oddissy4u
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A 22-year-old woman is admitted to the hospital with a headache, stiff neck and photophobia but an intact mental status. Lab test reveal cryptococcal meningitis, an infection commonly associated with HIV infection. When given the diagnosis, she adamantly refuses to be tested for HIV.
Should she be tested anyway by the medical staff?
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| dravedon
Forum Senior
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Doctors can identify HIV-positive patients to those they put at imminent risk,for example they could test her for HIV if she has a sexual partner or they believe she can harm someone by not telling.
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| jamdoc
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no,she cannot be tested without her consent
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| fox
Forum Guru
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she cant be tested without her consent, but at the same time cryptococcal meningitis becomes an AIDS defining condition & needs to be reported I guess. Can we report without testing for HIV? This is a tricky one.
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| dreamer
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kaplan always says pt is no 1 . since she is not killing herself or others, drs should respect her choice?
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| fox
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But wont the state screw u for not reporting a reportable disease?
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| MRMAVERICK
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i think she shudnt be tested as she refuses to consent
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| cutelildoc
Forum Newbie
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even though our suspicion for HIV is veryu strong, we cant test her against her will.
also if we dont test we cant confirm if she actually hav HIV. we can only report if we know for sure its hiv.
so baically dont test and report only if she allows the test and it comes positive
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| sukhs
Forum Senior
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i read in fadem yeSterday dat
if the patient denies to b tested against hiv,
but the doc is sure that the patient has hiv(as in this case,cryptoc meningititis as an aids defining condition) and in case the patient poses a risk to the medical staff (like e.g.any needle stick injury& all) THEN THE PATIENT CAN B TESTED WITHOUT HER CONSENT,,,,,,ALL OTHER CASES,WITHOUT HER CONSENT....NO
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| Ig F
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sukhs u r rite....
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| usmle4me
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I think she should not be tested against her contest.
But in case there has been a case of needle stick and she is a suspected case of HIV then she can be tested against her will as some other person is already on risk and depends on her test result!
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| tompat
Forum Elite
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i think she shud not be tested.
the threat to other medical staff of contracting hiv thru needle stick injury is not avalid reason as ur supposed to take universal precautions no matter with whom ur dealing this way u will avoid contracting hiv even from undiagnosed pt.
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| vwilldoit
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I think she should be tested for HIV as she can be a threat to her close contacts!
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| rock
Forum Elite
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i wasn't sure of the answer myself....just talked to one of the doctors i work with...he said the patient cannot be tested...we will counsel the patient and let her know why it is important to test her for HIV...i think we can also tell her that with current treatments she can still live a nice life even if she has HIV and so it is imp to test her to give her treatment if she needs it....but if the patient still says no then we cannot test her !!
well what about the infectious diseases rule in ethics...the one where we can treat the patient against his consent for an infectious disease if he is a treat to spread of infection to others ???
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