As health workers we are not allowed to reveal any medical information about a patients or their circumstances without their written permission. This confidentiality is sacred. But in some cases, that constraint felt inappropriate and irresponsible. What if the disease is HIV/AIDS? “CONFIDENTIALITY “ has been the trademark of this particular ailment. You see, some concepts are imposed on us and thinking otherwise will be suicidal. My 2 years stint in Namibia (a country where prevalence of the disease is more than 35% in some regions) has shown me how we can live in denial or is it sense of grandiose at the expense of human suffering. Its not uncommon to see “discordant couples” (where 1 partner is positive while the other is negative). “Exposing” the status to his/her partner is a crime punishable by the law. Example 1..Its very personal, it touched me. A 23 years old girl succumbed to HIV/AIDS under my care. Her mother asked me which disease killed her young daughter. I thought they knew. After beating around the bush, I dropped the bombshell. “why wasnt I told all along while I wash cleaning her secretions and excretions?” That question haunts me! Example 2.. A HIV positive patient urgently wanted to know her viral load — which would tell her the amount of HIV in her bloodstream. She had a new boyfriend and had decided that if the amount of virus in her blood was low and was controlled by her medication, she would not disclose her status until they were married. For the first time, I realized that our incredible achievements in reducing HIV infections could be undermined by the fact that good treatment may make people feel less responsible for disclosing their status. Are we (health workers) somehow complicit in perpetuating the dishonesty? Yes, we are!..By mystify it, we instilling more fear in the already edgy public causing panic, thus stigma. Why will thousands be infected at the expense of a single patient? Because of confidentiality?? I cringe when I see a HIV positive patient with negative partner (who doesnt know the status of his/her partner)..If health-care providers and patients viewed and handled the disease like the manageable and treatable condition it is, we could chip away at the negative perceptions associated with the virus, like we have done with cancer, tuberculosis and syphilis.. This ethical dilemma looms large in medical practices across the world. Since we can’t destroy the sacred patient-provider confidentiality, we encourage patients to tell their partners about their HIV status and to use condoms, some dont . The next patient comes in, and the cycle repeats.
Posted on: Fri, 25 Oct 2013 17:29:06 +0000
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