JAMA · 1992 · 33 citations · 3 references
LawHealth LawHealth PolicyHiv ControlMedical EthicsPatient RightsHealthcare-associated InfectionsInfection ManagementProtection Of Medical PersonnelStandard Of CareDoctor-patient DutyHuman Immunodeficiency Virus TransmissionInfection Control DutiesInfection Control EthicsInfection Control MeasuresPatient Rights AdvocacyPatient Rights Violations
HIV transmission risk during surgery is low, yet patients may wish to switch providers, and CDC risk estimates do not clarify whether patient or infected worker rights should prevail. The study examines and discusses the ethical issues surrounding CDC and AMA guidelines for health professionals infected with HIV. The authors find that the AMA’s claim of a duty to avoid any identifiable risk is implausible, that prioritizing patient rights through switching or removal harms all parties, and therefore reject the guidelines in favor of other infection‑control measures.
The ethical issues surrounding the Centers for Disease Control and American Medical Association guidelines for health professionals infected with the human immunodeficiency virus are examined and discussed. Although human immunodeficiency virus transmission risks during surgery are lower than many risks we routinely face, it is not irrational for a patient to want to switch from an infected professional to an uninfected one. The American Medical Association claim that physicians have a duty to avoid imposing any identifiable risks is implausible. Knowing the Centers for Disease Control estimate of risks gives us no way to decide whether the rights of patients or those of handicapped (infected) workers should be given priority. Granting priority to patient rights, either by giving patients the opportunity to know the risks they face and to switch to another provider, or by removing infected providers (compulsory switching), makes us all worse off. This gives us reason to reject these guidelines and emphasize other infection control measures.
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