“Very informative and interesting programme. Delighted that Danny made the exceptional recovery and very good news that he provided the consent.
Personally, I'm delighted that I don't sit on an ethics committee.”
Colette
“I believe it is wrong to test for HIV without an unconscious patient's consent.
In today's case the doctor who suffered the needle stick injury should immediately have started ARV treatment, anyway, without having to wait for test results (had they decided to make a test). Apart from the possible benefits of prompt ARV treatment, the psychological benefits to the injured party, from taking action, instead of worrying for 48 hours, outweighs the unpleasantness of the possible side-effects during a course of ARV treatment.”
Christopher
“Brilliant programme and discussion but why not in this particular case explore the idea of testing and not disclosing to Danny or his carers the result. The result would only be made available to the staff caring for the medical staff member who suffered the needlstick? A bit like transplants where there is one medical team dealing with the donor and another with the recipient.”
Andy
“As am person living with HIV for over 9 years I listened to this programme with increasing disappointment.
Stigma surrounding HIV is alive and well, as is evidenced by Dominic Bell's attempt to justify testing against Danny's will because healthcare professionals might not want to treat people in the future without a decision to test. My experience is that PWHIVA do face discrimination accessing healthcare, and health and social care professions, but this is an argument for tackling discrimination, not pandering to it.
While I have some sympathy for the healthcare worker it seems to me that she could only get that by testing HERSELF after 3 and 6 months. Had Danny been infected from shrapnel during the blast then he may well not have developed antibodies himself during the relevant period (not sure how long it was) so would test negative to antibodies anyway while remaining infectious. I know from experience that taking antiretrovirals can be very unpleasant but, had she tested positive, she may have had to anyway. If she, or Danny, tested negative then she would still not have the certainty she craved until the 6 month all-clear.
I now work in Health & Social Care and my experience is that ignorance and discrimination around HIV are common. Only once, when issues of risk and infection have been raised, has a colleague actually given the 'right' answer...work on the assumption that everyone is positive and risk assess on that basis.
While, personally, I believe that it is almost always in a person's best interests to test that has to be their decision while the negative consequences of a positive test can be so enormous. To override an individual's rights to palliate an understandable, but ultimately unattainable, wish for certainty is, in my view, unjustifiable.”
Andrew
“I agree with the actual outcome of this dilemma, namely that Danny was able to give his own consent to HIV testing once he had recovered sufficiently from his injuries, and that it as appropriate not to test him without consent. I wonder if the events would have been the same had he died 24hours after the needlestick injury to the "healthcare worker".”
David
“1)a) I thought that at the beginning of the programme it was said that the victims of the bombing had 'shrapnel' wounds which included intrusion by other victims' body parts - doesn't this circumstance vastly increase the 'risk' factor that he may have contracted HIV?
b) If, indeed, the young man did not have HIV before the incident but had contracted it BECAUSE of the accident and, because he was in a coma, had no way of authorising his own testing and treatment, aren't the health care professionals not taking due care of him by not giving him treatment that he might urgently need?
2) I agree with Dominic that if health care professionals cannot expect a certain level of care themselves, having already put themselves at risk in the service of others, then they could justifiably be expected to shy away from giving even more high risk treatment to patients. Firemen take on a certain level of risk but if an accident occurs to one of them, he is entitled to expect his colleagues to exert all their efforts to save him. This is also the case in the police force and the armed services. It is naive of your lady panellist to say that there are doctors and nurses who go to much higher risk areas in the world - that is their choice and I do not believe that they would expect to be abandoned there by their colleagues if something went drastically wrong.”
A.
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