Ethical dilemmas in HIV infection

1990 ◽  
Vol 80 (1) ◽  
pp. 26-30
Author(s):  
B Lo
Keyword(s):  
Health Care ◽  
Health Care Workers ◽  
General Public ◽  
Access To Health Care ◽  
Ethical Dilemmas ◽  
Health Professions ◽  
Hiv Positive ◽  
Aids Epidemic ◽  
Care Workers ◽  
Access To Health

As the AIDS epidemic continues to claim lives, the issues of testing, confidentiality, and refusal to care for seropositive patients generate increasing debate and concern among health care workers, legislators, and the general public. Protecting the uninfected from exposure to HIV, providing adequate medical care and counseling to HIV-positive persons, and preventing discrimination are necessary and immediate goals. Adherence by practitioners to both the current legislation on AIDS and the ethical imperatives of the health professions will facilitate adequate access to health care for all persons with AIDS. It will also provide necessary guidelines for issues of confidentiality.

scholarly journals Spatiotemporal modelling and mapping of cervical cancer incidence among HIV positive women in South Africa: a nationwide study

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Dhokotera Tafadzwa ◽  
Riou Julien ◽  
Bartels Lina ◽  
Rohner Eliane ◽  
Chammartin Frederique ◽  
...  
Keyword(s):  
South Africa ◽  
Health Care ◽  
Cervical Cancer ◽  
South African ◽  
Access To Health Care ◽  
Health Facilities ◽  
Hiv Positive ◽  
The South ◽  
Hiv Positive Women ◽  
Access To Health

Abstract Background Disparities in invasive cervical cancer (ICC) incidence exist globally, particularly in HIV positive women who are at elevated risk compared to HIV negative women. We aimed to determine the spatial, temporal, and spatiotemporal incidence of ICC and the potential risk factors among HIV positive women in South Africa. Methods We included ICC cases in women diagnosed with HIV from the South African HIV cancer match study during 2004–2014. We used the Thembisa model, a mathematical model of the South African HIV epidemic to estimate women diagnosed with HIV per municipality, age group and calendar year. We fitted Bayesian hierarchical models, using a reparameterization of the Besag-York-Mollié to capture spatial autocorrelation, to estimate the spatiotemporal distribution of ICC incidence among women diagnosed with HIV. We also examined the association of deprivation, access to health (using the number of health facilities per municipality) and urbanicity with ICC incidence. We corrected our estimates to account for ICC case underascertainment, missing data and data errors. Results We included 17,821 ICC cases and demonstrated a decreasing trend in ICC incidence, from 306 to 312 in 2004 and from 160 to 191 in 2014 per 100,000 person-years across all municipalities and corrections. The spatial relative rate (RR) ranged from 0.27 to 4.43 in the model without any covariates. In the model adjusting for covariates, the most affluent municipalities had a RR of 3.18 (95% Credible Interval 1.82, 5.57) compared to the least affluent ones, and municipalities with better access to health care had a RR of 1.52 (1.03, 2.27) compared to municipalities with worse access to health. Conclusions The results show an increased incidence of cervical cancer in affluent municipalities and in those with more health facilities. This is likely driven by better access to health care in more affluent areas. More efforts should be made to ensure equitable access to health services, including mitigating physical barriers, such as transportation to health centres and strengthening of screening programmes.

AIDS in Infancy: Diagnostic, Therapeutic, and Ethical Problems

1989 ◽  
Vol 34 (6) ◽  
pp. 576-580 ◽  
Author(s):  
J. Wittenberg ◽  
A. Lazenby
Keyword(s):  
Health Care ◽  
At Risk ◽  
Health Care Workers ◽  
Case History ◽  
Ethical Dilemmas ◽  
Critical Importance ◽  
Psychological Reactions ◽  
Ethical Problems ◽  
Care Workers ◽  
Grief Reactions

Congenital AIDS is on the rise and will pose multiple problems to society and to health care workers in particular, as more infants develop the disorder. Differentiation of AIDS from infantile grief reactions is of critical importance, as infants at risk for AIDS lose their mothers who have AIDS. Team approaches are optimal and should include psychiatric perspectives. Issues of diagnosis, maladaptive psychological reactions and ethical dilemmas are discussed and illustrated in a case history.

Quality of Life: Erosions and Opportunities Under Managed Care

2000 ◽  
Vol 28 (2) ◽  
pp. 144-158 ◽  
Author(s):  
E. Haavi Morreim
Keyword(s):  
Quality Of Life ◽  
Health Care ◽  
Managed Care ◽  
Functional Status ◽  
General Public ◽  
Access To Health Care ◽  
New Technologies ◽  
Access To Health ◽  
Disease Specific

In recent years a number of commentators have discussed the importance of measuring quality of life (QL) in health care. We want to know whether an intervention will help people to live better, not just longer, and whether some treatments cause more trouble than they are worth. New technologies promise wondrous benefits. But when millions of people have no insured access to health care, and when many others face increasingly stringent limits on care, technologies’ high costs require us to choose what we should do from the broader universe of what we can do.The challenges to measuring QL are formidable. Researchers debate whether to measure general QL or disease-specific QL; whether to focus on functional status such as the patient's ability to walk and dress himself, or on the value people ascribe to that functional status; whether to seek the values of the general public, or to concentrate on people actually affected by a given disease or disability.

Attitudes to coercion among health-care workers and the general public in Norway

2006 ◽  
Vol 2 (01) ◽  
pp. 31 ◽  
Author(s):  
Rolf Wynn ◽  
Lars-Henrik Myklebust ◽  
Trond Bratlid
Keyword(s):  
Health Care ◽  
Health Care Workers ◽  
General Public ◽  
Care Workers

scholarly journals Mixed Method Study to Explore Ethical Dilemmas and Health Care Workers' Willingness to Work Amid COVID-19 Pandemic in Palestine

2021 ◽  
Vol 7 ◽  
Author(s):  
Beesan Maraqa ◽  
Zaher Nazzal ◽  
Therese Zink
Keyword(s):  
Health Care ◽  
Health Care Workers ◽  
Online Survey ◽  
Ethical Dilemmas ◽  
Multivariable Analysis ◽  
Well Being ◽  
Related Factors ◽  
Care Workers ◽  
Work Distribution ◽  
Stress Levels

Background: The high potential risks involved in working in a healthcare setting during a pandemic and the associated fear that may affect health care workers' (HCWs') willingness to work are important to understand to eliminate potential barriers to working. This study aimed to assess Palestinian HCWs' willingness to work and the related factors as well as to explore their ethical dilemmas during the coronavirus disease 2019 (COVID-19) pandemic.Materials and Methods: Quantitative (survey questionnaire) and qualitative (semi-structured interviews) data were collected. Frontline HCWs (n = 550) received an online survey link via closed institutional networks. Frequencies summarized the data, and chi-square compared variables and outcomes. Odds ratios (ORs) and multivariable analysis examined predictors for willingness to work. Fifteen HCWs (physicians, nurses, and lab and radiology technicians) were purposefully sampled and agreed to interviews to explore their thoughts, motivations, and worries. Thematic analysis focused on ethical dilemmas to enhance the breadth and the depth of the study.Results: Almost 25% of surveyed HCWs were not willing to work during the pandemic. Logistic model results showed that physicians and nurses had higher willingness to work than others (p = 0.004, Adj. OR = 3.5). Lower stress levels and longer professional experience were predictors of more willing to work (p = 0.03, Adj. OR = 2.5; p = 0.03, Adj. OR = 2.6, respectively). Interviews showed that willingness to work did not preclude HCWs from fulfilling their duties despite grueling workloads and grave fears about safety and security. HCWs felt poorly prepared, unappreciated, and frustrated by unfair work distribution. The occupation presented additional safety issues.Conclusion: Physicians and nurses were more likely to comply with a commitment to their professional ethics and the duty or obligation to work. Stress levels could be mitigated in the future with better leadership, adding supports to address mental health and psychosocial challenges to enhance HCWs' well-being and improve quality of care. The realities of the occupation added additional threats and uncertainty.

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