Confidentiality and Sexual partner Betrayal. . Source: “AIDS Update 2013”. Ch. 13: Testing for Human Immunodeficiency virus.
This story took place in an HIV/AIDS clinic in the South. A husband and wife came into the clinic for an HIV test. They said the only reason for requesting the test was that they wanted to begin a family and hoped that nothing in their past would have led to either of them being HIV positive. The tests were completed.
The husband came in on Monday; the wife came in that Friday.
Monday A.M.
Counselor: Mr. X, your test came back HIV positive.
Then, Mr. X said he wanted to be the one to tell his wife; he insisted on it. The counselor agreed, Mr. X left the clinic agreeing to come back for a follow-up counseling session.
Friday A.M.
Counselor: Mrs. X, your HIV test was negative.
Mrs. X: That’s wonderful news. I can’t wait to tell my husband. We’ve been waiting for my results. I want to get pregnant immediately.
Mrs. X received HIV-negative counseling and left the clinic very happy.
Clearly, the husband did not tell his wife the truth about his test results. A follow-up phone call to the husband went unanswered; so did a letter from the clinic. Several months later, Mrs. X called the counselor to tell her that she was pregnant!
What do you think the counselor should do now?
1- Inform the woman about her husband.
2- Take no action.
3- Call the husband and discuss the situation.
4- Threaten the husband with legal action if he does not tell his wife.
5- A different course of action.
Discuss the moral, ethical, and legal responsibilities of each participant
HIV
The three participants involved in the HIV testing have their moral, ethical, and legal responsibilities. However, there is no single way to deal with the ethical and legal dilemma associated with HIV testing on whether to inform the partners of the infected persons. For Mr. X, he has an ethical and moral obligation and responsibility to inform her wife on her positive HIV test result to avoid infecting her. It is the right thing to do for Mr. X to inform her wife on her status. After Mr. X came for his result on Monday, it was revealed on Friday that he had not informed her wife on his HIV positive status. Legally, Mr. X was on the wrong as by lying to her wife she exposes her to the risks of contracting HIV.
In terms of Mrs. X, she has both a moral and ethical responsibility to inform his husband on her HIV status and try to determine the actual HIV status result of his husband. It seems that Mrs. X did not confirm the actual HIV status result for his husband and may be his husband verbally confirms the results without giving her the actual tests. Legally, Mrs. X is not exposed and nothing much she can do.
In terms of the counselor, she faces complex ethical and legal dilemma over maintaining confidentiality of the patient’s information. In some states, a third party can be informed if they are at risks of being exposed to risks of contracting HIV. On this basis, the counselor has the legal duty to inform Mrs. X that he is already infected with HIV. However, the application of the law is complex considering the confidentiality rights of all patients. The counselor has both moral and ethical responsibility to inform Mrs. X on the HIV positive status of his husband to inform her and protect her from HIV exposure. The counselor should call the husband and discuss the situation to determine whether he took duty of care for his wife.
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