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Ethical Issues of HIV and AIDS in Health Care


Ethical Issues of HIV and AIDS in Health Care Presented by Yu-Fen Lin HIV & AIDS HIV Human Immunodeficiency Virus AIDS Acquired Immune Deficiency Syndrome The ... – PowerPoint PPT presentation

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Title: Ethical Issues of HIV and AIDS in Health Care

Ethical Issues of HIV and AIDS in Health Care
  • Presented by
  • Yu-Fen Lin

  • HIV
  • Human Immunodeficiency Virus
  • AIDS
  • Acquired Immune Deficiency Syndrome

The legal definition of AIDS
  • When a persons T-cell count goes below 200,
    he/she is considered as having AIDS.

Three primary types of contact that can result in
transmission of HIV
  • Sexual contact, that is, contact with infected
    genital secretions (semen, vaginal fluids,
    menstrual blood)
  • Injection of infected blood through transfusions
    or needle sharing
  • Pregnancy in an infected mother

Transmission that is not biological possible
  • Shaking hands
  • Sharing a toilet
  • Sharing eating utensils
  • Being sneezed upon
  • Living in the same household
  • Working in the same room or attending the same
  • Closed-mouth kissing

Social stigmatization
  • HIV disease, in particular, carries with it the
    social stigmatization that complicates mental
    health and threatens life-sustaining activities.
  • Telling friends Im HIV positive is not the
    same as telling them Im gaydouble coming out,
    the first closet and the second closet

Ethics issues related to HIV AIDS
  • Disclosure
  • Disability rights
  • Economical resources
  • Employment rights
  • Medication Treatments
  • Suicide
  • Duty to warn

  • To tell or not?
  • Decisions whether to disclose the diagnosis in
    the workplace.
  • A doctor with HIV needs not to disclose?

Disability Rights
  • Disability rights awareness
  • e.g., Somehow a check-out person at a local
    grocery store found out I had AIDS and started
    wearing latex gloves every time she waited on me.
    I called their legal department and informed them
    that this needed to stop or I would sue them

Economical resources
  • Financing treatment
  • e.g., Medicare doesnt pay for my prescriptions
  • Different kind and degree of services than a
    person who is employed and who has health
    insurance and other resources available.

  • Can they decide whether to stay in their current
    position or not?
  • e.g., My old job as a nursing assistant was too
    high risk, so I had to leave.
  • Emotionally missing work
  • e.g., Work had always been important to me and
    it really hit me all at once that I wasnt able
    to do it anymore.

Medication Treatments
  • Dissatisfactory with the treatment providers
  • e.g., A lot of times Im not in the mood to
    talk with the doctors in the clinic. They dont
    listen and they are very clinical.

Medication Treatments contd.
  • Treatment effects
  • e.g., I had a very bad reaction to the drug I
    was taking and had to go back into the hospital

Suicide the dilemma of the right to die
  • High suicidal rate
  • the relative risk of suicide in men with AIDS
    aged 20-59 years was 36.30 timesthat of men aged
    20-59 years without this diagnosis. (New York
    City, 1988)
  • Seven people during a 6-week period took their
    own lives after testing positive for the virus,
    even though they were asymptomatic
  • (Miami, 1987)

Is there a legal duty to protect or warn third
  • Whether a therapist has a duty to protect third
    parties when his or her patient, if HIV-positive,
    persists in engaging in unprotected sex with an
    unknowing partner involves complex clinical and
    legal questions which have not been adequately

Counselors guide to make an ethical decision
  • Moral Principles
  • Ethical decision making model

Moral principles
  • Autonomy individual freedom and choice
  • Nonmaleficence do no harm to clients
  • Beneficence the welfare of the clients
  • Justice If an individual is to be treated
    differently, the counselors needs to offer a
    rationale that explains
  • Fidelity loyalty, faithfulness and honoring

Ethical decision making model
  • Identify the Problem
  • Apply the ACA Code of Ethics
  • Determine the nature and dimensions of the
  • Generate potential consequences of all options
    and determine a course of action

  • 5. Consider the potential consequences of
  • all options and determine a cause of
  • action.
  • 6. Evaluate the selected course of action.
  • 7. Implement the course of action.

Counseling implications
  • Counselors require to be knowledgeable about
    federal, state, and local laws.
  • Especially when illegal treatment in the
    workplace takes place, counselors advocate for
    clients who have encountered discrimination

About disclosure, counselors can
  • Help clients identify the risks and benefits they
    are likely to encounter by disclosing their
  • Help clients explore concerns associated with the
    fear of disclosure, living with nondisclosure.

About the treatment issues, counselors can/may
  • May find their clients feeling overwhelmed with
    their medical treatment, medical personnel, and
    health care systems.
  • Can help clients to cope with emotional reactions
    to their illness and to interpersonal
    insensitivity from medical care providers.

Risk reduction counseling is suggested
  • Safer sex practice
  • No needle sharing
  • Avoid pregnancy

  • Bartlett, J.G. (1991). The Guide to Living with
    HIV Infection, Baltimore The John Hopkins Press.
  • Forester-Miller, H. Davis, T. (1996). A
  • practitioners guide to ethical decision
    making., http//
  • Gaughan, D.M. (2004). Psychiatric
    Hospitalizations Among Children and Youths with
    Human Immunodeficiency Virus Infection.
    Pediatrics, vol.113, e544-e551.

Reference Contd.
  • Hunt, B., Jaques, J., Niles. S. G., Wierzalis
    E. (2003). Career concern for people living with
    HIV/AIDS. Journal of Counseling Development,
    81, 55-81.
  • Klitzman, R. (1997). Being Positive. Chicago
    Ivan R.
  • Dee.
  • Pope, K.S. () New Research, Ethical
    Responsibilities, Evolving Legal Frameworks
    Published Resources., http//