Parent refuses consent – part four

Background

Fara was infected with HIV over ten years ago but received HIV treatment only sporadically during this period. Since arriving in the UK, she has started regular treatment.

Fara has been seeing Dr Jegede, a HIV specialist, at her local hospital. She has confided in him that she is very uncomfortable about people knowing she has HIV.

Fara has a daughter called Amina. Amina was conceived after Fara contracted HIV. Fara is very reluctant for Amina to be tested for HIV.

Scenario

Dr Jegede has waited for twelve months but Fara still refuses to give consent for Amina to be tested. 

Fara is still very resistant to the idea of involving other people in Amina's care. She refuses to give consent to Dr Jegede to share information with the multidisciplinary team.

Dr Jegede is considering involving a multidisciplinary team. He thinks that the benefits to Amina of sharing information outweigh the benefits of keeping information confidential. 

What the doctor did

Dr Jegede decides it is in the public interest to proceed without consent. He explains his reasons for doing so to Fara.

The multi-disciplinary team begins to monitor Amina's care and shortly afterwards Fara starts to access peer support services. Over a period of time, with the ongoing help and support of Dr Jegede and his team, and her peer support group, Fara begins to accept her diagnosis. She agrees to have Amina tested for HIV three months later.

What the doctor had to consider

• Doctors are able to share confidential information without consent if it is required by law, or directed by a court, or if the benefits to a child or young person that will arise from sharing the information outweigh both the public and the individual’s interest in keeping the information confidential (paragraph 36 of Protecting children and young people: the responsibilities of all doctors) 

• Doctors must weigh the harm that is likely to arise from not sharing the information against the possible harm, both to the person and to the overall trust between doctors and patients of all ages, arising from releasing that information.

• If doctors share information without consent, they should explain why they have done so to the people the information relates to (paragraph 38)

• Doctors should explain what information they have shared, who it has been shared with, how the information will be used and provide information about where they can go for advice and support (paragraphs 35 and 38)