Occupational HIV infection in health care workers: what to take into account ?

Abstract

Introduction: Through the nature of their profession, the workers of the medical system, doctors and nurses, are assuming the exposure to pathogen factors. The primary prevention is the main objective and all the efforts are supposed to be directed in this way. Though, to err is human and sometimes accidents happen. What is to be done in this situation? Purpose and objectives: The aim of this paper is to present the ethical aspects of the occupational acquired HIV infection in health care workers, starting from a real case. In the Intensive Care Unit, while inserting a peripheral venous catheter, a doctor accidentally causes an injury to his finger with the contaminated needle. The patient was known as HIV infected and under appropriate treatment. The blood tests proved that until that moment the doctor was healthy. According to the protocol, new blood tests were performed after 6 months, demonstrating the presence of antibodies against the Human Immunodeficiency Virus type 1. Discussion: In this situation, there are some ethical issues regarding the doctor and his patients as well, because this relationship represents the fundament of the medical act. The HIV positive status of the doctor heightens several aspects to reflect upon. Should this person be allowed to keep working in the medical system? Then, may changing the specialty be required, particularly in the case of the surgical departments? In what measure will this doctor be supported by the administrative structures? But there are also things to see and understand from the patient's viewpoint. Would he accept being treated by this doctor, if he knew his status? Because indeed, the patient has the right to choose the person that will consult and treat him. However, the main controversy is that the decision will not be so much influenced by the real risk of transmission, which appears to be quite low in the scientific literature (under 0,3%), but primarily by the patient’s lack of knowledge and the phobia that persists around this disease. Conclusion: Occupational accidents in the medical system are a reality. Beside the human sufferance, the HIV infected health care worker will also fear the social and professional repercussions. Moreover, it would not be equitant for the patient to be exposed to the risk of infection, even if that is considerably low. Obviously, everyone’s priority is the prevention, but if it happens, which could be the most ethical solution and the best for everyone?