Do patients and health care workers have the legal right to know each other's HIV status? Professor Flanagan argues that they do not. Given that with appropriate precautions the risk of transmitting HIV in the health care setting is extremely small and that the discriminatory consequences of HIV disclosure can be extremely high, it is suggested that the right of a patient or a health care worker not to disclose their HIV status must outweigh the other's "right to know."
Opportunities for cancer prevention in adolescents range from limitation of sun exposure to the use of human papillomavirus vaccines. Those who develop malignant disease experience longer waiting times for diagnosis and treatment than do children, especially when referred to adult treatment centers, and they are less frequently enrolled in clinical trials. More attention to developmentally appropriate psychological support, enhancement of compliance/adherence, health promotion, and palliative care is needed. Improving cancer surveillance and control in adolescents in North America will require co-ordinated national efforts, involving pediatric and adult health care providers, institutions, and multiple levels of government.
Health care professionals' handling of patient data is to a large extent subject to legislation. The legal obligations are linked to individual professional authorization, and obligations imposed on health care institutions. The latter type of obligation is particularly relevant to the use of IT systems.
An anonymous questionnaire survey was undertaken the autumn 2007. 300 physicians, 200 medical secretaries and 200 radiographs were asked about their personal experience with situations requiring handling of patient data subject to legislation.
The overall response rate was 54.7 (395/688). Health care professionals relatively often come into situations in which they can, ought to or have to make exceptions from the general secrecy obligation. A discretionary decision is often needed when patient data are disclosed to a third party or even when patients are granted access to their own personal records. In most such situations, health care professionals comply with their patients' wishes. Regulations on handling of patient data are usually adhered to. The largest category of breaches is by far "snooping" into IT systems, because of curiosity or for other reasons, which are neither professionally nor ethically reputable.
"Traditional" obligations, linked to individual professional authorizations, and well-defined patient rights are largely respected and met. Internal routines and guidelines, in an enterprise subject to system control requirements, are violated more frequently.
Healthcare workers infected with blood-borne illnesses present profound ethical and legal problems. While we seek to protect patients from threat and respect their right to bodily integrity and informed consent, we also recognize the right to privacy and the human rights interests of the infected worker to be free from discrimination.