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06-11-2003, 09:31 AM
question
If a pt. is found to be HIV positive and the doctor know he /she is sexually active, should the physician contact the other partener and inform him/her? similarly for pt. who has AIDS, GONORRHOEA, HEPATITIS B, HEPATITIS C?
06-11-2003, 11:49 AM
CC
Yes-this is one of the exceptions to confidentiality we have to know. Physicians are required by law to warn the CDC and private parties at specific risk for certain infectious diseases. The reportable ones off the top of my head definitely include HIV/AIDS, all the hepatitises, anything suspected to be bioterrorism-related, Measles, Lyme Dz, Legionairre's, Tuberculosis, Smallpox... but then there are a long list of oddballs like Plague and even rarer things. For private parties such as a known sex partner, if the pt refuses to inform them directly, you still have a duty to inform the 3rd party, similar to the Tarasoff law which allows for breach of confidentiality when potential threat of homocide/abuse is significant.
06-11-2003, 11:51 AM
CC
just wanted to clarify my last response... the diseases I listed are reportable to the CDC. For the 3rd party (sex partner), only STDs are applicable.
06-11-2003, 12:23 PM
RAM
So if some one has HIV and if some one has AIDS it is ---not-- to be informed to the sex partner?
06-11-2003, 01:36 PM
CC
No, other way around. The dr is obligated to inform the sex partner if the pt refuses to.
06-11-2003, 04:36 PM
Nyfmg
In such situations there is a simple solution. If by keeping quiet...you might harm the sex partner or by informing the sex partner you may be able to save the sex partner, then you as a physician are morally obligated to do so. But the patient should be given a choice to do so if he/she wishes, which would be the best choice.
06-11-2003, 04:49 PM
CC
Nyfmg-- True, in a real life sense, but as an ethics question, they won't give that option; the scenario given usually (i.e. in Kaplan) is a necessity to breach dr-pt confidentiality in this case. It isn't just a moral issue, it actually is quite clear legally a la the Tarasoff law. |
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