Is this really necessary?

[edinOH]

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Why worry these people with this information? Seems like they are just encouraging phobias. Is litigation so severe in Canada as it is in the U.S. that the hospital felt they needed to be proactive with this information or risk lawsuits?

Thoughts?


MONTREAL -- A children's hospital has received nearly 4,000 calls after it asked 2,614 patients to be tested for HIV because a surgeon had contracted the virus, the hospital said Friday.
Ste-Justine's Children's Hospital had received 3,900 calls as of lunchtime Friday after announcing Thursday the infected doctor performed surgery between 1990 and 2003 at the hospital, a spokeswoman said.

She said parents who have received registered letters telling them their child was operated on by the surgeon are among those calling for information. The letters direct former patients to undergo blood tests to determine if they have contracted the virus.

Dr. Lucie Poitras, the hospital's director of professional services, has said the hospital's administration wasn't aware the doctor was HIV positive until two weeks ago, although the surgeon's supervisor and a committee of doctors knew in 1991. The virus causes AIDS.

Poitras has stressed that the chances of a patient becoming infected were extremely slight.

Parents whose children have had surgery and can't remember the name of the doctor who performed the surgery are also are calling the hospital, the spokeswoman said Friday.

There are also a number of calls from "curious" members of the public and there is a "level of insecurity", the spokeswoman said.

The doctor hasn't been named by the hospital for reasons of confidentiality.

However, media reports have identified her as Maria Di Lorenzo, 48, who died last year. They did not cite any sources.

Poitras has said there was no legal obligation for the doctor to disclose the condition to the hospital and there still isn't one that forces doctors to disclose such an illness.

Hospital staff said Thursday that there are only two known cases, which occurred in Europe, of surgeons transmitting the virus to patients.

A dentist in Florida is believed to have spread the virus to six of his patients

 

[Smurfette]

Am I naive? Why would a hospital...people educated in HIV transmission, etc., send a mass mailing to every patient a surgeon has had to ask them to be HIV tested? If the MD knew in 1991 he was HIV+, I would hope that if he got/gave an occupational exposure, he would arrange for the patient to be tested for HIV just as a precaution. Why test several thousand individuals and cause more panic and misunderstanding about how HIV is carried? Am I missing something here?

 

[WatchingWaiting]

Why would you allow a surgeon with a communicable disease to be operating? Isn't there some kind of moral/ethical issue here? I mean, it sucks if you're trained as a surgeon, get a tainted blood transfusion, get AIDS, but given basic norms of human decency, why would you keep operating given the not insubstantial risk of a needle stick coupled with a bloody patient?

 

[tofurious]

I don't think these issues are too well thought out given the lack of clear legal guidelines (as indicated by the report) and the ethical/political dilemma often involving one of your colleagues. What about a surgeon with Hepatitis? Or a surgeon with a seizure disorder? A surgeon with dementia who occasionally forgets where he is? Clearly, hindsight says that well, you probably shouldn't have let them operate. However, if you're the surgeon's primary physician, do you have an obligation to report it to the employer if the surgeon him/herself refuses to? And what jobs exactly fall under the reportable-to-employer category? What if instead of a surgeon, he/she was an interventional cardiologist? A scoping GI doc? An ophthalmologist? An internist? A psychiatrist? Or even a phlebotomist?

These things usually explode in the media if a patient catches something or there is a suspicion that a patient may have caught something, but medicine as a field has not really laid down clear guidelines yet. I think it's an issue that needs to be resolved ASAP as the prevalence of HIV and non-symptomatic HIV-positive patients goes up by the year.

 

[Seaglass]

Very well written tofurious. What s/he said.

 

[tofurious]

I actually did a little research (I should have done this before just posting whatever came to mind... thanks cg btw) and here's AMA's stance on this:

"Exceptions to confidentiality are appropriate when necessary to protect the public health or when necessary to protect individuals, including health care workers, who are endangered by persons infected with HIV. If a physician knows that a seropositive individual is endangering a third party, the physician should, within the constraints of the law, (1) attempt to persuade the infected patient to cease endangering the third party; (2) if persuasion fails, notify authorities; and (3) if the authorities take no action, notify the endangered third party."

As you can see, there is no clear definition on how an HIV-positive physician can "endanger" patients.