surgeons operating 298.8.
(photo credit: Courtesy)
The Health Ministry says it sees no reason for surgeons to undergo periodic tests for HIV, hepatitis B or other infectious diseases or to inform patients in advance if their surgeon is a carrier.
Ministry associate director-general Dr. Boaz Lev told The Jerusalem Post on Wednesday that "surgeons are not a high risk group" for HIV and that the risk of a surgeon infecting a patient during an operation with HIV is "infinitesimal."
Lev was commenting on the case of a senior and well-known but unnamed cardiac surgeon and professor who has operated on 1,000 patients in the last decade and only this week learned that he was an HIV carrier. The professor, married and with children, who is not a homosexual or a drug user, was ill with flu that didn't go away; when his tests came back, he was told he carried the AIDS virus. He is now at home, "digesting" the tragic news, and it has not yet been decided whether he will be allowed to resume surgery.
"We are discussing the issue," said Lev. "Such a surgeon could use double latex gloves to prevent his blood from mixing with that of patients if his hands are pricked with the scalpel. He will also receive the drug 'cocktail' that reduces the viral load and would make him less infectious."
The surgeon worked at Tel Aviv Ichilov Hospital, Carmel Hospital in Haifa, the Herzliya Medical Center and its Horev Center in Haifa. So far, only 55 of the surgeon's 1,000 former patients have asked to undergo HIV tests. As of Wednesday afternoon, all test results which were received came back negative.
The ministry has been trying to calm down patients by saying that the chance of being infected by a surgeon who carries HIV is very minimal, and that the US Centers for Disease Control and Prevention do not require sending out such letters when this is discovered, informing patients in advance or undergoing periodic tests for infectious diseases.
"HIV doesn't affect a surgeon's ability to do his job; it is now considered to be a chronic illness, although it is infectious," Lev asserted. "The professor is a private person," he added. The risk of a patient being infected with hepatitis B by a surgeon is higher than HIV, but the ministry still does not think periodic testing and informing patients of this are necessary.
The Israel Medical Association has reportedly opposed strongly the idea of periodic blood tests for surgeons and other doctors who perform invasive procedures on patients and of any requirement to inform patients that their scheduled surgeon is an HIV or hepatitis B carrier. No comment was available from the IMA.
International medical ethics told The Jerusalem Post that contrary to the Health Ministry and IMA positions, the rules of ethics require informed consent by patients, and if they are not told the surgeon is a carrier, informed consent is violated. For one operation, they said, the risk is very small, but if thousands of surgeons perform hundreds of thousands of operations and some are HIV carriers the public have a right to know, as the risk is more substantial. Legal experts added that if a surgeon is a carrier and doesn't tell his patient in advance, he could be accused of the criminal act of "attack"
The Ichilov spokeswoman said that if the ministry were to require all surgeons to undergo period blood tests, its doctors would observe this rule.
There is no way to prove how the surgeon was infected with HIV, whether by sexual or drug-injecting conduct or from a patient. "In the whole world, there have been only two reported cases of patients being infected with HIV by their medical practitioners, and one was an Israeli dentist over a decade ago who intentionally infected a girl with his HIV-infected blood," she said.
Ichilov has set up a special number - (03)6974058 - to coordinate free HIV tests for patients who were operated on by the professor.