confidentiality

I met a patient the other day when I was in a hurry to go off for ward rounds. I did not have my clinic day on that afternoon, however, he was sick and needed my attention right away as my nurse told me that he was not well clinically!

I entered the room and I met these 2 guys, one sitting and another one standing. I knew the one sitting was ill, most likely he had an opportunistic infection now. I presumed the brother whom the man standing beside the patient knew his status since he gave me the referral letter from the private physician.

So there i asked him loudly, when was his last test of HIV negative before this current test! He denied he has HIV.... And I told him that the letter stated that he was diagnosed HIV in private hospital! Then I saw his face grimacing and winking at me, putting his palm together praying to me begging me not to say anymore....oops then I realized I have breached the confidentiality about the disease to his brother and his brother apparently did not know his status!

I became panicked, I asked the brother to leave us alone in the room, and I apologize to him! However, he asked me not to let his brother know and he will tell the wife afterwards about his status!

Today, I received a call from oversea (patient is from oversea) and the lady claimed that she is the wife of that patient! She is very anxious as she told me that the brother of the patient called her up to inform her that he had over heard the conversation! She wanted to confirm the husband status! i cannot disclose over the phone, however, I really feel bad about the whole situation! YES! The spouse had the right to be informed about the status so that he or she could go for screening immediately. However, I always give time for the pateint to disclose the status themselves to their spouse, if not, I will bring them together and counsel them!

Some one asked me before, isn't it important to let the other family members who might be taking care of the patient while cleaning and sponging? The truth is, this disease does not spread by sponging and cleaning the patient! However, our health side workers are wearing gloves even nursing them...how am I going to sound convincing to the relatives??

In my opinion, the spouse should be informed by all means, however, if the patient refuse the let the family know, we as a clinician who treat them should respect their wish!

In this case....I will have a tough time....Have not really told him about the wife calling me up!!

The point is, Do NOT assume that all patient relatives who came with them knew the status!!

Some one told me, ASSUME is making an ASS Out of U and Me!!!