Policy on Students With Blood-Borne Pathogens
The College of Dental Medicine recognizes that candidates for admission to the College or students currently enrolled in the College may present with or contract blood borne pathogen diseases (BBPD) and that a “carrier state” for such pathogens may develop. The College policy pertinent to such individuals is contained in this document. Specific matters of clinical conduct such as infection control, accidental exposure of patients and their right to know, etc. are contained in the College’s “Clinical Policy and Procedure” document.
I. Candidates for Admission
An individual applying for admission to the College of Dental Medicine who is a carrier of a blood-borne pathogen (hepatitis B, hepatitis C, HIV, et.al.) may disclose such a condition. Such candidates are considered under the Americans with Disabilities Act to have a disability, and their application is addressed in that context. Specifically, individuals with disabilities which may affect their ability to meet all curriculum requirements will be individually appraised by a special ad hoc committee appointed by the Dean for that purpose. The support of the applicant’s personal physician’s assessment of the applicant’s ability to participate in the full curriculum will be an integral part of the process. If modification of the curriculum is required to protect the applicant, colleagues, or patients, the impact of those proposed curricular modifications and their effect on the applicant’s ability to meet the minimal, essential requirements for the receipt of the DDS degree must be evaluated. Again, such evaluations are done in a confidential manner in consultation with the individuals designated physician and in consultation with our own Student Health Service.
II. Enrolled students who become carriers of blood-borne pathogens
The ADA notes that: dentists infected with blood-borne pathogens can safely provide dental care...[and that] blood-borne pathogen infection alone does not justify the limiting of professional duties or automatically mandate disclosure, provided proper infection-control procedures are implemented. Infected dental healthcare workers must practice in compliance with CDC or equivalent infection-control recommendations, as required by applicable law.
In keeping with policies pursuant to the Americans with Disabilities Act, each person in this category is individually assessed with supporting documentation from his or her physician as to their ability to meet requirements for receipt of the degree, bearing in mind the safety of the student, colleagues, and patients. Whether or not the individual may continue in pursuit of the degree is dependent upon the extent to which their curriculum must be modified, and whether the minimal, essential requirements for the DDS degree can be met.
The Task Force for the Lexington Conference noted that there exists “No requirement that a patient be notified of a student’s serostatus for BBP infection before the student’s performing a procedure on the patient (informed consent is not deemed necessary) …Further, such students “...should consult with their own health care provider regarding their status and their professional goals, if appropriate.” Students must make any requests for curricular modification known to the appropriate personnel in the academic or clinical offices of the College. The acceptability of these requests for curricular modifications and the extent to which they can be implemented must be considered from the perspective of the institution’s technical standards.
III. Decision Process
Respecting confidentiality of medical records, access to this information for the decision process is limited to qualified medical staff of the University, the applicant or student’s personal physician, and to the ad hoc committee expressly designated for this purpose by the College.
IV. “Right to Know”
With an exposure, the patient has just as much “right to know” as does an exposed healthcare provider, although it may not be necessary to disclose the specific identity of the source. This places both a moral and an ethical responsibility on the student (as a source of exposure) to report such exposure immediately, to report any personally known possible infectious status, and to participate in testing.