The universal precautions of the Centers for Disease Control do not eradicate all risk to the patient or health care provider, says Baillie et al. (p. 129). While health care providers in all institutions have been educated in universal precautions, Beck, a registered nurse, cautions that some employees have failed to comply with the recommended procedures from the Centers of Disease Control. Some nurses find goggles, gloves, and other protective gear to be cumbersome to wear and/or too time consuming to put on and remove. Beck cites the case of Barbara Fassbinder, an RN documented by the CDC, who contracted AIDS by using her finger to apply pressure to a patient's intravenous site in an emergency room (p.12).
The identification of a positive HIV status would prevent the provider from performing certain 'exposure-prone' procedures that might place the patient at a higher risk for contracting AIDS from such contact (Beck, p.11). Such exposure-prone procedures include "digital palpation of a needle tip in a body cavity or the simultaneous presence of the healthcare worker's fingers and a needle or other sharp instrument or object in a poorly visualized or highly confined anatomic site" (p. 13-14).
The American Medical Association states that "the physician should err on the side of safety even when there is uncertainty about the physician's infection. In particular, the AMA believes that, if there is an identifiable risk, HIV-infected physicians have an ethical obligation either to withdraw from the case or to inform the patient of the condition" (Baillie, p. 128).
Mandatory HIV testing may provide epidemiological data.
Mandatory HIV testing may provide reliable epidemiological data. In order to plan rationally for the incidence of disease, it is necessary to know the extent of the problem. Research may provide information about the effectiveness of drugs, the demographics of the disease, and in particular, the transmissibility to patients and health care providers. "The more the public officials know about the spread of the disease, the easier it is to raise and distribute funds and to prepare hospitals and health care professionals for managing this devastating virus" (Werdel, p. 194).
Disclosure of the HIV Status
Disclosure of the HIV status of the health care provider pro...
... middle of paper ...
...y involvement in such mandatory testing, and of any revelation of positive test findings in terms of who is ultimately to be informed (Baillie, p. 291).
Although HIV testing has its benefits, it seems that any type of mandatory testing and subsequent "public disclosure" could potentially outweigh these positives via the harm and stigmas that arise as a result. Accordingly, it seems that a voluntary approach should be the course of action that is taken, while being advocated for both by the general public, and by health care providers together. That way the people that are infected can be educated about high risk behavior, so as to begin to help stop the spread of the disease. Otherwise, mandatory tests and disclosure only work to identify the infected individuals, but really do not provide much to help their plight. With the help of advocacy for voluntary testing, perhaps society can glean the benefits from the tests and privately identify those individuals or groups at risk that wish to remain anonymous, without the negative discrimination and stigmatisms that may result from direct identifiers in terms of mandatory testing and subsequent disclosure.
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