Clinics Guide to Law and HIV

posted: 23/04/2010

Have your say about the draft guidance for HIV clinics from BHIVA / BASHH about HIV transmission, the law and the work of the clinical team, 2010. The deadline for your comments is Friday 21 May 2010.

There have been prosecutions for reckless transmission of HIV in the UK since 2001 (Scotland) and 2003 (England & Wales). The prospect of prosecutions raises complex questions among medical practitioners about their ethical and legal responsibilities related to HIV transmission, particularly around disclosure of information on HIV status.
 

Although established generic ethical and professional principles continue to apply, certain features of the HIV epidemic have required special consideration.
 

An underlying principle in the provision of clinical care for people with HIV is the need for a secure and confidential environment in which extremely sensitive matters can be frankly and fully discussed. The importance of ensuring that full trust is maintained by people with HIV in their clinical services is fundamental, not only for the health of people living with HIV but also for people who may wish to seek information or testing and thus for the wider public health.
 

This guidance document sets out these responsibilities, and how these relate to the roles and responsibilities of health care professionals when caring for individuals infected with HIV.
 

Roles and responsibilities of Health Care Professionals

• Health care professionals have a central role to advise and support patients and to maintain confidentiality according to professional guidance and the law.
• For HIV positive individuals, advice must include the routes of HIV transmission, how to prevent transmission, with information about safer sexual practices and the use of condoms.
• Discussion of sexual health needs must take place regularly according to relevant BASHH guidelines to enable the giving of appropriate advice.
• There is individual and public interest in maintaining confidentiality; this may be outweighed in order to prevent serious harm to others.
• It is important when considering breaching confidentiality to weigh up all potential harms as there may be situations where disclosure of HIV status to protect a sexual partner results in considerable harm to an individual e.g. domestic violence.
• In situations where a health care professional believes that an HIV positive individual continues to put close contacts at risk their duties and subsequent action depend upon the type of contact (see figure one).
• No information should be released to the police unless there is verified consent from the patient or there is a court order in place.
• It is up to an individual patient to make a decision about complaining to the police and health care workers should remain impartial during discussions with patients.
• Those involved (complainant and defendant) in cases of reckless transmission are likely to need specialist legal advice and support and referral to THT direct would be appropriate.
• Sources of further information are listed in appendix two.

Vulnerable Groups

There are special considerations with regards cases of alleged reckless transmission in those under 18, or anyone with learning difficulties, discussed in section 5.
 

You can download the document and then submit any comments using this online form. 
 

Please make your comments here by Friday 21 May

 

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