Re: Doctor Slaps HIV Positive Patient at Hospital - Mumbai, India

May 25, 2004

FORUM/Moderator,

Allow me to begin with a Disclaimer across the table that such abuse of patients

cannot be condoned.

Allow me now to look at the doctor's side of the issue.

I don't know how many of the esteemed members of this forum are clinicians,

nurses or lab techs. But if you find it within you to raise your voice against

the doctors and nurses who are " discriminating " and " abusive " please do try to

locate where the blame should rightly be laid.

I have worked as a clinician myself and in the Emergency Ward/Casulty/OT we

dealt with patients without " complete information " (i.e. HIV status, etc).

This too without complete protective gear.

In cases of deliveries, C-sections on the OBGYn side and in emergency operations

for intestinal perforation, etc we would be forced to take the patient " on the

table " sometimes without knowing HIV status.

Admin personnel in BMC hospitals guard HIV Blood Safety Kits zealously and are

unwilling to have it used unless the use is justified (HIV positive status of

patient) Frequently, we re-used gloves which had grown fragile from multiple

uses.

The admin is not directly to blame either, for they have to justify their

actions to their superiors (officers) for kits used and such justification comes

ahead of the safety of doctors (unless it is someone of the level of a Head of

Unit or Head of Department or even a lecturer).

In this cycle are caught resident doctors and interns who cannot say NO and have

to expose themselves to the risk without adequate protection.

Furthermore when a patient wilfully hides HIV status from a doctor and

indirectly exposes her to more risk, anger and resentment is a natural reaction

though physical and emotional abuse is not.

If the surgeon knows the HIV status, she can take the extra bit of precaution.

Sometimes all it takes to be infected is a nick or a needlestick (even if

research says the probability of a needlestick inf. for HIV is 0.03% I dont know

many doctors who willingly take that risk).

Attention HAS to be paid to the safety of health personnel who attend to the

needs of HIV positive patients.

If we don't look for and solve the root cause of such incidents, such

" whistleblower " accounts would end up being no more than witch hunts.

Dr. Yatin Gadgil

MPH (s Hopkins Bloomberg School of Public Health)

Research Associate (Stanford School of Medicine)

E-mail: [yatingadgil@...]

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