True Ethical Dilemma

I often come across things in my line of work that don't sit right with me or I don't agree with what a patient chooses to do with their life but it is their choice so I deal with it. This week I came across a dilemma that had me in pieces.

I have a patient that has AIDS. She is in full blown AIDS for about a year. She is currently living with a "friend" that doesn't know that she has the disease. I asked her if they were having sex. She said no and gave me a long explanation as to how they were just friends. Then I was talking to the nurse who told me she had reason to believe otherwise. So what do you do?

My first thought was this man needs to be informed. My second thought was I can't tell him because I am bound by patient confidentiality. I talked about it with supervisors at work who decided we need to find out legally what we can do. The answer is NOTHING. According to the Health Dept. STD Clinic there is not one thing we can do. If she had Syphilis we have a duty to report and someone goes out and checks on the situation and takes proper action, but with AIDS there is no governing body that says we can't do a darn thing. Why lobbyist for AIDS patients wants complete confidentiality for their patients even at the risk of someone else's.

A side bar: Did You Know: If a patient doesn't want hospital staff to know they have AIDS or HIV it can be removed as a diagnosis from their records. So hospital staff is not even properly protected, or properly treating for that matter. Now hospital staff should always take proper precautions but we all know some don't.

What it all comes down to is I know a man that has cancer and a compromised immune system and now possibly has AIDS because a woman was more concerned about how he viewed her than what was safe for everyone.

AIDS is on the rise in Cincinnati according to AVOC. We as a community need to continue to education about STD's and the effects on someone's life and eventual death in some cases. My personal dilemma is that I know she could be killing him and there is nothing I can do about it. It goes against every grain of my being, but somehow I need to reconcile it in my own mind.


Babs said...

It really sounds like you're between a rock and a hard place. I found this article that isn't really helpful, but does say a doctor can disclose on two conditions...


Hope that helps a little :) Babs

Liz said...

wow. i dont even know what to say to that. that's really intense. is the AIDS confidentiality like this in every state or is it just a state to state basis? Why would they reveal syphilis patients but not AIDS/HIV? It doesnt make sense.. they both kill people.