anastamosis
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A 28-year-old male with a known history of bipolar disorder is admitted to the floor due to an acute manic episode. You are the senior resident on-call, and during your interview, he reports a weight loss of more then 30 lbs in the past three months, with associated fever and night sweats. He admits to having multiple sexual partners, and states he never uses protection. There is a strong suspicion for HIV, but the patient refuses to have his blood drawn for the test. With concerns about the potential risk to his sexual partners, which of the following is the most appropriate step at this point?
A. Go ahead and get the patient tested
B. Contact the hospital?s ethics committee
C. Obtain a court order to have the test done
D. Do not test the patient?s HIV status
E. Discuss with the attending and assess the patient?s competency to make a decision
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| kpmle2
Forum Elite
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? D. Do not test the patient?s HIV status
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| anastamosis
Forum Senior
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But wont that put his sexual partners at risk?
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| hero
Forum Elite
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# B,C E wrong by definition - your decision is tested.
Remains A and D - to test or not to test. For HIV testing concent needed. D.
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| anuba
Forum Elite
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D,
consent is needed for HIV testing
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| drduck
Forum Guru
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i go with D.......u just cannot force someone for any sort of procedure.
on asking if he predisposes many more people to contract HIV.
the answer is that if he has a girlfriend or wife with whom u know he is associated with unprotected sex...u have the right to inform the perticular person and discuss the whole scenario,
if after that she says she has no problem with that person u should also be least bothered.
but no way u can force someone for such or any kind of procedure.
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| BeeGees
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HEY FRIEND..
THE ANSWER HERE SHOULD BE "D"
BECOZ THE PATIENT IS 28 YRS OLD ADULT WHO IS LEGALLY BOUND TO GIVE GIVE CONSENT FOR HIS MEDICAL TESTS. EVEN A PREGNANT WOMAN WITH SUSPECTING HIV INFECTION WE CAN NOT PROCEED FOR TESTING WITHOUT HER CONSENT.
THERE IS EXCEPTION IN PSYCHI. EMERGENCY WHERE THE CONSENT DOESNT MATTER..BUT HERE ITS A KNOWN CASE OF BIPOLAR N ADMITTED ON FLOOR.
THERE IS ANOTHER EXCEPTION OF REPORTABLE ILLNESS .BUT FOR THAT HIV IS NOT IMP. AIDS MUST PRESENT. AND AGAIN IF THE INFECTION HAS INVOLVED ONE OF A HEALTH CARE PERSON THEN THE TEST SHOULD PERFORM WITHOUT CONSENT.
SO IN ABOVE TWO CASES DOC SHOULD GO AHEAD N PERFORM WITHOUT CONSENT.
OTHERWISE I WOULD LIKE TO GO FOR "D" WHICH IS NOT PERFORMING TEST
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| arlete
Intern in 2009!!!!!
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I think it's D.
I just want you to know that now a days testing for HIV is included in the general consent for treatment, so it's an opt-out test - the patient has to say he DOES NOT want it. Otherwise, go ahead and test, you are legally protected.
http://www.cdc.gov/hiv/topics/testing/CDC-respons...
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| Ivonne
Forum Guru
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Thanks for info Arlete it is clear that the answer is D.
No forced HIV testing if the patient refuses( opt-out test  ) to be tested. But we can encourage later right... maybe when the patient is in a different mood.
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| BeeGees
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thanks arlete for giving updated information..
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| arlete
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You're welcome.
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