Cold comfort for healthcare workers? Medico-ethical dilemmas facing a healthcare worker after occupational exposure to HIV

Following exposure to the human immunodeficiency virus (HIV) it is advisable for the healthcare worker (HCW) to take postexposure prophylaxis. A prerequisite for this is the establishment of the HIV status of the HCW and the patient. Ordinarily, this would be preceded by the ascertainment of the HIV...

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Main Authors: T.E. Madiba, C.L. Jack, Y.A. Vawda
Format: Article
Language:English
Published: AOSIS 2011-12-01
Series:South African Family Practice
Subjects:
Online Access:https://safpj.co.za/index.php/safpj/article/view/2264
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author T.E. Madiba
C.L. Jack
Y.A. Vawda
author_facet T.E. Madiba
C.L. Jack
Y.A. Vawda
author_sort T.E. Madiba
collection DOAJ
description Following exposure to the human immunodeficiency virus (HIV) it is advisable for the healthcare worker (HCW) to take postexposure prophylaxis. A prerequisite for this is the establishment of the HIV status of the HCW and the patient. Ordinarily, this would be preceded by the ascertainment of the HIV status of the HCW and the patient. This should be done as soon as possible after exposure, usually within 24 hours. If the exposure takes place when the patient is under anaesthetic, which is often the case, consent for HIV testing is not readily forthcoming and this poses an ethical dilemma. A similar dilemma is posed by a patient who, having awoken, is not in a position or is unwilling to give consent. This paper discusses the ethical and legal constraints on the HCW and the employer in circumstances where the patient is not in a position to give consent. The paper concludes by restating the need to respect confidentiality and the autonomy of the patient and that informed consent is paramount in testing for HIV status. The paper proffers the view that testing the patient will not substantially alter the course of action open to the HCW and, in any event, will do little to allay the fears of HCWs.
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spelling doaj-art-cdeafb8eb168480f851b8fe983a2ccf72025-08-20T03:07:09ZengAOSISSouth African Family Practice2078-61902078-62042011-12-0153610.4102/safp.v53i6.22644879Cold comfort for healthcare workers? Medico-ethical dilemmas facing a healthcare worker after occupational exposure to HIVT.E. Madiba0C.L. Jack1Y.A. Vawda2Department of Surgery, University of KwaZulu-NatalDepartment of TeleHealth, University of KwaZulu-NatalFaculty of Law, Howard College, University of KwaZulu-NatalFollowing exposure to the human immunodeficiency virus (HIV) it is advisable for the healthcare worker (HCW) to take postexposure prophylaxis. A prerequisite for this is the establishment of the HIV status of the HCW and the patient. Ordinarily, this would be preceded by the ascertainment of the HIV status of the HCW and the patient. This should be done as soon as possible after exposure, usually within 24 hours. If the exposure takes place when the patient is under anaesthetic, which is often the case, consent for HIV testing is not readily forthcoming and this poses an ethical dilemma. A similar dilemma is posed by a patient who, having awoken, is not in a position or is unwilling to give consent. This paper discusses the ethical and legal constraints on the HCW and the employer in circumstances where the patient is not in a position to give consent. The paper concludes by restating the need to respect confidentiality and the autonomy of the patient and that informed consent is paramount in testing for HIV status. The paper proffers the view that testing the patient will not substantially alter the course of action open to the HCW and, in any event, will do little to allay the fears of HCWs.https://safpj.co.za/index.php/safpj/article/view/2264human immunodeficiency virusacquired immunodeficiency syndrome
spellingShingle T.E. Madiba
C.L. Jack
Y.A. Vawda
Cold comfort for healthcare workers? Medico-ethical dilemmas facing a healthcare worker after occupational exposure to HIV
South African Family Practice
human immunodeficiency virus
acquired immunodeficiency syndrome
title Cold comfort for healthcare workers? Medico-ethical dilemmas facing a healthcare worker after occupational exposure to HIV
title_full Cold comfort for healthcare workers? Medico-ethical dilemmas facing a healthcare worker after occupational exposure to HIV
title_fullStr Cold comfort for healthcare workers? Medico-ethical dilemmas facing a healthcare worker after occupational exposure to HIV
title_full_unstemmed Cold comfort for healthcare workers? Medico-ethical dilemmas facing a healthcare worker after occupational exposure to HIV
title_short Cold comfort for healthcare workers? Medico-ethical dilemmas facing a healthcare worker after occupational exposure to HIV
title_sort cold comfort for healthcare workers medico ethical dilemmas facing a healthcare worker after occupational exposure to hiv
topic human immunodeficiency virus
acquired immunodeficiency syndrome
url https://safpj.co.za/index.php/safpj/article/view/2264
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AT yavawda coldcomfortforhealthcareworkersmedicoethicaldilemmasfacingahealthcareworkerafteroccupationalexposuretohiv