To tell or not to tell

Questions asked on who should be the authority to reveal one’s HIV status 

Health: The 29-year-old woman, who was claimed to be an alcoholic and an alleged HIV positive, is admitted to the Thimphu referral hospital for treatment, health officials said.

A post about her alleged HIV status and risky sexual behavior went viral on social media after Chithuen Phendey Association, a CSO that helps recovering alcoholics posted a letter it had written to police seeking their intervention in rehabilitating her.

Health officials said she was admitted to the hospital on December 9 for detoxification and has an attendant from Chithuen Phendey.

The association’s post alleged that despite knowing her HIV status, she continues to drink and sleep on the streets, from where men pick her every night. “It’s also assumed that by now she might have contacted sex with at least 50 men,” the letter alleged.

Chithuen Phendey’s executive director Tshewang Tenzin said he shared the letter on social media in the interest of public health and not to imply that they received no support from police.

“I posted it on social media out of desperation because I thought it’s a problem that needed immediate response,” he said. “I have seen her being picked up by men.”

While cautioning the public, the letter has also thrown up questions on who should be responsible for cases such as hers and who, in the interest of public health, should at all be the authority on revealing an individual’s HIV status.

The health ministry and CSOs it works closely with are aware about her health issues and have regularly intervened to provide her treatment and employment.

But officiating secretary Dr Ugen Dophu said the ministry and its relevant programme should still intervene in handling the case even though it was the police’s help that the association had sought.

“Breaking one’s confidentiality will not necessarily stop other people from having sex,” he said. “Instead, the person will be marginalized which would build up more anger in them.”

According to sources, the woman is a divorcee with a nine -year old daughter, abandoned by her family and husband, which could have been the cause behind her drinking problem.

Chithuen Phendey’s allegation of her HIV status has however concerned Lhak-sam, the Bhutanese network of people living with HIV.

Lhaksam’s executive director Wangda Dorji said such allegation would affect not only her but also her family. “Irrespective of her HIV status, the association is not allowed to reveal such information,” he said. “It’s a violation of human rights and such allegation would not only shame HIV positives but also discourage people from getting tested.”

He said that according to UN estimates, there are still more than 700 HIV positives undetected in the country. When men take advantage of a woman under the influence of alcohol, he said, it’s not right to blame her, irrespective of her HIV status.

Officials at the Health Information Service Centre (HISC) are also concerned about the impact such an allegation would have on the work done to de-stigmatize HIV.

Head of HISC Ngawang Choida said all health personnel who are bound by the ethics and the policy to maintain confidentiality of their clients and patients.

“This is sad and we are not in favour of what Chithuen Phendey is alleging,” he said. “We all are at risk and she is not the only one who should be held responsible. Others are equally responsible.”

Chithuen Phendey’s executive director Tshewang Tenzin said he did not reveal the woman’s name but only brought it out as an issue.  He had also posted, section 410 of the Penal Code which states that  “A defendant shall be guilty of the offence of criminal nuisance, if the defendant knowingly or recklessly creates or maintains a condition including spreading of dangerous disease that injures or endangers the safety or health of the public.

Wangda Dorji said in case of HIV diagnosis, the health officials are the first ones to know about one’s status and if they don’t reveal, confidentiality is usually maintained.

The Bhutan medical council regulations mandate all health personnel to keep patient information confidential except where disclosure of patient information is allowed by ethical and legal obligations. Maintaining professional confidentiality is listed as one of their duties to patients, under the code of conduct.

Sonam Pelden

4 replies
  1. logical
    logical says:

    I appreciate the custom of keeping apart persons suspected of contacting new illness. If persons just SUSPECTED of contacting illness that may be contageous are so treated for the good of the rest, why are persons with confirmed cases of certain contageous illness (like AIDS) let loose, witholding information from the public?
    The Medical Department should be responsible for moral, legal and technical complications, by their own controversial standard. Let the ARMY of SICK PERSONS with contageous diseases be contained in confined territiries till they cure or are no more! Privacy of the sick people is less important to safery of healthy population. Peace.

    • Ihavepopcornyeah
      Ihavepopcornyeah says:

      Are you Stupid? Or just simply ignorant? What this man did was unethical!
      Would you like it if I or anyone wrote an article of your health status or deviant behavior? Is your pen-name “Logical” a way to be ironic? If your idea to isolate others with HIV/AIDS is “Logical”? Why not do the same with uneducated people? Why not separate the intelligent and worthy from the stupid and the unworthy? Why not sterilize the poor, the peons, the villagers, the weaker beings, the mentally unstable, the sick, the ones with cancer, the ones with absolutely no ties with the royalties or the nobles, the people who cannot contribute to the country? So we may have the chance to reduce the likely hood of having more stupid, unhealthy, unstable, poor, unworthy etc.
      Do I sound logical to you now? Because what you say can be said for every aspect not just the “Sick”.

  2. awakened
    awakened says:

    i think the director of Chithuen Phendey did the right thing. In the name of ethics i don’t think we can put anyone’s lives at risk. I am just dreading thinking about how many people she has already infected. The onus is on the medical professionals who should brief people with HIV properly, esp those with additional drinking or drugs problem.

    • Ihavepopcornyeah
      Ihavepopcornyeah says:

      She was raped! Do you expect her to go “OH I have HIV!” as the men force themselves on a woman who cannot fight for herself? Would the same thing have happened to your sister or cousins or mother, would you still blame your female relatives? Should a rape victim be blamed for the acts of criminals? OR in a way you may understand, should the person who was robbed be blamed and not the robber? Does the blame fall on the murdered and not the murder?

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