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DERECHOS Y OBLIGACIONES DE LOS TRABAJADORES DE LA SALUD QUE CONVIVEN CON EL HIV/SIDA

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Autor:
Lawrence Gostin
Columnista Experto de SIIC
Artículos publicados por Lawrence Gostin
Recepción del artículo
12 de Septiembre, 2002 		Primera edición
11 de Octubre, 2002 		Segunda edición, ampliada y corregida
7 de Junio, 2021

DERECHOS Y OBLIGACIONES DE LOS TRABAJADORES DE LA SALUD QUE CONVIVEN CON EL HIV/SIDA


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Rights and Duties of Health Care Workers Living with HIV/AIDS


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Especialidades
Principal: Medicina del Trabajo
Relacionadas: Epidemiología, Infectología, Medicina Interna



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Patrocinio y reconocimiento:
El autor agradece a los oficiales del CDC Julie L. Gerberding y Robert Janses por sus conceptos y colaboración. Las opiniones expresadas en este trabajo no necesariamente coinciden con las expresadas por el CDC (Centers for Disease Control and Prevention) o el Departamento de Salud y Servicios Humanos (Department of Health and Human Services).
Bibliografía del artículo
  1. "Health Professionals Must Confront HIV/AIDS," Journal of the American Medical Association 286 (September 26, 2001): 12.
  2. Carol Ciesielski et al., "The 1990 Florida Dental Investigation: The Press and the Science," Annals of Internal Medicine 121 (December 1, 1994): 886-888; Centers for Disease Control, "Update: Investigations of Persons Treated by HIV-Infected Health-Care Workers," Morbidity and Mortality Weekly Report 42 (1993): 329-331.
  3. Centers for Disease Control, "Recommendations for Preventing Transmission of Human Immunodeficiency Virus and Hepatitis B Virus to Patients During Exposure-prone Invasive Procedures," Morbidity and Mortality Weekly Report 40 (July 12, 1991) No. RR-8: 1-9.
  4. PL 102-141, Title VI, § 663, 42 U.S.C. § 300ee-2 (2001).
  5. Lawrence Gostin, "The HIV-infected Health Care Professional: Public Policy, Discrimination and Patient Safety," Archives of Internal Medicine 151 (April 1991): 663-665.
  6. Centers for Disease Control, "Recommendations for Preventing Transmission of Human Immunodeficiency Virus and Hepatitis B Virus to Patients During Exposure-prone Invasive Procedures," Morbidity and Mortality Weekly Report 40 (July 12, 1991) No. RR-8: 1-9.
  7. American College of Surgeons, "Statement on the Surgeon and HIV Infection," Bulletin of the American College of Surgeons 83 (February 1998): 27-29.
  8. PL 102-141, Title VI, § 663, 42 U.S.C. § 300ee-2 (2001).
  9. Letter from William L. Roper to State Health Departments, dated June 16, 1992.
  10. Patti Miller Tereskerz, Richard D, Pearson, and Janine Jagger, "Infected Physicians and Invasive Procedures: National Policy and Legal Reality," Milbank Quarterly 77 (1999): 511-529; Phillip L. McIntosh, "When the Surgeon has HIV: What to Tell Patients about the Risk of Exposure and the Risk of Transmission," University of Kansas Law Review 44 (February 1996): 315-364.
  11. Committee on Pediatric AIDS and Committee on Infectious Diseases, "Issues related to Human Immunodeficiency Virus Transmission in Schools, Child Care, Medical Settings, the Home, and Community," Pediatrics 104 (1999): 318-324; AIDS/TB Committee of the Society for Healthcare Epidemiology of America, "Management of Healthcare Workers Infected with Hepatitis B Virus, Hepatitis C Virus, Human Immunodeficiency Virus, or Other Bloodborne Pathogens," Infection Control and Hospital Epidemiology 18 (1997): 349-363; American College of Surgeons, "Statement on the Surgeon and HIV Infection."
  12. Alicia Noble, Troyen A. Brennan, and Andrew L. Hyams, "Snyder v. American Association of Blood Banks: A Re-examination of Liability for Medical Practice Guideline Promulgators," Journal of Evaluation in Clinical Practice 4 (1997): 49-62.
  13. Todd Summers, "Public Policy for Health Care Workers Infected with Human Immunodeficiency Virus," Journal of the American Medical Association 285 (February 21, 2001): 882.
  14. Linda T. Kohn, Janet M. Corrigan, and Molla S. Donaldson, Eds., To Err is Human: Building a Safer Health System (Washington, D.C.: National Academy Press, 1999).
  15. Edward N. Robinson Jr. and Ruth de Bliek, "The College Student, the Dentist, and the North Carolina Senator: Risk Analysis and Risk Management of HIV Transmission from Health Care Worker to Patient," Medical Decision Making 16 (1996): 86-91.
  16. Centers for Disease Control and Prevention, Fact Sheet: Surveillance of Health Care Workers with HIV/AIDS (Atlanta: Centers for Disease Control and Prevention, 2000) .
  17. Ibid.
  18. Florence Lot et al., "Probable Transmission from an Orthopedic Surgeon to a atient in France," Annals of Internal Medicine 130 (January 5, 1999): 1-6; Alain Blanchard et al., "Molecular Evidence for Nosocomial Transmission of Human Immunodeficiency Virus from a Surgeon to One of his Patients," Journal of Virology 72 (1998): 4537-4540.
  19. Christophe P. Goujon et al., "Phylogenetic Analyses Indicate an Atypical Nurse-to-patient Transmission of Human Immunodeficiency Virus Type 1," Journal of Virology 74 (2000): 2525-2532.
  20. Laurie M. Robert et al., "Investigations of Patients of Health Care Workers Infected with HIV," Annals of Internal Medicine 122 (May 1, 1995): 653-657; Audrey S. Rodgers et al., "Investigation of Potential HIV Transmission to Patient of an HIV-infected Surgeon," Journal of the American Medical Association 269 (April 14, 1993): 1795-1801.
  21. Centers for Disease Control and Prevention, Fact Sheet: HIV and Its Transmission (Atlanta: Centers for Disease Control and Prevention, 1999) .
  22. Michael Donnely et al., "Are HIV Look Backs Worthwhile Outcome of an Exercise to Notify Patients Treated by an HIV Infected Health Care Worker," Communicable Disease and Public Health 2 (1999): 126-129.
  23. Michael S. Saag et al., "HIV Viral Load Markers in Clinical Practice," Nature Medicine 2 (1996): 625-629.
  24. Panel for Clinical Practices for the Treatment of HIV, Guidelines for the Use of Antiretroviral Agents in HIV-Infected Adults and Adolescents, April 23, 2001 .
  25. Thomas C. Quinn et al., "Viral Load and Heterosexual Transmission of Human Immunodeficiency Virus Type 1," New England Journal of Medicine 342 (March 30, 2000): 921-929; Matthew G. Law et al., "Modeling the Effect of Combination Antiretroviral Treatments on HIV Incidence," AIDS 15 (July 6, 2001): 1287-1294.
  26. R. Stefan Ross, Sergei Viazov, and Michael Roggendorf, "Risk of Hepatitis C Transmission from Infected Medical Staff to Patients: Model-based Calculations for Surgical Settings," Archives of Internal Medicine 160 (2000): 2312-2316.
  27. Rafael Harpaz et al., "Transmission of Hepatitis B Virus to Multiple Patients from a Surgeon Without Evidence of Inadequate Infection Control," New England Journal of Medicine 334 (February 29, 1996): 549-554.
  28. Siew L. Ngui, Ruth P. F. Watkins, Julia Heptonstall, and Chong G. Teo, "Selective Transmission of Hepatitis B Virus after Percutaneous Exposure," Journal of Infectious Diseases 181(2000): 838-843; R. Stefan Ross, Sergei Vlazov, and Michael Roggendorf, "Provider-to-Patient Transmission of Hepatitis B Virus," Lancet 353 (January 23, 1999): 324-325; The Incident Investigation Team and Others, "Transmission of Hepatitis B to Patients from Four Infected Surgeons Without Hepatitis B e Antigen," New England Journal of Medicine 336 (January 16, 1997): 178-184.
  29. Hepatitis B Outbreak Investigation Team, "An Outbreak of Hepatitis B Associated with Reusable Subdermal Electroencephalogram Electrodes," Canadian Medical Association Journal 162 (2000): 1127-1131.
  30. Yvan J. F. Hutin et al., "An Outbreak of Hospital-Acquired Hepatitis B Virus Infection Among Patients Receiving Chronic Hemodialysis," Infection Control and Hospital Epidemiology 20 (1999): 731-735.
  31. Centers for Disease Control and Prevention, "Recommendations for Prevention and Control of Hepatitis C Virus (HCV) Infection and HCV-related Chronic Disease," Morbidity and Mortality Weekly Report 47 (October 16, 1998) RR19: 1-39.
  32. Juan I. Esteban et al., "Transmission of Hepatitis C by a Cardiac Surgeon," New England Journal of Medicine 334 (February 29, 1996): 555-560.
  33. R. Stefan Ross et al., "Transmission of Hepatitis C Virus from a Patient to an Anesthesiology Assistant to Five Patients," New England Journal of Medicine 343 (December 21, 2000): 1851-1854.
  34. Xavier Bosch, "Hepatitis C Outbreak Astounds Spain," Lancet 351 (1998): 1415.
  35. Georgia J. Duckworth et al., "Transmission of Hepatitis C Virus from a Surgeon to a Patient," Communicable Disease and Public Health 2 (1999): 188-192; Anonymous, "Hepatitis C virus transmission from health care worker to patient," Communicable Disease Report Weekly 5 (1995): 121.
  36. R. Stefan Ross, Sergei Viazov, and Michael Roggendorf, "Risk of Hepatitis C Transmission from Infected Medical Staff to Patients: Model-based Calculations for Surgical Settings," Archives of Internal Medicine 160 (2000): 2313-16.
  37. American College of Surgeons, "Statement on the Surgeon and Hepatitis," Bulletin of the American College of Surgeons 84 (1999): 21-24.
  38. Centers for Disease Control and Prevention, "Guidelines for Prevention of Transmission of Human Immunodeficiency Virus and Hepatitis B Virus to Health-Care and Public-Safety Workers," Morbidity and Mortality Weekly Report 38 (1989) (S-6): 1-36.
  39. 29 C.F.R. § 1910.1030 (2001).
  40. Hepatitis B Outbreak Investigation Team, "An Outbreak of Hepatitis B Associated with Reusable Subdermal Electroencephalogram Electrodes," Canadian Medical Association Journal 162 (April 18, 2000): 1127-31; R. Stefan Ross et al., "Transmission of Hepatitis C Virus from a Patient to an Anesthesiology Assistant to Five Patients," New England Journal of Medicine 343 (December 21, 2000): 1851-54.
  41. Julie Gerberding, "Provider-to-Patient HIV Transmission: How to Keep it Exceedingly Rare," Annals of Internal Medicine 130 (January 5, 1999): 64-65.
  42. American Academy of Orthopaedic Surgeons, Advisory Statement: Preventing the Transmission of Bloodborne Pathogens (August 8, 2001); Alicia Mangram et al., "Guideline for Prevention of Surgical Site Infection, 1999," Infection Control and Hospital Epidemiology 20 (1999): 247-278.
  43. Julie Gerberding, "Provider-to-Patient HIV Transmission: How to Keep it Exceedingly Rare," Annals of Internal Medicine 130 (January 5, 1999): 64-65.
  44. Centers for Disease Control and Prevention, "Updated U.S. Public Health Service Guidelines for the Management of Occupational Exposures to HBV, HCV, and HIV and Recommendations for Postexposure Prophylaxis," Morbidity and Mortality Weekly Report 50 (June 29, 2001) No. RR-11: 1-52.
  45. Julie Gerberding, "Provider-to-Patient HIV Transmission: How to keep it Exceedingly Rare," Annals of Internal Medicine 130 (January 5, 1999): 64-65 (stating, "[u]nfortunately, for most patient infections... recontact is either not recognized or not reported in time to initiate prophylactic treatment").
  46. Correspondence from Janet Heinrich, Director of Health Care-Public Health Issues, GAO to Representative Pete Stark entitled Occupational Safety: Selected Cost and Benefit Implications of Needlestick Prevention Devices for Hospitals, (November 17, 2000).
  47. Pub. L. No. 106-430 (2000).
  48. Bernard Lo and Robert Steinbrook, "Health Care Workers Infected with the Human Immunodeficiency Virus," Journal of the American Medical Association 267 (February 26, 1992): 1100-1105.
  49. Lawrence O. Gostin, Chai Feldblum, and David W. Webber, "Disability Discrimination in America: HIV/AIDS and Other Health Conditions," Journal of the American Medical Association 281 (February 234, 1999): 745-752.
  50. 42 U.S.C. § 12113(b) (2001).
  51. 42 U.S.C. § 12112(b)(5)(A) (2001).
  52. Parks v. Female Health Care Assoc., Ltd., No. 96 C 7133, 1997 WL 285870 (N.D. Ill. May 23, 1997).
  53. School Bd. of Nassau County. v. Arline, 480 U.S. 273, 287 (1987).
  54. 29 C.F.R. §1630 pt. 1630, App. (2001).
  55. Ryan J. Rohlfsen, "HIV-Infected Surgical Personnel Under the ADA: Do They Pose a Threat or are Reasonable Accommodations Possible," Journal of Contemporary Health Law and Policy 16 (1999): 127-144.
  56. Scoles v. Mercy Health Corp., 887 F. Supp. 765 (E.D. Pa. 1994); Adam G. Forrest, "Is there a Significant Risk or High Probability of HIV Transmission from an Infected Health Care Worker to Others The Sixth Circuit's Answer Lies in Mauro v. Borgess Medical Center," Creighton Law Review 32 (June 1999): 1763-1803.
  57. Jeffrey A. Van Detta, "Typhoid Mary meets the ADA: A case study of the direct threat standard under the Americans with Disabilities Act," Harvard Journal of Law and Public Policy 22 (Summer 1999): 853-949.
  58. Bradley v. Univ. of Texas M.D. Anderson Cancer Ctr., 3 F.3d 922, 924 (5th Cir. 1993).
  59. Onishea v. Hopper, 171 F.3d 1289 (11th Cir. 1999) (en banc), cert. denied sub. nom, Davis v. Hopper, 528 U.S. 1114 (2000).
  60. Robert S. Rhodes, Gordon L. Telford, Walter J. Hierholzer Jr., and Mark Barnes, "Bloodborne Pathogen Transmission from Health-care Workers to Patients. Legal Issues and Provider Prospective," Surgical Clinics of North America 75 (1995):1205-1217.
  61. Estate of Mauro v. Borgess Med. Ctr., 137 F.3d 398, 404 (6th Cir. 1998); Doe v. Univ. of Maryland Med. Sys. Corp., 50 F.3d 1261,1266 (4th Cir. 1995). But see Tolman v. Doe, 988 F. Supp. 582 (E.D. Va.1997) (determining that HIV infected cardiologist followed the CDC's guidelines thus cardiologist had a valid defamation claim against his partner in practice who implied to patients that cardiologist was unfit for practice).
  62. Estate of Mauro v. Borgess Med. Ctr., 137 F.3d 398 (6th Cir. 1998).
  63. Estate of Mauro v. Borgess Med. Ctr., 137 F.3d 398 (6th Cir. 1998).
  64. Parks v. Female Health Care Assoc., 1997 WL 285870.
  65. Doe by Lavery v. Attorney General, 44 F.3d 715, opinion superceded by 62 F.3d 1424 (9th Cir. 1995), judgement vacated by 518 U.S. 1014; Doe v. Westchester County Med. Ctr. State Div. of Human Rights, No. 91-504-2 , N.Y.L.J., Dec. 26, 1990, at *30.
  66. Doe v. Univ. of Maryland Med. Sys. Corp., 50 F.3d 1261, 1264 (4th Cir. 1995).
  67. Leckelt v. Bd. of Comm'rs, 909 F.2d 820 (5th Cir. 1990).
  68. Doe v. Washington Univ., 780 F. Supp. 628 (E.D. Mo. 1991).
  69. David W. Webber, ed. AIDS and the Law (New York: John Wiley and Sons Inc., 1997).
  70. Estate of Mauro v. Borgess Med. Ctr., 137 F.3d 398 (6th Cir. 1998); Leckelt v. Bd. of Comm'rs, 909 F.2d 820 (5th Cir. 1990).
  71. Doe v. Univ. of Maryland Med. Sys. Corp., 50 F.3d 1261 (4th Cir. 1995); Doe v. Washington Univ., 780 F. Supp. 628 (E.D. Mo. 1991).
  72. Norman Fost, "Patient Access to Information on Clinicians Infected with Bloodborne Pathogens," Journal of the American Medical Association 284 (October 18, 2000): 1975-1976.
  73. Byron B. Rediger, "Living in a World with HIV: Balancing Privacy, Privilege, and the Right to Know Between Patients and Health Care Professionals," Hamline Journal of Public Law and Policy 21 (Spring 2000): 443-487; Patti Miller Tereskerz, Richard D, Pearson, and Janine Jagger, "Infected Physicians and Invasive Procedures: National Policy and Legal Reality."
  74. Norman Daniels, "HIV-infected Professionals, Patient Rights, and the 'Switching' Dilemma," Journal of the American Medical Association 267 (March 11, 1992): 1368-1371; American College of Surgeons, "Statement on the Surgeon and HIV Infection," (stating that the CDC's policy towards HCWs with HIV is "intrusive in the extreme.")
  75. Lawrence Gostin, "CDC guidelines on HIV or HBV-positive Health Care Professionals Performing Exposure-prone Invasive Procedures," Law, Medicine and Health Care 19 (1991): 140-143.
  76. Estate of Behringer v. Princeton Med. Ctr., 592 A.2d 1251 (N.J. Super. Ct. Law Div. 1991).
  77. In re Milton S. Hershey Med. Ctr., 634 A.2d 159 (Pa. 1993).
  78. Faya v. Almaraz, 620 A.2d 327 (Md. 1993).
  79. Williamson v. Waldman, 696 A.2d 14 (N.J. 1997)(granting emotional distress damages to cleaning employee who feared contracting AIDS after she was pricked by a discarded lancet while cleaning a medical office); Madrid v. Lincoln County Med. Ctr., 923 P.2d 1154 (N.M. 1996) (granting emotional distress damages without evidence of actual exposure to worker who feared exposure to HIV when body fluid samples she was transporting to lab leaked).
  80. Eric S. Fisher, "Aidsphobia: A National Survey of Emotional Distress Claims for the Fear of Contracting AIDS," Tort and Insurance Law Journal 33 (1997): 169-226.
  81. Majca v. Beekil, 701 N.E.2d 1084 (Ill. 1998); K.A.C. v. Benson, 527 N.W.2d 553 (Minn. 1995); Brzoska v. Olsen, 688 A.2d 1355 (Del. 1995); Kerins v. Hartley, 33 Cal. Rptr. 2d 172 (Cal. Ct. App. 1994).
  82. Leckelt v. Bd. of Comm'rs, 909 F.2d 820 (5th Cir. 1990).
  83. Watson v. City of Miami Beach, 177 F.3d 932 (11th Cir. 1999); EEOC v. Prevo's Family Market, Inc., 135 F.3d 1089 (6th Cir. 1998).
  84. Doe v. High-Tech Inst., 972 P.2d 1060 (Colo. Ct. App. 1998).
  85. Benjamin Schatz, "Supporting and Advocating for HIV-positive Health Care Workers," Bulletin of the New York Academy of Medicine 72 (1995): 263-272.
  86. Letter from the Gay and Lesbian Medical Association to the CDC, dated June 26, 1996.
  87. American College of Surgeons, "Statement on the Surgeon and HIV Infection."
  88. Julie Gerberding, "Provider-to-patient HIV Transmission: How to Keep it Exceedingly Rare;" Annals of Internal Medicine 130 (January 5, 1999): 64-65; Julie Gerberding, "The Infected Health Care Provider," New England Journal of Medicine 334 (February 29, 1996): 594-595.
  89. Julia S. Garner, "Hospital Infections Practices Advisory Committee. Guideline for Isolation Precautions in Hospitals," Infection Control and Hospital Epidemiology 17 (1996): 53-80; Susan E. Beekman et al., "Temporal Association Between Implementation of Universal Precautions and a Sustained Progressive Decrease in Percutaneous Exposures to Blood," Clinical Infectious Diseases 18 (1994): 562-569.
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