Working with doctors Working for patients

 

Introduction

Dr Peters' first patient is Adrian, a 27 year old man who has come for the results of some tests. Adrian's partner, Maria, also attends the same clinic, although Adrian does not know this. Last week Dr Peters confirmed to Maria her suspicion that she is HIV positive.

Dr Peters

Dr Peters

Well, Adrian, the test results all came back negative, so everything's fine there, no concerns.

Adrian

Adrian

Thank goodness for that! I never thought there would be a problem of course, but it's still a bit nerve-wracking getting test results...phew, what a relief!

Dr Peters

Dr Peters

But of course you should still continue to practise safe sex. You're using condoms at the moment aren't you?

Adrian

Adrian

Yes that's right. But...actually doctor can I tell you something? I'm going to see if I can persuade my girlfriend to start trying for a baby! I'm one of five myself and really keen to start a family as soon as I can.

Dr Peters

Dr Peters

I see...does your girlfriend mean to have these tests done as well? Many couples decide to have them done, just to make sure everything's okay, before trying for children.

Adrian

Adrian

Yes, absolutely. In fact, Maria already had some tests done as she's been thinking of binning the condoms and going on the pill. Her results came back last week and everything's fine. So all I need to do now is convince her not to go on the pill but to try for a baby instead.

What should the doctor do...? (Select A,B or C)

A

Tell Adrian that Maria is HIV positive because he has a right to know he is at risk of infection?

B

Call Maria and try to persuade her to tell Adrian the truth about her test results?

C

Do not tell Adrian because it is Maria's confidential medical information and he has no right to know?

Dr Peters

See what the doctor did

Dr Peters did not disclose anything to Adrian immediately, but instead called Maria as soon as Adrian left the clinic, and tried to persuade her to tell him herself. He also said that he would consider telling Adrian directly if she chose not to and Adrian remained at risk of infection.

Maria was very angry that Dr Peters was considering breaching her confidentiality. Dr Peters explained that she had a responsibility to tell him she was HIV positive if they were going to have unprotected sex, though he did not disclose what Adrian had told him about wanting to try for a baby.

Although Maria was still reluctant to talk to Adrian, she agreed to come to the surgery the next day to speak to Dr Peters about it in more detail. Dr Peters resolved that, if he could not persuade Maria to tell Adrian - or if she failed to show for the appointment - he would disclose information to Adrian without Maria's consent.

References

You may disclose information to a known sexual contact of a patient with a sexually transmitted serious communicable disease if you have reason to think that they are at risk of infection and that the patient has not informed them and cannot be persuaded to do so. In such circumstances, you should tell the patient before you make the disclosure, if it is practicable and safe to do so. You must be prepared to justify a decision to disclose personal information without consent.

(Confidentiality: disclosing information about serious communicable diseases, paragraphs 13-15)