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Moving From Autonomy to Responsibility in HIV-Related Healthcare

Published online by Cambridge University Press:  29 July 2009

John F. Tuohey
John F. Tuohey
Affiliation:
an assistant professor in the Department of Theology at the Catholic University of America, Washington, D.C.
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Extract

No healthcare issue has generated as much ethical debate on the relationship between the individual and society as HIV Infection. In this debate, an appeal is most often made to such principles as autonomy and confidentiality to protect individuals who are HIV positive or who have AIDS from an invasion of privacy thought to be justified by society's need for information. In the first years, this emphasis on the protection of the individual was essential. Even today, there are risks in disclosing one's HIV status. However, as more and more persons become Infected, live longer, and move within the healthcare industry for non-HIV related care, as both patients and healthcare workers, the terms of the debate need to be redefined.

Type
Special Section: Beyond Autonomy
Information
Cambridge Quarterly of Healthcare Ethics , Volume 4 , Issue 1 , Winter 1995 , pp. 64 - 70
Copyright
Copyright © Cambridge University Press 1995

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References

1. Reisman, EC. Ethical issues confronting nurses. Nursing Clinics of North America 1988;23:789–802.Google ScholarPubMed

2. Srivastava, AC, Pinching, AJ, Adler, MW, Robertson, R, Higgs, R. Identity cards for patients infected with HIV? British Medical Journal 1987;294:495–6.CrossRefGoogle Scholar

3. Uzych, L. HIV testing: the legal balance between individual and societal rights. Southern Medical Journal 1990;83:304–7.CrossRefGoogle ScholarPubMed

4. Zuck, TF. Legal liability for transfusion injury in the acquired immunodeficiency syndrome era. Archives of Pathology and Laboratory Medicine 1990;114:309–15.Google ScholarPubMed

5. Walters, L. Ethical issues in the prevention and treatment of HIV infection and AIDS. Science 1988;239:597–603.CrossRefGoogle ScholarPubMed

6. Lo, B, Steinbrook, RL, Cooke, M, Coates, TJ, Walters, EJ, Hulley, SB. Voluntary screening for human immunodeficiency virus (HIV) infection: weighing the benefits and harms. Annals of Internal Medicine 1989;110:727–33.Google ScholarPubMed

7. Lentz, S. Confidentiality and informed consent and the acquired immunodeficiency syndrome epidemic. Archives of Pathology and Laboratory Medicine 1990;114:304–8.Google ScholarPubMed

8. Wold, JL. AIDS testing, an ethical question. Journal of Neuroscience Nursing 1990;22:258–61.CrossRefGoogle ScholarPubMed

9. Matthews, GW, Neslund, VS. The initial impact of AIDS on public health law in the United States—1986. Journal of the American Medical Association 1987;257:344–52.CrossRefGoogle Scholar

10. Tanne, JH. US decides not to lift AIDS ban [news]. British Medical Journal 1991;302:1360.Google Scholar

11. Mondragon, D, Kirkman-Liff, B, Schneller, ES. Hostility to people with AIDS: risk perception and demographic factors. Social Science and Medicine 1991;32:1137–42.CrossRefGoogle ScholarPubMed

12. Centers for Disease Control. Possible transmission of human immunodeficiency virus to a patient during an invasive dental procedure. Morbidity and Mortality Weekly Report 1990;39:489–93.Google Scholar

13. Samaranayake, LP, McDonald, KC. Patient perception of cross-infection prevention in dentistry. Oral Surgery, Oral Medicine and Oral Pathology 1990;69:457–60.CrossRefGoogle ScholarPubMed

14. Gerbert, B, Maguire, BT, Spitzer, S. Patients' attitudes toward dentistry and AIDS. Journal of the American Dental Association 1989;Suppl:16S–21S.CrossRefGoogle ScholarPubMed

15. Centers for Disease Control. Update: transmission of HIV infection during an invasive dental procedure-Florida. Journal of the American Medical Association 1991;265:563–8.CrossRefGoogle Scholar

16. Helms, J. Yes: protect innocent victims. American Bar Association Journal 1991;77:46 with the reply of Isbell M. No: don't scapegoat doctors. 47.Google Scholar

17. Orentlicher, D. HIV-infected surgeons: Behringer v medical center. Journal of the American Medical Association 1991;266:1134–7.CrossRefGoogle Scholar

18. Rhame, FS. The HIV-infected surgeon. Journal of the American Medical Association 1990;264:507–8.CrossRefGoogle ScholarPubMed

19. Mishu, B, Schaffner, W, Horan, JM, Wood, LH, Hutchenson, RH, McNabb, PC. A surgeon with AIDS: lack of evidence of transmission to patients. Journal of the American Medical Association 1990;264:467–70.CrossRefGoogle ScholarPubMed

20. Gostin, L. HIV-infected physicians and the practice of seriously invasive procedures. Hastings Center Report 1989;19:32–9.CrossRefGoogle ScholarPubMed

21. Dudley, HAF, Sim, A. AIDS: a bill of rights for the surgical team? British Medical Journal 1988;269:1449–50.CrossRefGoogle Scholar

22. Whalen, JP. Participation of medical students in the care of persons with AIDS. Journal of Medical Education 1987;62:53–4.Google ScholarPubMed

23. Clarke, OW, Conley, RB. The duty to ‘attend upon the sick.’ Journal of the American Medical Association 1991;266:2876–7.CrossRefGoogle Scholar

24. Blumenfield, M, Smith, PJ, Milazzo, J. Survey of attitudes of nurses working with AIDS patients. General Hospital Psychiatry 1987;9:58–63.CrossRefGoogle ScholarPubMed

25. Barbara, G, Maguire, BT, Bleecker, T, Coates, TJ, McPhee, SJ. Primary care physicians and AIDS: attitudinal and structural barriers to care. Journal of the American Medical Association 1991;266:2837–42.Google Scholar

26. National Commission on AIDS, Report Number Three. Research, the workforce and the HIV epidemic in rural America. 1990: August 21.Google Scholar

27. These statistics have been challenged by Kunzel, C, Sadowsky, D. Comparing dentist's attitudes and knowledge concerning AIDS: differences and similarities by locale. Journal of the American Dental Association 1991;122:55–61.CrossRefGoogle Scholar

28. Hartley, M. Dentists wear gloves, balk at treating victims. Dentist 1988;66:46–7.Google Scholar

29. Centers for Disease Control. Recommendations for prevention of HIV transmission in healthcare settings. Morbidity and Mortality Weekly 1987;36: 3S–18S.Google Scholar

30. Centers for Disease Control. Update: universal precautions for prevention of transmission of human immunodeficiency virus, hepatitis B virus, and other bloodborne pathogens in health-care settings. Morbidity and Mortality Weekly Report 1988;37:376–89.Google Scholar

31. Koska, MT. AIDS precautions: compliance difficult to enforce. Hospitals 1989;63:58–60.Google ScholarPubMed

32. Baraff, LJ, Talan, DA. Compliance with universal precautions in a university hospital emergency department. Annals of Emergency Medicine 1989;18:654–7.CrossRefGoogle Scholar

33. Talan, DA, Baraff, LJ. Effect of education on the use of universal precautions in a university hospital emergency department. Annals of Emergency Medicine 1990;19:1322–6.CrossRefGoogle Scholar

34. Hammond, JS, Eckes, JM, Gomez, GA, Cunningham, DN. HIV, trauma, and infection control; universal precautions are universally ignored. Journal of Trauma 1990;30:555–8.CrossRefGoogle ScholarPubMed

35. Klein, RS, Phelan, JA, Freeman, K et al. , Low occupational risk of human immunodeficiency virus infection among dental professionals. New England Journal of Medicine 1988;318:86–90.CrossRefGoogle ScholarPubMed

36. Jakush, J. AIDS: the disease and its implications for dentistry. Journal of the American Dental Association 1987;115:395–403.CrossRefGoogle ScholarPubMed

37. Bachner, P. The epidemiology of fear. The Archives of Pathology and Laboratory Medicine 1990;114:319–23.Google Scholar

38. Henry, K, Thurn, J. HIV infection in healthcare workers: how great is the risk? what can be done before and after exposure? Post Graduate Medicine 1991;89:30–8.CrossRefGoogle ScholarPubMed

39. Weisman, AD. On Dying and Denying: A Psychiatric Study of Terminality. New York: Behavioral Publications, 1972.Google Scholar

40. Cousins, N. Denial: are sharper definitions needed? journal of the American Medical Association 1982;248:210–2.CrossRefGoogle ScholarPubMed

41. Strauss, DH, Spitzer, RL, Muskin, PR. Maladaptive denial of physical illness: a proposal for DSM-IV. American Journal of Psychiatry 1990;147:1168–72.Google ScholarPubMed

42. Stoudemire, A, Rhoads, JM. The physician-patient. Annals of Internal Medicine 1983;98:654–9.CrossRefGoogle ScholarPubMed

43. Meyers, C. The impact of physician denial upon patient autonomy and well-being, journal of Medical Ethics 1992;18:135–7.CrossRefGoogle ScholarPubMed

44. Fournier, AM, Zeppa, R. Preoperative screening for HIV infection: a balanced view for the practicing surgeon. Archives of Surgery 1989;124:1038–40.CrossRefGoogle ScholarPubMed

45. Gerst, PH, Fildes, JJ, Rosario, PG, Schorr, JB. Risks of human immunodeficiency virus infection to patients and healthcare personnel. Critical Care Medicine 18; 1990:1440–8.CrossRefGoogle ScholarPubMed

46. Taylor, KM, Shapiro, M, Skinner, HA, Eakin, J, Kelner, M. Understanding physicians' response to AIDS. Canadian Medical Association Journal 1989;140:597–602.Google ScholarPubMed

47. Schwartz, JN. Physician education: the challenge of acquired immunodeficiency syndrome. Archives of Pathology and Laboratory Medicine 1990;114:316–8.Google ScholarPubMed

48. Menitove, JE. Current risk of transfusion-associated human immunodeficiency virus infection. Archives of Pathology and Laboratory Medicine 1990;114:330–4.Google ScholarPubMed

49. Marcus, R, CDC Cooperative Needlestick Surveillance Group. Surveillance of health care workers exposed to blood from patients infected with the human immunodeficiency virus. New England Journal of Medicine 1988;319:1118–23.CrossRefGoogle Scholar

50. Neuberger, JS, Harris, J, Kundin, WD, Bischone, A, Chin, TDY. Incidence of needlestick injuries in hospital personnel: implications for prevention. American Journal of Infection Control 1984;12:171–6.CrossRefGoogle Scholar

51. Jagger, J, Pearson, RD. Universal precautions; still missing the point on needlesticks. Infection Control and Hospital Epidemiology 1991;12:211–3.CrossRefGoogle ScholarPubMed

52. Whitby, M, Stead, P, Najman, JM. Needlestick injury: impact of a recapping device and an associated education program. Infection Control and Hospital Epidemiology 1991;12:220–5.CrossRefGoogle ScholarPubMed

53. Stock, SR, Gafni, A, Block, RF. Universal precautions to prevent HIV transmission to health care workers: an economic analysis. Canadian Medical Association Journal 1990;142:937–46.Google ScholarPubMed

54. Occupational exposure to bloodborne pathogens: proposed rule and notice of hearings (29 CFR 1910). Federal Register 1989;54:23042–139.Google Scholar

55. McCurdy, SA, Ferguson, TJ, Schenker, MB. Mucocutaneous injuries at a university teaching hospital. Western Medical Journal 1989;8:101–6.Google Scholar

56. Jagger, J, Hunt, EH, Brand-Elnaggar, J, Pearson, RD. Rates of needle-stick injury caused by various devices in hospital workers. New England Journal of Medicine 1988;319:284–8.CrossRefGoogle Scholar

57. Henry, K, Campbell, S, Jackson, B et al. , Long-term follow-up of health care workers with worksite exposure to human immunodeficiency virus [Letter]. Journal of the American Medical Association 1990;263:1765–6.CrossRefGoogle Scholar

58. Whyte, J. HIV testing [letter]. Archives of Medicine and Rehabilitation 1988;69:899.Google Scholar

59. Centers for Disease Control. Public health service statement on management of occupational exposure to the human immunodeficiency virus, including considerations regarding zidovudine postexposure use. Morbidity and Mortality Weekly Report 1990;39:1–14.Google Scholar

60. Failures renew doubts about prophylactic zidovudine. AIDS Alert 1992;7:177–9.Google Scholar

61. Fillipo, BH, Russin, SJ. What to do when results of a Western blot test are indeterminate. Post Graduate Medicine 1991;89:39–47.CrossRefGoogle Scholar

62. Reed, JS, Anderson, AC, Hodges, GR. Needlestick and puncture wounds: definition of the problem. American Journal of Infection Control 1980;8:101–6.CrossRefGoogle Scholar

63. Spears, R, Abrams, D, Sheeran, P, Abraham, SCS, Marks, D. Social judgements of sex and blame in the context of AIDS: gender and linguistic frame. British Journal of Social Psychology 1991;30:37–49.CrossRefGoogle ScholarPubMed

64. Northcott, HC, Reutter, L. Public opinion regarding AIDS policy: fear of contagion and attitude toward homosexual relationships. Canadian Journal of Public Health 1991;82:87–91.Google ScholarPubMed