health care law and legislation week 5
Chapter 16
Acquired Immune Deficiency Syndrome
LEARNING OBJECTIVES
• Describe what AIDS is and how it is spread.
• Discuss confidentiality concerns for AIDS patients.
• Describe how AIDS patients are discriminated against.
• Explain the importance of AIDS related education.
AIDS
• Deadliest epidemic in human history.
• Collection of specific, life-threatening, opportunistic infections & manifestations that are result of underlying immune deficiency.
• Caused by HIV, highly contagious blood-borne virus is most severe form of HIV infection.
• Destroys body's capacity to ward off bacteria & viruses that ordinarily would be fought off by immune system.
Spread of AIDS
• Body Fluids – Breast Milk
• Blood transfusions • Sexual Transmission
– Vaginal secretions – Semen – Partner’s Right to Know
• Healthcare Workers Transmission
Confidentiality • Patients have a right to privacy.
• An individual’s HIV status must be kept confidential.
• Patient information can be shared with other health professionals
– for purposes of patient care on a need to know basis.
Unauthorized Disclosure
• Estate of Behringer v. Med, Ctr, at Princeton
– Hospital & lab director breached duty by allowing a surgeon’s test results to be placed in medical record.
– Hospital should have taken reasonable precautions to prevent disclosure.
Proper Disclosure
• Tarrant Cty. Hospital District v. Hughes
– wrongful death action alleging patient contracted AIDS from blood transfusion administered in hospital.
– societal interest in maintaining an effective blood donor program did not override plaintiff's right to receive such information.
– court order prohibited disclosure of donors' names to 3rd parties.
Duty & Right to Confidentiality
• Right to know when caring for patients with highly contagious diseases.
• Times when duty to disclose out ways rights to confidentiality.
• A prisoner has limited privacy rights.
• Prison authorities have strong interest in preventing the spread of HIV.
Confidentiality Sexual Partners
• Person has right to know when his or her partner has tested positive for HIV.
• Physicians expected: – counsel HIV-positive patient to notify
sexual partners or – to seek help in doing so from public health
officials. • Some states have developed informational
brochures & consent, release, & partner notification forms.
Mandatory Testing
• U.S. District Court found routine testing of firefighters & paramedics for AIDS virus does not violate individual's 4th Amendment or constitutional privacy rights.
– caregivers high-risk group for contracting & transmitting HIV to public.
– city has compelling interest & legal duty to protect public from contracting virus.
• Anonymous Fireman v. Willoughby
Discrimination
• Access to Health Care
– Right to Treatment
• Education
• Employment
• Insurance Benefits
Negligence
• Administration of Wrong Blood
• Failure to Make Timely Diagnosis
• Patient Wrongly Notified She Had AIDS
• Insurance Company Fails to Disclose HIV Status
Reporting Requirements
• AIDS is reportable communicable disease in every state.
• Physicians & hospitals must report with patient's name—to government public health authorities.
AIDS Emergency Act
• Provide emergency assistance to localities that are disproportionately affected by HIV epidemic & make financial assistance available to States & other public or private nonprofit entities to provide for development, organization, coordination & operation of more effective & cost efficient systems for delivery of essential services to individuals & families with HIV.
OSHA & AIDS
• OSHA requires health care organizations to implement strict procedures to protect employees against AIDS virus.
• OSHA requires strict adherence to guidelines developed by CDC.
• Complaints investigated by OSHA can result in issuance of fines for failure to comply with regulatory requirements.
Protecting Caregivers – I
• Personal Protective Devices – Gloves – Masks – Gowns – Goggles
• Engineering Controls – sharps disposal containers – ventilation systems
Protecting Caregivers – II
• Work Practices – hand washing – use of needles – safe collection, transporting & disposal of body
fluids • Practice Universal Precautions
– infection control guidelines – prevent contact with patient blood & body fluids – Assume all patients infected for blood-borne
diseases such as AIDS & hepatitis B
CHAPTER REVIEW – I
1. Describe how AIDS patients are discriminated against.
2. Discuss the privacy and confidentiality issues of HIV- positive patients.
3. Should a hospital be permitted to publish identity of AIDS patients in order to protect other patients and staff?
4. Is AIDS a reportable disease? Why?
5. What steps can be taken to help prevent spread of AIDS