Angry Doctor

Tuesday, August 07, 2007

How I Learned to Stop Worrying...

... and Love Mandatory HIV Testing.

What a glorious day on the ST Forum page.

Two letters supporting the move to implement 'opt out' HIV testing for patients admitted to hospitals!

Bring a tear to angry doc's eyes, they do.

Mr Goh believes that:

To protect our health-care workers, all patients admitted to a hospital should be subject to a mandatory HIV test.

In this way, they could take extra precaution in handling patients who have been diagnosed as having Aids or HIV infection.

Mr Goh also believes that we should take it a step further and make HIV testing mandatory, a belief shared by Mr Koh, who wrote that:

This should not be interpreted as ignoring civil rights. We are talking about protecting lives - especially those of our health-care workers.

angry doc predicts that a year after we implement 'opt out' or mandatory HIV testing, the number of healthcare workers who become infected with HIV in the course of their work will fall to zero.

From the current rate of zero case per year.

But of course, even though such a scheme will protect the lives of healthcare workers, it doesn't mean that everyone will support it, like say Mr Szeto here, who obviously hates doctors so much he dares question the benefits of 'opt out' HIV testing:

Protect health workers from all blood-borne ills

I REFER to the article, 'HIV tests may be part of hospital admission process' (ST, Aug 4).

I am very pleased to see the Singapore Government placing the safety of healthcare workers at the top of the agenda.

Health Minister Khaw Boon Wan identified the potential transmission of HIV via accidental injuries as a problem, but one has to question if HIV testing is the solution.

By identifying a patient as HIV positive, we have not decreased the risk of accidents. It is through the implementation of strict safety protocols and stringent training that the risk of injuries can be minimised (e.g., wearing protective gear when handling sharp objects).

Implementing a separate set of protocols for dealing with HIV-positive patients will not only highlight what is already a much stigmatised group in society, but could also compromise the standard of care delivered.

Furthermore, why the focus on HIV? Health-care workers may come into contact with many other serious blood-borne infections while on duty.

Should we not have a set of protocols that will effectively protect them from, say, Hepatitis A as well as HIV?

Matthew Szeto

Shame on you, Mr Szeto, for trying to shift the responsibility of infection-control from HIV patients to healthcare workers!

Added: angry doc did a bit of googling to try to find any documented incidence of healthcare workers being infected wiith HIV in the course of their work, but was unable to find any reference.

He did manage to find this rather recent and informative article on HIV/AIDS Prevention published in the Singapore Family Physician though. Well worth a read.

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  • Truth be told, I don't have strong opinions about either position (depends on how the testing is implemented), but when you note that:

    angry doc predicts that a year after we implement 'opt out' or mandatory HIV testing, the number of healthcare workers who become infected with HIV in the course of their work will fall to zero.

    From the current rate of zero case per year.

    I can't say it any better.

    By Blogger Lim Leng Hiong, At August 07, 2007 7:08 pm  

  • I am open to the idea of an 'opt out' or even mandatory test, but so far the arguments used to support it are weak or flawed, and I am not sure it will achieve its stated aims.

    In the meantime, I allow myself to be amused by the news articles and letters.

    Notice how the exact figure of how many healthcare workers are infected by their patients each year is never mentioned, while the figure of 1 in 350 is oft-repeated?

    Notice also how those who write in to support 'opt out' or mandatory testing never seem to think that they will test positive? It's never we ourselves who pose a threat to healthcare workers, but always 'they' and 'these people'. The 'Lake Wobegon Effect', perhaps?

    By Blogger angry doc, At August 07, 2007 8:39 pm  

  • Two more letters in the forum today. The debate seems to be heating up.

    You are right that some of these strong supporters have a tone of moral superiority.

    As the debate gets more emotional I think they will make more mistakes that reveals their true agenda.

    By Blogger Lim Leng Hiong, At August 08, 2007 11:22 am  

  • I would go much further and argue for mandatory HIV testing for the entire nation. Patients have a right to know if their surgeons are HIV positive, as much as doctors may want to know the HIV status of their patients.

    We need to know the size of the problem and better epidemiology to plan public health control measures. It is also necessary so that we do not waste precious resources investigating undeclared patients with mysterious symptoms. HIV can manifest in many forms and doctors must have all the information necessary for proper clinical management.

    By Anonymous Anonymous, At August 08, 2007 2:42 pm  

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