a1.htm
    [color=#0b3d91]
    [color=#0b3d91]
    from the aclu:

    http://www.aclu.org/hiv/testing/26819prs20060921.html
  9. by   Bluehair
    I have probably read too many novels in my lifetime. I can see all sorts of possibilities in the couple's history that may be unknown to anyone but them. Like maybe she got pregnant by someone else and he offered to 'make her an honorable woman' as they used to say. Or they knew about his HIV status and had invitro fertilization from an anonymous sperm donor trying to have a family in hopes of hubbies long term survival. Toooo many unknowns from the sounds of things. There is a system in place in most states for dealing with STD's, notifying partners, etc. I haven't seen anything in this thread yet that says whether or not the regulatory agencies are or are not involved? Your compassion and desire to help is so admirable! It's hard to let things go that grab at your heart strings when you just want to help.
  10. by   bigsyis
    No, according to the law you can't tell her. But what makes you think (or know) that she didn't already know? And, you OB nurses out there-isn't HIV something that preggo ladies are routinely tested for these days, as we were tested for syphylis and gonorrhea back in the 70's?
  11. by   ElvishDNP
    Most of our OB patients at our hospital are tested for HIV; it is strongly encouraged and most will get it, although a few decline it.

    I delivered my son at a different hospital a couple counties away & it was the same way. I got tested even though I don't have any risk factors (other than being a nurse, which I'm not convinced automatically makes you a higher risk).
  12. by   chuck1234
    Quote from Suesquatch
    Why do you assume the fiancee doesn't know he was positive? I'm sure she suspected something during his lengthy decline. And why do you assume that she is "totally innocent"? What, he's guilty of something?
    "Lengthy decline?"
    You were not there...why are you assuming that this is a lengthy decline!
    How many patients who are HIV+ and still look very normal.
    Remember that there was a case in Upstate New York...this guy looks very normal and he had sex with 21 girls...he knew he was HIV+...
    As a normal and fair person, don't you think you should think twice before having a baby...so...he is guilty...at least for not thinking twice...and no consideration for another human being...oh....it is two human being in this case...
  13. by   mamason
    Big ethical dilemma here. But, as someone mentioned before, there are laws concerning the disclosure of this info to protect the HIV positive person's partner. It is scary to think that his fiance is pregnant and there is the possiblity that she and her child have been exposed to HIV.
    Last edit by mamason on May 11, '07

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