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Doctor had ‘ethical duty’ to notify hotel about HIV guest, Paphos clinic says

The Evangelismos Hospital in Paphos

The Paphos private hospital at the centre of controversy over an alleged violation of an HIV patient’s privacy, said on Saturday the doctor who had treated the British tourist had a duty and responsibility to inform the hotel of the man’s condition to protect the staff, and the public health.

The tourist and his tour operator had filed an official complaint that after being treated at the clinic, one of the doctors informed the hotel and on his return he was asked to leave, that word had spread and that he could no longer find either treatment, nor accommodation in the area except for one hotelier who took him in and saw that he was visited by a doctor. He has since gone back to the UK.

Subsequent investigations were launched by the health ministry and the medical association. Hoteliers said they were within their rights to deny service to the tourist under hotel regulations citing a provision under a law dating from the sixties relating to contagious diseases, though they said it was because the man in question was drunk and disorderly, another provision.

On Saturday, the Evangelismos Hospital in Paphos said the clinic’s On Call doctor was the first medical practitioner to treat the patient and that the full facts had already been reported to the ministry of health.

It said that on August 30, the on-call doctor was called to a nearby hotel at the management’s request to administer first aid to a patient who had an open wound following an accident he had suffered whilst a resident there.

It said the hotel was close to the Evangelismos medical centre on Tombs of the Kings Avenue.
“When the medical staff arrived at the hotel they noticed that the area where the patient was waiting had several bandages soiled with blood. The doctor recommended that the patient should visit the hospital for therapeutic and diagnostic radiological investigation to eliminate the possibility of a fracture,” the statement said. “The patient, however, refused to visit or be admitted to the hospital and he signed the necessary “Refusal of Further Treatment” documentation. This document has been maintained on his patient file.”

It said the patient was then taken to their nearby medical centre for further treatment for his wounds where he informed the medical staff that he was HIV positive. The patient was discharged from the medical centre and given assistance back to his hotel, the statement added.
He was further advised by the doctor to return to the medical centre in 48 hours for his dressings to be changed. “Understandably, as they were unaware of the potential dangers, at this stage, the domestic staff were cleaning the hazardous areas containing the blood soiled dressings without taking any precautionary measures,” it said.

“An HIV positive patient suffering from an open wound, is potentially hazardous because of the high risk of transmission of the virus (blood-borne exposure), being a risk to the hotel staff and its residents.
“The doctor, therefore, had an ethical duty and responsibility to notify the hotel management of the patient’s HIV status in view of his open wounds and the dangers of potential contamination at the scene of the accident.”

It said the Pancyprian Medical Ethics Code states that in some cases a doctor can be released from patient confidentiality and reveal information on a patient’s medical condition where this information can be used to avoid endangering public health and safety.
“The public must realize that certain fluids—blood, semen, pre-seminal fluid, rectal fluids, vaginal fluids and breast milk—from an HIV-infected person can transmit HIV,” the clinic said.

“The Code of Ethics further states that the doctor who is treating an HIV patient has an obligation to protect not only the patient, but also the public health as well as safeguard the community.”

The Evangelismos said the patient did not return to the medical centre as advised and had on further contact with him “nor with any subsequent hotel”.
“If the patient had not been directed to another hospital or clinic on the advice of the tour representative and instead, had follow-up treatment from our hospital which was aware of his medical history, no confusion would have occurred to make the patient feel so distressed. It remains a serious cause for concern that some Tour Operators from UK appear to recommend and persuade their clients who need medical care to attend certain medical facilities in the area because they receive benefits in return,” the clinic added.



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