Introduction
Health care is one of the fields facing very difficult legal and moral issues in the society. Professionals in health care are put in a hard position while executing their duties due to the underlying moral and legal implications involved. Health policies regarding Acquired Immune Deficiency Syndrome (AIDS), abortions, end of life care and many other aspects vary from state to state as well as the international level. There are no internationally accepted standards that determine in finality how doctors and health care providers should handle such matter. Laws and constitutions have attempted to provide guidelines as to how such controversial medical position can be handled legally.
Legal and Moral Stance towards HIV/AIDS
Several profession organizations and societies such as Association of Reproductive Health Professionals (ARHP) and the American Association of Nurse Anesthetists (AANA) have taken upon themselves to provide guidelines for its members . This paper studies the moral and legal stance of health care profession towards Human Immune Deficiency Virus (HIV) and AIDS status. The AANA has developed policies with respect to provision of health care to AIDS patients and the procedure for voluntary testing for HIV. Questions have been raised whether medical professionals who have contacted the HIV virus should be allowed to continue with the practice. In case of practicing professionals who have contacted the virus, there is question as whether they are obligated to inform the patients about their HIV status.
While the society expect health care providers to treat AIDS patients without discrimination on the basis of the HIV status of the patients, the same society has a problem with health care providers who have contacted the virus. Many people are of the view that medical professionals, especially surgeons, should not continue to practice since there is an unfounded theory that chances of transmitting the virus is increased . Though this might not be the case, there are valid arguments in support for the disclosure of HIV status of the health care profession based on moral reasons.
Two cases clearly illustrate the need for such a disclosure. The premise of the cases was that an oncological surgeon had continued to practice after he had been diagnosed to be HIV positive. In the first case the surgeon operated on the patient in 1989 with full know ledge that he was HIV positive. In the second case, the same doctors operated on a second patient with the status now at a much developed stage of confirmed AIDS. This was due to the fact that the surgeon had cytomegalovirus retinitis, an infection of the retina of the eye which was found to be due to AIDS. He went ahead and operated on the two patients with the risk of transferring the virus in case of an accident in the operating room. The doctors stopped practicing surgery the following year and passed on later that year due to AIDS.
The two patients learned of doctor’s death and its cause through a local newspaper. The two individuals were tested for HIV and AIDS and the result was negative. Even so, the two patients went ahead and sued the professional association, the hospital and what was the late surgeon estate. In the suit, the two claimed to have suffered emotional distress, fraud and intention to afflict pain due to the fact that they had not been informed that the doctor was HIV positive. The claim further suggested that two were in danger of contacting the virus due to the commingling of blood. And that had they been informed of the doctor’s condition, they would have opted for a different surgeon. Thus the two were demanding for compensation of the late doctor’s estate.
During the initial trial, the court dismissed the case as the plaintiffs were both HIV negative and that the surgeon was said to have a good job. On the contrary, upon appeal at the Court of Appeals of Mary land, the court gave a conflicting verdict and held that a surgeon and the hospital have the obligation to inform the patient of his HIV status. Failure to this the hospital, the medical association and the health practitioner will be held liable in such a case.
Implication
The Court of Appeals of Maryland brought to the fold the policy adopted by American Medical Association (AMA). In the policy, health care workers and other physician who are HIV positive have the obligation to inform the hospital and local review committee of their condition. Secondly, the physician should refrain from performing any medical procedures that pose a danger in HIV transmission to the patient unless after obtaining an express consent for the patient. This consent must also come from the local review committee .
This then puts the health care at great risk of court trails and other legal proceedings. Physicians who do not know about their HIV status are in danger of such proceedings. To avert this, health care professional are required to undergo frequent voluntary testing without failure. This puts a big emotional burden to the health care workers in the United States.
References
American Association of Nurse Anesthetists, (1992). Infection Control Guide. Professional Practice Manual for the Certified Registered Nurse Anesthetist. Park Ridge, Illinois.
Blumenreich, G. A. (1993). Legal Briefs: The law and the AIDS-infected healthcare worker. Boston: Powers & Hall.
Maḥmūd, J. (2004). Aids in the World. APH Publishing.
Spiegel, A. D., & Kavaler, F. (2003). Risk management in health care institutions: a strategic approach; Administration and Management Series. Jones & Bartlett Learning.
