Infection of patients by bloodborne viruses.
BACKGROUND
Despite taking precautions, healthcare workers performing invasive procedures run a small risk of infection by bloodborne viruses. When injury occurs, the viral status of the patient is often unknown and testing requires informed consent, which may be refused. On the other hand, although the chance of transmission of infection from a healthcare worker to a patient is extremely small, such personnel have an obligation of disclosure and, if seropositive, are barred from performing invasive procedures.


METHODS
The medical literature on bloodborne virus transmission between carers and patients was reviewed, and the UK Department of Health, General Medical Council and Royal College of Surgeons of England guidelines on the risk management of these infections were read, along with secondary references from all sources.


CONCLUSIONS
Patients have complete protection of confidentiality and the right to refuse testing, but these rights do not apply to the healthcare worker. When injured in circumstances in which the patient cannot or will not permit testing, carers can only submit to the risks of prophylactic treatment or go into denial. Infection may have devastating professional, personal and financial implications to carers and their dependants. Ways to re-establish a just balance between the legitimate rights of patients and healthcare workers are discussed.
Tansley
P D T
PD
Departments of Thoracic Surgery Royal Brompton Hospital, London, UK.
Beresford
N
N
Ladas
G
G
Goldstraw
P
P
Dusmet
M
M
D017848:Blood-Borne Pathogens; D003219:Confidentiality; D004992:Ethics, Medical; D006291:Health Policy; D006801:Humans; D017758:Infectious Disease Transmission, Patient-to-Professional / Q000517:prevention & control*; D016602:Needlestick Injuries; D016273:Occupational Exposure; D028701:Patient Rights; D018570:Risk Assessment; D012307:Risk Factors; D014777:Virus Diseases / Q000517:prevention & control / Q000635:transmission*