Random Conversation – Ethics Case

Standing around in the MO room, A, B were talking.

A: Hey, have you finished your ethics case writeups yet? It’s due on the 1st.

B: Aw man, gotta finish it soon. It’s a complicated case.

A: What cases are you doing?

B: It’s a complicated case of MTPT (Mid-Term Pregnancy Termination). I wish I had picked an easier case. By the way, did you know that F did a 4000 word writeup on HIV testing without patient consent? 4000!

A: Huh? Is there even an ethical issue? It’s quite straightforward.

B: What? Why wouldn’t there be an ethical issue? HIV is a serious diagnosis to make.

A: No, you can test for HIV. Now we can just test. Last time, an alternative was to do CD4 counts, but now it’s legal to test for the HIV virus.

B: Wait, wait, wait. Just because something is legal doesn’t mean it’s ethical. Legal change often comes after ethical debate.

A: Well, there’s a need to protect healthcare workers. Otherwise it’s terrible if we get HIV.

B: How would it protect healthcare workers? We’re already using universal precautions. Gloves to avoid blood splashes and whatnot. We’re treating every patient as though they have HIV. How would testing help?

A: Yah, but how many healthcare workers actually follow universal precautions?

B: Wait, wait, wait. Are you saying that to protect the healthcare workers who aren’t following guidelines to protect themselves that they should already be doing, we should forcibly test patients without consent… possibly coming to a diagnosis that has a great deal of social stigmata, expensive treatment without possibility of cure, heavy monetary burden in the form of insurance, etc., when the converse would be to test patients only with their consent? Please note that once a patient is diagnosed positive for HIV, there’s no retracting the information and that we are legally obliged to report the case.

A: Hmmm… I see your point. Actually quite a bit to discuss for ethics case writeup.

Link: angrydr’s post on the topic of an opt-out scheme for HIV testing

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