Examining public health nurses’ documentary practices: the impact of criminalizing HIV non-disclosure on inscription styles

Abstract

In Canada, there has been a rise in criminal HIV non-disclosure cases where public health records have been subpoenaed for use in police investigations and criminal court proceedings. In particular, public health nurses’ written counseling notes, originally collected for the purposes of creating a record of treatment and a plan of care, have been used as evidence against their clients. This article engages sociologically with this issue by analyzing whether and how this criminal law development has affected public health nurses’ reasoning and documentary practices in settings of HIV post-test counseling sessions. The paper argues that variations in nurses’ inscription styles result in part from considerations about the criminal law, which indicates the influence of ‘medico-legal’ relations that connect health care and the criminal justice system. Implications for nursing practice and the broader goals of HIV prevention are discussed. Data are drawn from interviews with thirty nurses working at four public health units in Ontario.

Keywords:

• criminalization
• documentation
• HIV
• nursing

Acknowledgements

The author is grateful to Eric Mykhalovskiy, Julia Dickson-Gomez, and the anonymous reviewers for their thoughtful suggestions on improving this article.

Additional information

Funding

This work was supported by Universities Without Walls, a Strategic Training Initiative In Health Research (STIHR) of the Canadian Institutes of Health Research (CIHR) housed at the Ontario HIV Treatment Network (OHTN); and a NRSA postdoctoral training grant [T32-MH19985] from the National Institute of Mental Health.