Canadian Clinics and HIV+ Patients

[corvettester]

Hey all,

 

A buddy of mine was recently refused an HT procedure from two separate HTN recommended clinics in Canada because he is HIV positive. Basically, they told him that in Canada the technicians can legally refuse to work on HIV positive patients.

 

This is the first that I've heard of this. Does anyone know what the law is on this? Is it only for elective surgeries? Does it only apply to technicians and nurses, or doctors too?

 

 

Corvettester

Edited October 3, 2011 by corvettester

[GreaseDJ]

In the US, Dr's are required to use universal precautions and treat all patients as though they have a blood born infection. It is ethically (if not legally) not allowed (in the US at least) to refuse treatment solely on the basis of HIV status. Of course, that is assuming that the positive person's immune system is not compromised and there are no other contraindications. There actually was a case a little while back where Dr. Brett Bolton (who has been accused many times of being privy to questionable reviews on this site) refused a patient a HT because he was positive. Not sure how the case turned out- HIV-positive man denied hair transplant - Health - AIDS - msnbc.com

[zenmunk]

Unfortunately, HIV stigma & discrimination is not limited to Canadian medical practices. This is a world-wide phenomenon. Despite the ethical concerns and illegality of discrimination (in the U.S.) by medical personnel, and universal precautions available to prevent the transmission of blood-borne pathogens in a clinical setting, there are numerous reports of HIV discrimination in medical practices. Some doctors/practices have been sued.

 

This is from a 2009 American Medical Association article:

 

"A 2006 study of specific-service health care professionals in Los Angeles County found HIV discrimination to be prevalent. The researchers surveyed 131 skilled nursing facilities, 102 obstetricians, and 98 plastic and cosmetic surgeons to determine how many of these institutions practice a policy of blanket discrimination against people living with HIV. Of the institutions surveyed, 56 percent of the skilled nursing facilities, 47 percent of the obstetricians, and 26 percent of the plastic and cosmetic surgeons refused to treat people living with HIV and had no lawful explanation for their discriminatory policy."

 

This is from the Canadian Human Rights Commission:

 

"The Canadian Human Rights Act provides that it is not a discriminatory practice for a service provider to deny goods, service or facilities to a person if the denial is based on a bona fide justification (BFJ). The Canadian Human Rights Commission policy on BFJ recognizes the service provider's right to ensure a person is able to comply with a requirement that is essential for the safe and effective delivery of the service.

 

 

Incidents have been reported of service providers refusing to provide services to a person who is HIV positive on the grounds that to do so would pose an unacceptable risk of infection to them or their employees and, therefore, would constitute a BFJ.

For example, it had been thought that rescue workers, such as police and firefighters dealing with trauma victims who were HIV positive might come in contact with the body fluids of HIV-positive people and, therefore, be at added risk of infection.

 

 

The CMA has, however, concluded that in such circumstances the risk of transmission is extremely low, and no cases of transmission have been recorded. As a general measure to minimize the risk of infection, the CMA states that workers should take reasonable precautions when handling human blood or other bodily fluids capable of transmitting HIV.

 

 

For the reasons explained above, the Commission would not generally accept a BFJ based on an alleged danger to the service provider. It is well established that employee or customer preference is not a legitimate reason for a discriminatory action. Therefore, employee or customer concerns about dealing with a person who is HIV positive can not be the basis of a BFJ."

 

 

 

Your friend may have a case if he/she chooses to pursue it.

[Gin0rm0usF0rehead]

Why do you even have to tell a HT youre HIV positive to begin with?

[gottitgood4me]

It tends to be my belief that when person, like a health care worker, or prison guard, or other "high risk for infection job" willingly puts themselves in a position that increases the possibility of a contagious illness, that the person with the contagion should not have to tell the other person(s) about it, unless not doing so could compromise the health of the person from actions taken, or not taken by the professional.

 

It is also my general belief that in a non-life threatening situation, like a HT, that if a worker happens to find out about a contagious illness, they should not be forced by law to start the treatment, or procedure, or whatever it is that they may do that, even with universal precautions, puts them in a position of increased risk. However, if they have already started their action, then find out, and failure to complete their job, puts the patient at increased risk, of infection, or death, of deformity, or the such as a result of the refusal to finish what they started, they should be held liable.

 

Generally speaking, a cop goes on the job knowing they might be bit, or shot, or poked with a needle, just as many health care people know they may be exposed to blood, or vomit, or any other thing that increases risk for illness or death. When they know FOR SURE that someone has a disease that is contagious, there may be some situations where they should be able to choose not to proceed with what they are doing. ,

I worked in a jail for years, and if I knew someone was HIV positive, and they stopped breathing, Im NOT doing CPR on them, and I would be extra cautious if they were violent and I had to handle them. Say what you want, but when you know for sure that someone has something, I bet you will take extra precautions, and it will go through your head, or you will just find a way not to do it.

 

I have slept with women unprotected and taken a chance, yes, thats dumb.

But if I had unprotected sex with someone that told me they had a contagious disease, well, that is just REALLY, REALLY DUMB.

See the difference?

[NEWHAIRPLEASE]

Why do you even have to tell a HT youre HIV positive to begin with?

 

It will show up in the blood work you are required to take!

[GreaseDJ]

Not all docs do bloodwork. And it is illegal to test for HIV in the US unless the patient is explicitly informed and gives consent (except in cases of accidental needle sticks, etc where a health worker may have been exposed). As an aside- unless your HT Dr explicitly told you they were testing for HIV, don't rely on that as having a negative test. (However, ethics work both ways, and a positive person should always inform their health care providers, even though they are not obligated)

Edited October 4, 2011 by GreaseDJ

[SteelWorker]

And it is illegal to test for HIV in the US unless the patient is explicitly informed and gives consent (except in cases of accidental needle sticks, etc where a health worker may have been exposed).

 

Actually the law changed in 2006. It is state dependent, but in most states HIV can be checked for legally without the patients consent. This is due largely to the change in the way we view HIV and it doesn't carry the stigma it used to (except in Canadian hair transplant clinics).

 

Per the CDC:

Consent for testing — "According to the CDC 2006 guidelines, a separate written consent for HIV testing should no longer be required in the United States.

 

However, this may not apply in certain states that have legislation that requires written consent, often with required pretest and posttest counseling. Ten states that still require specific written consent include Alabama, Connecticut, Hawaii, Massachusetts, New York, Michigan, Pennsylvania, Rhode Island, Wisconsin, and Nebraska. Several other states still have laws requiring counseling (ie, Connecticut, Delaware, Florida, Indiana, Montana, Ohio, and West Virginia)."

 

 

Physicians and techs should use universal precautions on all patients. That means wearing gloves, clean needles, disposing of any needles or materials that have been exposed to bodily fluids in a proper way. No HIV patients should be denied the right to treatment, however the laws in Canada may be different.

[corvettester]

Thanks for all the input so far guys. This is an interesting topic.

 

I think it's clear now that in the US, HIV+ patients must be accepted regardless of the procedure, elective or not. However, my original post was referring to Canada. If anyone else has any further information on Canada's laws regarding such matters, it would be great to hear.

 

As of yet, I'm still not sure if it is an actual law or not. If anyone knows for certain, please chime in. Thanks.

 

 

Corvettester