(griffiths Et Al 2002) to Provide A Balanced View On The Subject We Should

(Griffiths et al 2002)
To provide a balanced view on the subject we should observe that the converse of our argument so far is put by other workers in the field (EHC 1999), who argue for the enhancement of the contact tracing facilitators and facilities in order to properly maximise a reduction in the risk of both personal re-infection and the level of infection in the community

The central importance of this argument is exemplified in an excellent paper by Patel (HC et al 2004). This looked at the reliability of contact tracing mechanisms. The paper itself is both long and involved. It followed up over 250 patients over a five year period. in short, the authors reported that if the infected patient had a regular partner, they were likely to turn up for treatment in about 53% of cases, whereas if there was an extramarital partner only about 13% would receive treatment. The implication is clearly (although it is obviously admitted that there are significant confounding factors), that an infected patient is far more likely to tell their marriage partner than an extramarital sexual partner.
Conclusions and suggestions for practice.
In order to help with such considerations we note that the main professional bodies issue their own comprehensive guidelines. They are issued jointly by both the BMA and RCN for all healthcare professionals(Dimond. B. 1999). The documents themselves are unsurprisingly enormous, and offer outline guidance on virtually every major issue and they follow the principles that we have already set out. They equally make the point that not every eventuality can either be predicted or catered for, and in these circumstances the healthcare professional is left to make their own judgement based on their interpretation of the underlying principles and circumstances.

In our interpretation of these principles, it would appear that the overriding consideration in the case of Mrs.P. is that of autonomy. There may well be a substantial evidence base that we could point to which would suggest that Mrs.P.'s refusal to tell either her husband or sexual partner could have serious and possibly long lasting adverse effects on their health. But in the last analysis, Mrs.P. has the right of consent to her personal details being divulged either explicitly or by inference and implication to any other person. If that consent or permission is withheld then the healthcare professional would be expected to respect that right, even if they had personal difficulty with it themselves.

There is an implicit obligation on healthcare professional not only to enhance the patient's autonomy but also to take as many steps as possible to ensure that any decision reached by the patient is truly autonomous.