Non-consensual testing after needlestick injury is an increasingly important issue for many healthcare workers, and also for police, prison officers and others who have suffered a sharps injury with a needle from an individual who is known but in circumstances where his/her infection status is unknown.

This creates an immediate and hugely important question – do we treat the sharps injury victim with anti-retrovival drugs, or can this be avoided safe in the knowledge that the source patient is not infected?

This particular legal and ethical drama is played out regularly – though in the waste sector the opportunity to identify the source patient is inevitably lost raising the index of suspicion for all sharps injuries in this group.

A recent training case is described here, by Charles Foster and Jonathan Herring of the University of Oxford Practical Ethics blog.

Like many patients in ICU, X is incapacitous. He also needs a lot of care. Much of that care involves needles. Late at night, tired and harassed, Nurse Y is trying to give X an intravenous injection. As happens very commonly, she sticks herself with the needle.

What comes next?

The case is reviewed from the perspective of barristers acting for X and for Y. Played out as if in The Royal Courts of Justice the judgment is of crucial importance, but perhaps surprisingly it is not given. You decide!