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  #1  
Old 12-05-2011
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Medicolegal and Ethics HIV Patient refuses to tell wife!

A 30-year old male patient is recently diagnosed with HIV. He lives with his wife and two other children but is promiscuous. He requested the physician not to tell his wife. He lost his job recently. Physician advises to tell the diagnosis to wife and sexual partners but patient refuses. What is the best option

a. tell the wife directly
b. tell the patient his information would be made public
c. Inform the health authorities
d. Inform the police about the danger of this man spreading disease in community
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  #2  
Old 12-05-2011
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Is it inform the health authorities???????????
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  #3  
Old 12-05-2011
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Tell the wife directly.

When there is threat to harm,then break the confidentiality.
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  #4  
Old 12-06-2011
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It is to inform the wife directly CORRECT ANSWER
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Old 12-06-2011
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The best answer is always, to follow the law, and do good medicine,

the best answer should be, arrange to have the wife and pt in the office and inform the wife. But in this case, telling the wife is the way to go.
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Old 12-06-2011
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Default Up to individual physician

Both A) and C) are correct.
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Old 12-06-2011
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Quote:
Originally Posted by bengggggg View Post
Both A) and C) are correct.
I think A and C both are correct .. However, telling only the wife is not gomma prevent him from spreading the virus in the community
So I would go with C ...
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Old 12-06-2011
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Yes, you are right. The alternative would be to contact the wife and all the other sexually partners directly, but that's not a given option here.
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Old 12-06-2011
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Quote:
Originally Posted by AMIODARONE View Post
I think A and C both are correct .. However, telling only the wife is not gomma prevent him from spreading the virus in the community
So I would go with C ...
I would go with A,
rules about reporting HIV vary by state; only some infections like hepA and B, salmonella, Rubella,.... are reportable in all states. (AIDS is in the second group although HIV is not !))) so choice C is unlikely to be the answer I guess.
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Old 12-06-2011
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I looked it up in Fischer's Ethics book (chapter on HIV issues):

"The method of notification follows the steps of first counseling a patient to notify his partners voluntarily. [...] If the patient is either emotionally unable or unwilling to notify their partners the next step is to notify the Department of Health to start the process of contact tracing. [...]
[...] If a patient will not notify his partners and you have a certain knowledge pf the partner at risk, you have legal immunity to carry out the notification yourself."

The problem in this case is that we do not know the sexual partners of this individual except for his wife. So contacting the Health Department for contact tracing (they will interview the individual and then sent out letters) is better in this case since you will have a higher likelihood to contact all potentially infected individuals.

Note that Fischer does not say either Department of Health of notify yourself. If there was only one sexual partner, neither option would be better.
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  #11  
Old 12-06-2011
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Quote:
Originally Posted by poorya View Post
I would go with A,
rules about reporting HIV vary by state; only some infections like hepA and B, salmonella, Rubella,.... are reportable in all states. (AIDS is in the second group although HIV is not !))) so choice C is unlikely to be the answer I guess.
The reportable diseases you are talking do not necessarily mean that you breach their confidentiality by reporting their name. You can only do that if someone else's life is at risk.
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Old 12-06-2011
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Default C

there is an issue here promiscuity, plus its a reportable disease (though varies acc to state ) but we have to protect here by reporting to local health authorities .. definitely C
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C will not help in this case as the patients personal information are not divulged when reporting a case. So the answer is still A
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Informing the wife has to be done first and then if the patient is promiscuous contact tracing ca be done
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Old 12-06-2011
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in my hospital we did this
c. Inform the health authorities then health authorities tell the family and wife

from where this q can i ask ???/
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  #16  
Old 12-06-2011
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Kaplan PLS
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Old 12-07-2011
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Quote:
Originally Posted by indigo View Post
A 30-year old male patient is recently diagnosed with HIV. He lives with his wife and two other children but is promiscuous. He requested the physician not to tell his wife. He lost his job recently. Physician advises to tell the diagnosis to wife and sexual partners but patient refuses. What is the best option

a. tell the wife directly
b. tell the patient his information would be made public
c. Inform the health authorities
d. Inform the police about the danger of this man spreading disease in community
tell the wife directly......
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  #18  
Old 12-07-2011
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Quote:
Originally Posted by miss patho View Post
in my hospital we did this
c. Inform the health authorities then health authorities tell the family and wife

from where this q can i ask ???/
well my expression was answer is C . .
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