Legal and ethical issues in healthcare

Kimberly Ann Bergalis

Q1. Should it be mandated that HIV-positive healthcare professionals inform their patients of their status?

According to Department of Health Guidelines (2005), exposure risk from HIV-infected providers is highly limited to select situations, where there is the risk of so-called bleed-back. However, HIV-infected personnel have an ethical responsibility to make patient health a priority (Health Care Workers, 2005). It should be noted that an ethical responsibility differs from a legal responsibility to inform patients. There are also many instances where such information would not be necessary. This may include physical and occupational therapy, routine examinations, and other common healthcare procedures which have no risk of HIV.

If it was required to fully inform patients before every single procedure, even those without risk, this would create unnecessary stigma upon healthcare providers with HIV and also, very likely, stigma against LGBT+ providers, given the association in America between HIV and gay men. Also, it might encourage patients to make decisions about their care not really grounded in medical science, for example, not seeing the best provider for their condition because he or she was HIV.

Finally, it should be noted that there are also risks for transmitting hepatitis C and other infections in healthcare settings that are in fact higher than HIV, which occur during similar high-risk blood-borne procedures (Health Care Workers, 2005). Individuals with HIV should not be unfairly stigmatized, and certainly not more so than those with other illnesses. While patients have a right not to be infected, it is important not to make HIV providers feel stigmatized in particular.

Q2. What can be done to prevent exposure of HIV and other infectious diseases in a healthcare setting?

As noted previously there can be a great deal done to protect patients. Healthcare settings can encourage providers to be candid about their HIV status so proper precautions can be taken, such as ensuring providers do not undertake procedures which can put patients at risk. It is also important to encourage patients to disclose their HIV status in a nonjudgmental and open fashion, so providers will not be exposed (Health Care Workers, 2005). Using goggles and protective gear when there is a risk of blood exposure, washing hands after performing blood-based procedures, taking care to avoid being pierced by sharp instruments during procedures, and disposing of or securing all sharp equipment should be routine standard operating practices (HIV and occupational exposure, 2019).

Q3. What should the consequences be if an HIV-positive healthcare professional infected his or her patients today?