This is a homework question

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    My homework question asks if your patient is engaging in intercourse with his wife but does not disclose to her he has HIV and she contracts is what is the legal consequence of the doctor and/or nurse? My thought is we are bound by confidentiality and therefore protected by it. However, morally I dont want that on my conscience. I know with homicidal patients there is a duty to warn with therapists and confidentiality is broken but does this carry over in medicine? He is braking the law with criminal transmission of HIV. Regardless of the lack of intent is there a consequence for us? I also polled a lawyer about this and havent heard back.

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  2. 12 Comments...

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    You can find the answer in your state public health department that monitors sexually transmitted diseases. Call them.
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    I remember having this question in nursing school and I believe we decided that in my state the answer is to call an ethics consult, strongly encourage the husband to tell the wife, refer to social work, etc. Basically use all resources but do not outright tell the wife.
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    If the HIV test is positive, the clinic or other testing site will report the results to the state health department. They do this so that public health officials can monitor what’s happening with the HIV epidemic in a particular city and state.

    The state health department will then remove all personal information (name, address, etc.) from test results and send the information to the U.S. Centers for Disease Control and Prevention (CDC). CDC is the Federal agency responsible for tracking national public health trends. CDC does not share this information with anyone else, including insurance companies.

    Many states and some cities have partner-notification laws—meaning that, if you test positive for HIV, you (or your healthcare provider) may be legally obligated to tell your sex or needle-sharing partner(s). In some states, if you are HIV-positive and don’t tell your partner(s), you can be charged with a crime. Some health departments require healthcare providers to report the name of your sex and needle-sharing partner(s) if they know that information—even if you refuse to report that information yourself.

    Some states also have laws that require clinic staff to notify a “third party” if they know that person has a significant risk for exposure to HIV from a patient the staff member knows is infected with HIV. This is called duty to warn. The Ryan White HIV/AIDS Program requires that health departments receiving money from the Ryan White program show “good faith” efforts to notify the marriage partners of a patient with HIV/AIDS.

    Have you checked your states requirements?
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    I have a friend of mine who is a lawyer and she gave me the statute number and citation for our state which essentially says the doctor can notify the spouse if efforts to convince the patient to do so on his own fails without any legal repercussions. I tried to go on the department of public health website but there is something with my computer that will not allow that website to work. I am not sure why it just says page can not be found.
    Last edit by bear14 on Oct 18, '13 : Reason: Grammer
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    So I just cited the law and referenced it. I didnt know if the law varied state from state or is it just a blanketed law. Thank you again for all your help I really appreciate it!
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    It varies state to state and cities with in certain states....here is a PDF hhs document.....http://oig.hhs.gov/oei/reports/oei-05-98-00391.pdf

    do you mind if I ask what state?
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    I did counseling at a HIV/STD clinic for men and one of my patients came in who was tested for HIV and never told his wife that he was sleeping with men. I encouraged him to talk to his wife and disclose his status, but, he did not want to. So, I couldn't force him even though it made me disgusted.
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    Quote from StephenAndrews
    I did counseling at a HIV/STD clinic for men and one of my patients came in who was tested for HIV and never told his wife that he was sleeping with men. I encouraged him to talk to his wife and disclose his status, but, he did not want to. So, I couldn't force him even though it made me disgusted.
    But in some stated and cities you are required by law as a mandated reporter to inform partners. It's called the Ryan White care act.

    Go to page 34 for states summaries ........http://oig.hhs.gov/oei/reports/oei-05-98-00391.pdf
    KelRN215 likes this.
  11. 1
    Quote from Esme12
    But in some stated and cities you are required by law as a mandated reporter to inform partners. It's called the Ryan White care act.

    Go to page 34 for states summaries ........http://oig.hhs.gov/oei/reports/oei-05-98-00391.pdf
    This is different than health professionals' obligations but I saw a 20/20 (or something similar) special a few years back about this man who knowingly infected several women with HIV. He was charged with assault/battery with a deadly weapon and is serving a 45 year prison sentence currently:

    http://abcnews.go.com/2020/hiv-crimi...ory?id=8579258
    Esme12 likes this.


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