Ethics Question

[DrMantisTobogganMD]

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So I was just watching an episode of Scrubs where this guy comes in with his girlfriend and he is diagnosed with gonorrhea. However, they have yet to be intimate. HIPAA doesn't allow physicians to tell the SO, but what if it was a more serious disease like HIV or hepatitis? Is there a scenario where a physician can inform a SO about their partner's condition, without permission, if it may affect them?

 

[Lucca]

So I was just watching an episode of Scrubs where this guy comes in with his girlfriend and he is diagnosed with gonorrhea. However, they have yet to be intimate. HIPAA doesn't allow physicians to tell the SO, but what if it was a more serious disease like HIV or hepatitis? Is there a scenario where a physician can inform a SO about their partner's condition, without permission, if it may affect them?

Every State maintains their own list of "reportable diseases", often these include STDs and especially diseases like HIV. There is a confidential partner notification process following the original report to the state (which is also anonymous, the state knows that SOMEONE NEW has HIV). When partners are contacted notifying them they may have been exposed to a disease and notifying them of what to do next, they will also not receive any particular information. However, if the partner has been in a serious monogamous relationship for quite a while and receives such a report, they can put 2 and 2 together, obviously. The responsible partner will just let his/her partner(s) know right away anyway, but, in any case, there is no violation if HIPAA involved in this process.

 

[Kgizzle]

Can you contact the SO directly if your pt states that they will have unprotected sex with their partner without telling them that they have HIV?

 

[Lucca]

Can you contact the SO directly if your pt states that they will have unprotected sex with their partner without telling them that they have HIV?

It's a good question but I don't know about this particular case. I imagine that in the case of encountering someone this inconsiderate and evil you would be protected under something like "Good Samaritan" even if there isnt a provision for it

 

[DrMantisTobogganMD]

I believe it is illegal to knowingly give another person HIV

 

[Goro]

In my state and others (I don't know how many), it is a felony.

I believe it is illegal to knowingly give another person HIV

 

[CliveStaples]

In my state it would be illegal for a physician to tell a person's partner that the person has HIV without the person's consent.

However, the physician does not need consent to report the person's HIV status to the health department which is responsible for notifying any known sexual contacts of that person that they potentially have had exposure to HIV (and this would be a dead giveaway to somebody in a monogamous couple as to who they have been with that is HIV positive), but they do not specifically name anybody who has a diagnosis of HIV.

Ultimately, it is the physician's duty to encourage anybody with a new diagnosis of HIV to inform their partner(s).