4 hours ago The paper analyses some specificities of confidentiality keeping in HIV pandemia, the responsibilities of a physician concerning the third party and his duty to warn him/her. Special attention is paid to those cases, when the fact of HIV infection has to be reported upon the patient's death or when the disclosure of the confidential information ... >> Go To The Portal
Physicians must be cognizant of their patients' circumstances and the sensitivities surrounding the discussion of HIV disclosure. This means that they should know their patients well and follow the well-worn aphorism to treat the patient as an individual, rather than as simply a disease.
HIV-specific reporting regulations are in Article 3.5 Reporting of Human Immunodeficiency Virus (HIV) Infection. The Syringe Exchange Program regulations are in Subchapter 15. Syringe Exchange Program (SEP) Certification . Statutory Authority in HSC 131019, 131051, & 120960.
This guidance is intended for clinicians who diagnose persons with HIV infection, laboratories, HIV surveillance programs, and health department staff. Additional guidance for epidemiological analyses of HIV surveillance data are also listed.
However, if HIV-related information is readily disclosed by health care providers, individuals may become more reluctant to seek testing.
All 50 states and the District of Columbia require health-care providers to report new cases of acquired immunodeficiency syndrome (AIDS) to their state health departments. As of July 1989, 28 (56%) states also required reporting of persons infected with human immunodeficiency virus (HIV) (Figure 1).
ACUTE HIV INFECTION REPORTING Labs and health care providers may call (213) 351-8516 to report a case of acute HIV infection. California law (17 CCR §2505) requires laboratories to report positive tests for syphilis, gonorrhea, chlamydia trachomatis infections, including lymphogranuloma venereum.
Doctors generally need a patient's written consent to disclose HIV-related information to employers and others requiring medical forms. These consent requirements are in HIPAA and many state laws, including New York's.
An unsuccessful attempt to infect, or acting with “reckless disregard,” would be a class D felony. That is punishable by a maximum of five years in prison. A person who simply failed to disclose their HIV status could be charged with a misdemeanor.
Generally, physicians have a legal and ethical obligation of keeping confidentiality regarding their communications with patients. So, the most complicated ethical and legal questions arise when the HIV-infected person deliberately avoids to report to the interested individuals about the possibility of HIV transmission. The decisive factor, which emphasizes the need of such a discussion about confidentiality in HIV cases, is the character of the HIV: HIV is incurable, causes the danger of fatal outcome, discrimination etc. The aim of the paper is to explore the limits of confidentiality, as there is a duty to warn the third party about the danger of HIV transmission in that case on the part of the physician, even when the HIV-infected individual categorically refuses doing so. The paper analyses some specificities of confidentiality keeping in HIV pandemia, the responsibilities of a physician concerning the third party and his duty to warn him/her. Special attention is paid to those cases, when the fact of HIV infection has to be reported upon the patient's death or when the disclosure of the confidential information is connected with the possibility to start the post-exposure prophylactics. The paper presumes that confidentiality is not an absolute value, when there exists a real danger to the third party (e.g. a spouse, a care-taking relative, a victim).
The decisive factor, which emphasizes the need of such a discussion about confidentiality in HIV cases, is the character of the HIV: HIV is incurable, causes the danger of fatal outcome , discrimination etc. The aim of the paper is to explore the limits of confidentiality, as there is a duty to warn the third party about the danger ...
Some states also have laws that require clinic staff to notify a “third party” if they know that person has a significant risk for exposure to HIV from a patient the staff member knows is infected with HIV. This is called “duty to warn.”.
Your state health department will then remove all of your personal information (name, address, etc.) from your test results and send the information to the U.S. Centers for Disease Control and Prevention (CDC). CDC is the Federal agency responsible for tracking national public health trends.
The Ryan White HIV/AIDS Program requires that health departments receiving money from the Ryan White program show “good faith” efforts to notify the marriage partners of a patient with HIV.
Many states and some cities have partner-notification laws—meaning that, if you test positive for HIV, you (or your healthcare provider) may be legally obligated to tell your sex or needle-sharing partner (s).
The purpose of this report is to help public health agencies and others understand and interpret their responsibilities under the Privacy Rule.
HIV Diagnostic Tests LOINC Map#N#excel icon#N#[XLS – 254 KB]#N#To increase semantic interoperability for HIV laboratory reporting, the Division of HIV/AIDS Prevention, HIV Incidence and Case Surveillance Branch at CDC participated in a pilot project to develop a LOINC map for all FDA-approved HIV diagnostic tests. The standardized mapping was developed in coordination with Association of Public Health Laboratories, the Regenstrief Institute, Inc., and the Division of Laboratory Systems at CDC. The benefits of the LOINC map is in providing a concise document that defines LOINC codes for use with specific tests.#N#Intended Audience: Diagnostic laboratory personnel, public health surveillance personnel and in vitro diagnostic developers.
The personal view presented by Tak Kwong Chan and Li Ka Shing1 regarding breaching patient confidentiality to protect others at risk of HIV not only confuses personal morals with professional ethics but also presents a rather simplistic view of ethical decision making.
As Tak Kwong Chan writes, balancing the competing duties of maintaining privacy in a doctor-patient relationship with minimising potential harm caused by non-disclosure of HIV status is not always easy.
Chan's comments are useful but include nothing about the testing of any children Mr A,B,C or D have. Children have the right to be tested and treated whether or not their parents consent to their own treatment and testing. This is often not straightforward but cannot be ignored.
Tak Kwong Chan's makes some interesting points about patient confidentiality. The article highlights at present, there is no clear defining legal framework dealing with situation regarding the breach of confidentiality in UK.
Laws to determine the boundaries of liability and reporting in HIV and AIDS will have to be developed because, clearly, there are conflicting legal doctrines at work in the mandatory reporting case law that judges have made.
Patients may be debilitated and physically vulnerable and may be subject to significant insurance and social discrimination if HIV status is wrongfully disclosed. Physicians must be cognizant of their patients' circumstances and the sensitivities surrounding the discussion of HIV disclosure.
Public policy encourages high-risk groups to submit to HIV testing because those individuals who know they are HIV-positive are more likely to seek treatment and take precautions that may prevent transmission of the virus.
Partner notification is critical so that individuals know they are at risk, receive HIV counseling and testing, and get appropriate medical care. One of the most controversial issues is whether physicians may disclose the HIV status of their patients to known contacts and, further, whether failure to do so may give rise to liability if the known contact becomes HIV-positive. Though the threat of the contact is clear and immediate, individuals may be discouraged from undergoing testing if they know someone will notify contacts.
Legal protection of patient privacy and confidentiality depends on whether or not public health concerns outweigh the interest in preserving the doctor-patient privilege. The balancing of these interests is a particular challenge when it comes to privacy concerns associated with HIV status. A core legal dilemma in the case ...
A core legal dilemma in the case of HIV/AIDS is determining when the need to protect others, such as sex partners to whom the patient is likely to transmit HIV, supersedes the patient's right to confidentiality .
In code-based reporting, coded identifiers are substituted for names. Name-to-code-based reporting means that cases were initially reported by name, but were converted to code after public health follow-up and collection of epidemiologic data.
This page houses HIV-related laws, fact sheets, and legislative highlights by year.
All of Office of AIDS' regulations are in Title 17. Public Health, Division 1. State Department of Health Services, Chapter 4. Preventive Medical Services. All communicable disease reporting (including HIV) is in Chapter 4. Preventive Medical Service, Subchapter 1. Reportable Diseases and Conditions, Article 1. Reporting.
Hospitals also have 60 days within which to report "any information which reasonably appears to show that a physician is guilty of professional misconduct" as defined in New York Education Law §6530-31.
The Patient Health Information and Quality Improvement Act of 2000 6 introduced by Senate Health Committee Chairman Kemp Hannon and others, would tighten these reporting requirements by reducing from 60 days to 30 days the time within which hospitals have to conduct their investigations of incidents or to report physician problems.
These four cases are deeply troubling not only because patients died or were seriously harmed, but also because in each case, the New York State Health Department concluded that in addition to serious lapses in medical care, the hospitals involved violated legal requirements for reporting these incidents to the Health Department. In the Beth Israel case involving the mutilation of a patient by Dr. Allan Zarkin, the Health Department found that the hospital had been less than forthcoming, citing "a failure on the part of [Beth Israel's] administrators to appropriately report the seriousness of the incident once they became aware of it." 1 Specifically, the Health Department found that in reporting the incident:
The suspension, restriction, termination or curtailment of the training, employment, association or professional privileges of a doctor or resident for "reasons related in any way to alleged mental or physical impairment, incompetence , malpractice or misconduct, or impairment of patient safety or welfare.".
fires in the hospital which disrupt the provision of patient care services or cause harm to patients or staff; equipment malfunction during treatment or diagnosis of a patient which did or could have adversely affected a patient or hospital personnel; poisoning occurring within the hospital; strikes by hospital staff;
In the meantime, New York State's Commissioner of Health, Dr. Antonia C. Novello, has taken a hard line on hospitals' failures to protect patients and to abide by reporting requirements.
In the Beth Israel case involving the mutilation of a patient by Dr. Allan Zarkin, the Health Department found that the hospital had been less than forthcoming, citing "a failure on the part of [Beth Israel's] administrators to appropriately report the seriousness of the incident once they became aware of it.".
A health care provider’s “duty to warn” generally is derived from and defined by standards of ethical conduct and State laws and court decisions such as Tarasoff v. Regents of the University of California.
HIPAA permits a covered health care provider to notify a patient’s family members of a serious and imminent threat to the health or safety of the patient or others if those family members are in a position to lessen or avert the threat. Thus, to the extent that a provider determines that there is a serious and imminent threat ...
Thus, to the extent that a provider determines that there is a serious and imminent threat of a patient physically harming self or others, HIPAA would permit the provider to warn the appropriate person (s) of the threat, consistent with his or her professional ethical obligations and State law requirements.
Consequently, if the court were to open physicians up to negligence lawsuits filed by non-patients, it would open physicians up to liability for “anyone whom the patient may have sexual contact in the future, which theoretically, is an infinite number of potential victims,” the brief states. The brief goes on to ask: How long will ...
After a Connecticut physician tested a patient for sexually transmitted diseases, his office may have mistakenly informed the patient that the test results came back negative. The patient’s girlfriend claims her boyfriend—who was the patient—tested positive for herpes and later infected her with the disease.
While the doctor, Charles Cochran, MD, may have known the patient was planning to have a sexual relationship with a woman, he didn’t know who the woman was; physicians told the court through their brief.