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HIV Patient
Discussion in 'All Categories' started by Dr Peter Sangasten - Jun 22nd, 2014 3:27 pm.
Dr Peter Sangasten
Dr Peter Sangasten
One of my patient came for laparoscopic Cholecystectomy. When I did all the preoperative investigation, patient was found to be HIV positive. I discussed with the patient and patient said not to discuss this issue with his wife and other family member. I asked my patient that I need to buy disposible laparoscopic instrument if he want to get laparoscopic cholecystectomy performed. He was ready to buy disposable laparoscopic instrument so I did is Lap Chole Surgery. Everything was fine until he developed little sinus in his umbilicus. After seeing pus coming from umbilicus now I started some HIV medication. Now the wound is fine and he dont have any problem. But his wife has doubt about the medicine which I have prescribed. She is asking me that what is the problem with mu husband? Is he suffering from HIV. I did not say her anything. Now she is asking on phone repeatedly about the fact. please tell me ethically what should I do. Should tell the wife of the patient fact or should I keep the professional secrecy of my patient. Please help.
re: HIV Patient by ADITYA RAJESHWAR - Jun 23rd, 2014 8:11 pm
Dear Peter Sangasten ,

HIV/AIDS is a very serious disease, And its impact over the social and economic condition of the patient is even more serious. I can understand your dilemma about either to reveal your knowledge about his infection to his spouse or not.

Many countries in world have issued guidelines over the privacy issue regarding HIV infected person. It is the duty of a doctor, not to disclose the information of the patient being HIV positive to any group or individual without the consent of the patient.

Informing sexual partners is an extremely complicated issue, and depends on whether a legal or an ethical view is taken on the issue. Consideration should be given to the following in this regard,
1) During pre or post HIV test counselling patient should be told the need to disclose the information to their partner (spouse), and how they should protect their partner.

2) Patient should be persuaded to consent to disclosure or to self disclosure.

3) Patient should be encouraged towards his responsibilities to prevent others from being infected, and also about possible penal action against him in case of his irresponsible conduct.

4)If patient is not willing, then medical practitioner may offer to speak to both the parties, with the consent of patient. As a matter of health care to him and his partner

5) If patient still unwilling, then medical practitioner may choose to disclose the fact , If
(a) Sexual partner is a known person
(b) Such partner is at the risk of being infected,
and patient has refused to take necessary

Two precautions must be taken by medical practitioner before disclosing the fact to the partner, firstly you must be prepared that you may be required by the court to show that you was acting on substantial information not merely on suspicion. Secondly, patient should be informed beforehand or should be allowed to disclose it himself within a time specified.

With Regards

re: HIV Patient by Dr R K Mishra - Jun 23rd, 2014 9:40 pm
Dr R K Mishra
Dr R K Mishra
Very nice advice by our medicolegal expert Mr. Aditya Rajeshwar
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