Consent for HIV testing

Nurses Safety

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Specializes in Telemetry, ICU, Resource Pool, Dialysis.

One of my patients was almost tested for HIV without his knowledge or consent the other day. I can't find any laws in my state specific to requiring consent for HIV testing in a non-criminal patient. Does anybody know if there ARE laws requiring consent from a patient, and if they are state-specific. Other staff thought consent was only needed in the case of a needle-stick. Any thoughts or information? By the way, the patient was upset about almost being tested (I think he is in denial), but I think he had a right to know he was being tested for HIV, and a right to refuse (which he did).

I can't cite any particular law, but in the eyes of the courts, HIV testing is in a different realm than other medical information/testing. It is considered especially private. HIV testing is in a catagory by itself in the legal sense. Reason being the discrimination that can result in employment, getting insurance, etc.

Maybe he was upset because he knew the law and was frightened that his health care provider didn't (or maybe he was in denial).

Specializes in Maternal - Child Health.

I can't speak to the legal issues, but I am certain that every healthcare institution/organization has a policy and procedure regarding HIV testing. To test a patient without his knowledge and/or consent would likely be in violation of such a policy. Check your policy and procedure manual.

Why would a provider order an HIV test without discussing it with the patient? As with any medical condition, the patient has a right to know his (potential) diagnosis, along with any tests, procedures, medications, treatments, etc. that are being ordered. He also has the right to refuse, a right which is taken away by testing him without his knowledge. Talk about a breech of trust! I'd be ticked off, too!

Specializes in Telemetry, ICU, Resource Pool, Dialysis.

I'm upset about it, too. Actually, really angry. Nobody else seemed too concerned. The Dr was a psych Dr who is sometimes not very sympathetic towards her patients. She is convinced that his recent health problems (mainly a large weight loss in the last 6 months) are due to HIV. I'm willing to bet if he was a white, middle-class man testing would have been discussed with him. He's unemployed, mentally ill, and admits to drug use. I guess where I work this means he really doesn't have any rights. Some of his reluctance was due to financial issues, but I really think most of it was denial. I think she was irritated with him because he wouldn't admit to any risk behaviors.

Specializes in NICU, PICU, educator.

We have to have consent, even for a needle stick injury. If they won't give it for the stick, then we get a court order.

Specializes in 5 yrs OR, ASU Pre-Op 2 yr. ER.
We have to have consent, even for a needle stick injury. If they won't give it for the stick, then we get a court order.

Same here. It was like an act of Congress when i got stuck with a suture needle, to get blood from the pt.

Specializes in Emergency.

i believe in the instance of a needle stick of a health care worker that testing can be done without the patients specific consent. in fact at the hospital i currently work at our er and admission consent papers state that in the instance that this were to occur testing will take place without specific consent due to the urgency of needing to start antiviral meds ie less than 4 hours. i also know that this could be done in iowa and michigan as well if a ems/firefighter/police officer were exposed per state code.

heres iowa's law/rule:1. a. notwithstanding any provision of this chapter to the contrary, if a care provider sustains a significant exposure from an individual, the individual to whom the care provider was exposed is deemed to consent to a test to determine the presence of [color=white]hiv infection in that individual and is deemed to consent to notification of the care provider of the [color=white]hiv test results of the individual, upon submission of a significant exposure report by the care provider to the hospital or other person specified in this section to whom the individual is delivered by the care provider. the significant exposure report form may be incorporated into the iowa prehospital care report, the iowa prehospital advanced care report, or a similar report used by an ambulance, rescue, or first response service or law enforcement agency

rj:rolleyes:

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