The case related to a diagnosed HIV client who sees a psychologist for psycho-education and psychological support following the diagnosis of his condition. In discussing it becomes apparent that the client is reluctant in telling his partner or practicing protective sex. The client is angry and indicated that he even considers deliberately infecting other potential partners.
1) Reluctance to advise partner
2) Reluctance to practice safe sex
3) Deliberate intention to infect others
Working through ethical dilemma to find management strategies that are ethically and legally defendable and justifiable;
I) Public Health Act
a. GP is mandatory reporter, and this act would allow the health department to detain the client.
II) PBA code of ethics
a. ‘if there is immediate and specified risk of harm to an identifiable person or persons that can be averted only by disclosing information.
III) When obtaining INFORMED CONSENT, client was advised of the reporting requirements- ‘harm to self and other’.
National Privacy Principle September 2001 http://www.privacy.gov.au/law/act/npp http://www.privacy.gov.au/materials/types/download/8774/6582 Schedule 3, 2e&f
IV) Prima facie personal values- client autonomy vs. non maleficience and fidelity.
V) Discuss case with other senior practitioners
VI) Discuss case with industry body
VII) Obtain legal advice.
1) Advise client that you have a requirement by the professional code to advise his partner (Immediate and specified risk)
2) Alert client to past criminal cases in NSW where deliberate infectors where imprisoned.
3) Advise client of his requirement under the Public Health Act to inform any partner before engaging in a sexual act.
4) Advise referring GP about the matter and discuss process from here. GP may want to do the reporting.
5) Contact partner and advise of the situation
6) Advise health department and/or inform the POLICE