Ethical ? about AIDS....

Liddle Noodnik · Mar 23, 2008

There is a patient in my unit that is dying of full-blown AIDS (PCP). His wife who lives in Mexico is completely unaware. The doctors are not telling the wife what the problem is. They just say he has pnemonia. Is this right? I know it may be considered a HIPPA violation, but isnt HIV/AIDS status reportable to ALL partners...especially the wife? What if she was infected by him before he came to the States and is sick? How can we control this virus if we won't notify people who have come in sexual contact with infected individuals?

That is just incredible that they won't - for her sake and for others in contact w/ her blood if it is infected!!!

I thought it was required to be reported too. I would ask your local STD clinic about the law (anonymously) and then figure out what to do. I am just stunned at this!

elkpark · Mar 23, 2008

It is a HIPAA violation for the treatment team to tell family members without the specific consent of the client.

In my state (and, I believe, most states), HIV/AIDS is a reportable disease, but that means it's reportable to the local public health authority -- and they do the investigation and whatever notification of partners is legally warranted, not the treating clinicians. It is not the responsibility (nor the right) of the front-line clinicians to start telling people about someone's HIV status.

Liddle Noodnik · Mar 23, 2008

It is a HIPAA violation for the treatment team to tell family members without the specific consent of the client.
In my state (and, I believe, most states), HIV/AIDS is a reportable disease, but that means it's reportable to the local public health authority -- and they do the investigation and whatever notification of partners is legally warranted, not the treating clinicians. It is not the responsibility (nor the right) of the front-line clinicians to start telling people about someone's HIV status.

Thank you. So it's a REQUIREMENT that it's reported to public health authorities?

So - I wonder if this has been done.

Personally, I'd rather hear it from a husband/wife (or his dr w/ permission) than from a public health authority. Also I would think by the time they got hold of her it would be many more days. Potentially more cases of HIV/AIDS, WE don't know the situation. Too sad. But - I do understand pts have a right to privacy while seeking treatment.

:no: AIDS stinks no matter how you slice it

Nacki, MSN, NP · Mar 23, 2008

I forgot to mention this pt is intubated and on dialysis on a daily basis. He's that sick. If my loved one was on the vent dying of "pnemonia" at the age of 47 I would start to think something else was going on.

So because of the fact he is vent dependant...no one will ever know???

morte, LPN, LVN · Mar 23, 2008

Hipaa, HipAa, Tmi , Tmi

Editorial Team / Admin · Mar 23, 2008

In most states, the HCP is required to counsel and encourage the individual to contact partners.

Now, in this instance, since the wife is not in this country, I haven't a clue how this would play out.

So, if this comatose and dying patient never told his wife, it is quite possible she will never know.

Here is a very lengthy and verbose PDF of Texas law re: HIV/AIDS. TX has a "benefits of partner notification and partner notification program":

http://www.ucsf.edu/hivcntr/StateLaws/50%20States%20Laws/02262008/Texas%202008.pdf

Nacki, MSN, NP · Mar 23, 2008

I don't think so...I've heard of a few cases like this, where the pt gets sick and no one tells the family the truth. Just b/c the pt has HIV or AIDS it shouldn't be taboo to speak about. This is something we all need to be aware of. What if your wife or husband was infected and too sick to tell you (intubated, ect)? wouldn't you like to know??? I havent given you a name, hospital name, location or a SSN or my name for that matter! Tell me how you would know who this person is with the millions of people infected and dying of AIDS everyday regardless of race, color, age, gender...

SEOBowhntr · Mar 24, 2008

i don't think so...i've heard of a few cases like this, where the pt gets sick and no one tells the family the truth. just b/c the pt has hiv or aids it shouldn't be taboo to speak about. this is something we all need to be aware of. what if your wife or husband was infected and too sick to tell you (intubated, ect)? wouldn't you like to know??? i havent given you a name, hospital name, location or a ssn or my name for that matter! tell me how you would know who this person is with the millions of people infected and dying of aids everyday regardless of race, color, age, gender...

cutie,

check out the bullets of the link siri gave you, there is a requirement for notifying partners...

notification to partners of a possible exposure to hiv is required.

there is some more definitive answers on pg. 21-23 of the document.

good info siri, thanks!!!

elkpark · Mar 24, 2008

Cutie,
Check out the bullets of the link Siri gave you, there is a requirement for notifying partners...
There is some more definitive answers on pg. 21-23 of the document.
Good info Siri, thanks!!!

Yes, and the document specifies that that notification is to be done by an employee of a partner notification program. That would be a division of the public health authority, not the hospital staff. Farther down in the document, it talks about the civil liability for disclosing the results of HIV testing (to anyone) if you are not authorized to do it, and the rules specify that you cannot claim any kind of privilege to avoid liability for disclosing -- clearly, the state does not want people, including healthcare providers, running around willy-nilly disclosing people's HIV status because they think it's the right thing to do ...

Thanks, sirI.

Editorial Team / Admin · Mar 24, 2008

yes, and the document specifies that that notification is to be done by an employee of a partner notification program. that would be a division of the public health authority, not the hospital staff.

exactly.

Nacki, MSN, NP · Mar 25, 2008

This whole situation is sad. I don't know if the proper authorities have been notified and if this poor woman has been made aware finally...