Part 2
Dr Jegede listens to Fara, explaining that he can see her distress and takes her concerns seriously. He asks her to think carefully about the benefits of agreeing to testing Amina, stressing that the earlier doctors make an HIV diagnosis, the more options they have for treatment and the better the prognosis is. He reminds her that treatment for HIV infection can be extremely effective.
Dr Jegede also describes the risks of not testing Amina, stressing that it is possible that she is infected with HIV even though she is healthy now. He tells Fara that if Amina is infected and is not treated, she is likely to become very ill at some point in the future and could eventually die as a result.
Fara remains reluctant to consent to tests, pointing out that it would be difficult to explain them to Amina without frightening her. Dr Jegede describes to Fara how this could be done sensitively and honestly without alarming Amina. He also stresses that he and the healthcare team have a duty of confidentiality to both Fara and Amina, and emphasises that any test results would remain completely confidential and private. He tries to make sure that Fara understands he has a duty of care to Amina, as well as to her, and that he has to consider Amina’s welfare.
Although Dr Jegede spends some time trying to persuade Fara that it is in Amina’s best interests for her to have the tests, he can’t change her mind. Dr Jegede is concerned about Amina’s welfare, but is also conscious of the risk of Fara disengaging from her own treatment if he applies further pressure. He is worried that this could result in a worse situation for both Fara and Amina and is unsure about how best to act on his concerns.
What should Dr Jegede do?
- Should he share information with child protection agencies about Amina straight away?
- Should he seek advice from a named or designated doctor for child protection, or an experienced colleague?
In paragraph 1(h) of Protecting children and young people: the responsibilities of all doctors, we say that if doctors are not sure about whether a child or young person is at risk or how best to act on their concerns, they should ask a named or designated professional or a lead clinician or, if they are not available, an experienced colleague for advice. We say in paragraph 43 that, if possible, they should do this without revealing the identity of the child or young person.