HIV and Confidentiality, Essay Example

Since time immemorial, doctors have been held to the highest standard of responsibility and ethical behavior. However, there has been recent debates about doctors releasing private information about their patients to other people; some have cracked under the pressure of being threatened with legal action and some doctors were doing what they were told by their patient’s spouse or significant other. The ethical problem is that doctors are releasing important information such as patients with HIV to other patients or other people as well as other staff.

Analytically, those suffering with HIV are not telling their partners because of fear of what might happen or what awaits and people suffering from this feel that they can’t confide in their partner for other private reasons. This forces those in the dark to confront the doctors who are seeing patients with HIV, and asking the doctor to break confidentiality in order to get information on their spouse’s condition.

Doctors are doing just that, but they’re not taking the time to fully consider the course of their actions as well as the consequences that goes with it. It can be argued that doctors releasing this private information about their patient’s HIV condition to their loved ones are doing the right thing because they can help that person prepare for what awaits, and it’s mandatory for a doctor to disclose the information because they’re legally obligated to do so. It can also be argued that they are looking out for other people, ethically.

Doctors are disclosing private information about their patients’ conditions in the name of helping their patients when all they are doing is showing their patients that they can’t be trusted with such sensitive info, it is a bad thing when a patient feels that they can’t trust a medical professional to do the right thing. The biggest problem with this is that doctors who are treating patients with HIV are not keeping their information confidential, they are violating their patient’s rights. I will fully evaluate the ethical arguments that are for confidentiality of HIV patients as well as the ones against it. I’ll illustrate once and for all why the confidentiality of HIV patients matter.

One of the ethical arguments involving confidentiality of HIV patients is respect for persons, which basically says that no matter what anyone says or anything that happens, that person’s wishes must be respected. However, there are mandatory reporting laws on individuals with HIV; a doctor is just doing what they have to do, that’s no crime. A person can tell their doctor that it’s okay to release the information to their family members but not their spouse, but the spouse would say “I’m entitled to their medical information because I’ve been married to my partner for this many years”.

In theory, it could be said that they are but ethically, the doctors should never release that information to people that the patient didn’t say should have it or know about it. According to Fitzpatrick (2012), “doctors have an ethical responsibility to their patients which means that whatever their patients say goes” (Fitzpatrick, 2012). For a doctor to give that information to the spouse anyway is just wrong; the doctor clearly violated the respect for persons edict. HIV is one of the most common yet dangerous diseases to exist, doctors are always in the wrong when they go against their patients wishes to give out medical information involving HIV; privacy and confidentiality should be exercised by all health care providers.

Hundreds of thousands of people are diagnosed with HIV every day and no matter how much that person loves their relatives, friends, aunts, uncles, mothers and fathers, if they request that the doctor keep their HIV condition confidential then the doctor should do just that. Ethically, it can be argued that a doctor isn’t really doing any real harm releasing HIV confidential information to people directly involved with the patient; the doctor is just helping the person through a tough time. However, health care provider may not fully acknowledge the damage that they are not doing, they could be putting that information into the hands of those who would use that information to deal a great amount of lethal damage to that person’s reputation. HIV and Confidentiality is protected by respect for persons which all doctors should honor as well as respect.

It can be said that HIV and Confidentiality is an issue involving normative ethics, this brand of ethics includes how a person should speak or act in the aspect of ethical issues. It can also be said that doctors are held to the normative ethical standards because they are entrusted with very sensitive information about their patients that can do a great good or cause great harm to the person.

A doctor treating a patient with HIV should never act or suggest that there is something wrong with their patients to other people, the doctors are violating their own code of ethics which would force that patient to switch doctors because of their release of their information to other people.

For example, Jennifer has been diagnosed with HIV and has been living with the disease for 8 years. Jennifer has been exhibiting signs of HIV and her family has seen these signs, Jennifer’s husband Mitchell has been helping her cope with the disease ever since they met. Jennifer’s doctor is the only other person who can tell Jen’s family about terminal illness or to confirm their suspicions about her condition.

From the normative ethical perspective, Jen’s doctor has every right to tell her family because they deserve to know but since Jennifer told her doctor to NEVER tell her family about her HIV diagnosis; the doctor should comply with Jennifer’s wishes because Jennifer is the one going through it.

Ethically speaking, doctors are professionals with a good head on their shoulders and can be trusted with just about anything including a person’s life. However, beneficence describes how a person has a moral and ethical obligation to treat people with respect making sure that their confidence isn’t being breached or they are not being taken advantage of since they can’t properly make their own decision about things.

It can be said that if a person or people in the future want to see a particular doctor or even the same doctor to get an HIV test, their confidentiality must be protected because hiding who they are in shame is no way to live. According to Smith (2012), “People are more than likely to entertain getting an HIV or AIDS blood test if doctors can guarantee that their information will be forever safeguarded and unreleased to the general public; it’s ironic that doctors cheat the very patients they swore to treat by releasing their medical information to help them” (Smith, 2012).

Now, it can be argued that if a person isn’t in their right mind to be able to make decisions about their HIV diagnosis then the doctor should tell the next person close to them despite the unethical backlash that they would otherwise receive.

However, I want to argue that if the health care professional did that then that would enable them to tell every patient that they treat that they’re going to tell their next of kin or spouse about any medical problems if the patient doesn’t. The doctor would practically be forcing the person to tell their peers about their HIV diagnosis, it’s not fair for the doctor to turn any information pertaining to a person with HIV over to anyone let alone people with power of attorney; that information is for the person alone. Doctors are hailed as ethical professionals and are held to that standard, but when they compromise their patient’s rights and violate their confidentiality involving their HIV condition, they compromise their title as well.

Personally, no medical professional anywhere should ever give out a patient’s medical information whether it’s a food allergy or the last time they had a mammogram or even the last time they were intimate with their partner. Knowledge is a very powerful thing. The kind of knowledge that a doctor has and is entrusted with is not only sacred, but it can mean the difference between life and death.

People with HIV are already afraid of what being judged or what they think other people might feel about them and doctors are usually the people of ethics that can provide comfort, give people with life-threatening diseases a comfort like they have never known; total privacy. I think my views of doctor acting unethical regarding their patient’s HIV confidentiality is just because I feel that when doctors take the oath to cause no harm, they should apply that oath to everything involving their patients.

According to Barnett (2015), “when doctors take their Hippocratic Oath, they are pledging their allegiance to their patients to keep everything they discuss confidential; doctors can’t be professionals and friends at the same time” (Barnett, 2015). Oddly enough, I believe that if a doctor was in the same position that the person or people that come see them are in, they would act the same way which is confidentiality come first. People don’t trust doctors today because they are too quick to go back on their Hippocratic Oath which is centrally important when becoming a doctor because patients have a right to peace of mind, it shouldn’t just be something that people they are told they have; doctors need to feel like the patient has that peace of mind that only the doctors can give them.

There has been a lot of debate over a doctor’s ethical behavior as far as ethics versus doing the right thing, doctors should do the right thing always but I want to argue as well that doctors should only go against ethics if they have that person’s permission to do so.

However, the person’s permission is half-hearted at best and it puts the doctor in a bad place; the doctor should still protect that HIV patient’s privacy. As opposed to the doctors’ sense of ethics as far as their behavior and what they should and should not do, the opposition believes that a doctor should break the confidentiality of HIV patients if it is meant to save someone else’s life. In a wholehearted way, I can see where the opposition is coming from on this matter.

There are people in the world who are HIV positive who don’t care about who they give the disease to and those who get the disease without being warned first are stuck with a terminal disease that they can’t get rid of, some people find it difficult to do the right thing because of short term gratification.

According to Symington (2013), “Confidentiality is the underlined reason why doctors get business, they are hired to withhold their patients’ confidentiality that includes those who have HIV” (Symington, 2013). However, even though I argued how illogical and unethical it is for a doctor to never release their patient’s information to anyone so as to protect that person, it’s argued by the opposition that a doctor violating their Hippocratic Oath to save someone’s life is just; I can agree with that because no one deserves to live their life with a disease especially a terminal one.

Ironically, it can be argued that doctors get into less trouble warning the populace or a group of people about a person having HIV; doing it for the sake of saving thousands of lives far outweigh one doctor losing their job over their oath violation. Even though I argued earlier on that there are people in the world who should never have their HIV confidentiality compromised, violating that confidentiality is necessary if it means that a newborn baby isn’t diagnosed with HIV upon birth or hundreds of thousands of college students are saved from one person’s irresponsibility.

Even though I think that the person should be the one to tell people themselves, the doctors should definitely get involved if the person is being negligent of who they’re spreading the disease to. Doctors are saving the lives that the person chose to destroy with their negligence. It can’t be argued that doctors are ultimately wrong for violating their HIV patients’ confidentiality but considering that the opposition believes that this is a necessary evil in order to save thousands, getting into a little legal trouble is absolutely worth it.

After conferring with the opposition and listening to their views on the matter, I feel that a lot of HIV and Confidentiality issues that doctors face are unnecessary and doctors don’t need to be put in a position where they have to choose between the confidentiality of the patient and the ethics that their job demand they uphold.

The opposition also believes that doctors who are violating an HIV patients’ confidentiality are not violating their patients’ privacy because doing the right thing in the eyes and logic of normative ethics. A doctor protecting their patients’ privacy is mandatory for them to keep their jobs, but there are laws in place that clearly protects the doctor against legal action if they are doing the right thing by informing people that might be infected with HIV by one of their patients.

Now, I personally think that the laws should protect the HIV patients’ confidentiality because the media is merciless when doing stories on people who are HIV positive, but the idea set forth by the opposition is that everyone deserves to know hence the mandatory HIV reporting laws.

Ultimately, the opposition believes that the laws protect those of the greater good; doctors in this case who are violating their HIV patients’ confidentiality. Under no circumstance should people be forced to tell other people that they are HIV positive, but it is a person’s moral responsibility to do this when the time comes that they have to; not everyone who’s HIV positive is forced to live alone or die alone.

The opposition and I are in agreement that people who are HIV positive should have their confidentiality compromised by their doctor when they refuse to tell people that they have HIV, the opposition believes that there is no greater good than saving a child’s life especially if that child’s theirs. I can argue here that HIV positive people’s confidentiality isn’t worth a court case on the grounds of unethical behavior by the doctor.

I can easily side with the HIV patient saying that by them not telling people, they are protecting themselves as well as those around them, but the opposition believes that the person is just being selfish and unfeeling. The choice should be taken out of their hands since they chose not to exercise their ability to do the right thing by the people that they’ve infected. Peoples’ lives matter; those with HIV who don’t tell those they infect, should be told by a third party.

I want to go on record as saying that I’ve demonstrated that HIV positive people’s confidentiality should be preserved and protected by any means necessary.

I argued that the greatest good is letting the HIV positive person tell people when they were ready however long it takes, being rushed into telling people is not ideal. I also argued that people who are HIV positive should have their confidentiality withheld to the highest degree. It is a very private, and personal issue involving the person alone. Health care providers would be proving how unfeeling and soulless they were by telling their patient’s private business; that would say that the doctor doesn’t care about the patient at all.

A doctor’s Hippocratic Oath is a sacred code of conduct that they are forced to live their lives and profession by, it is completely unethical for a doctor to violate that oath for the greater good; they have to draw the line somewhere.

Personally, it’s against the law for a doctor to act unethical for monetary gain or satisfying a person’s curiosity; they have a responsibility to be loyal to their patients and that includes making sure that no one else finds out about their HIV condition as well as keeping their HIV confidentiality a secret. Every day, people are growing more and more distrustful of doctors because of their unethical behavior. HIV and Confidentiality go hand in hand, a person shouldn’t have to choose between the two.

They are expected to follow the guide of normative ethics which demands that they act studiously with their patients, and give no part of their patients’ information that might suggest that their confidentiality is at risk. The ethical principle, Justice, is all about the fair and just treatment of all people that includes those with HIV confidentiality.

There are a lot of people who are trying to find ways to cope with having HIV besides possibly taking their own life, asking their doctor about what they should do is mostly a good idea. Doctors are usually a good source of information as far as coping with HIV. A particular solution to protecting the confidentiality of HIV patients is encouraging the patients to attend support groups, there are millions of Americans that are HIV positive that don’t have anyone to talk to about their problem.

A support group would give HIV positive people a chance to talk out how they feel as well as bring relief to that person, there’s nothing more terrifying than having to walk or grocery shop and being treated like a monster or leper. It’s reasonably understandable how people are afraid of getting someone else’s illness or terminal illness, but it doesn’t mean that the person with the illness is any less of a person. Doctors overseeing the meetings or support group would be empowering to the HIV patients.

Another solution is that the doctor can request the HIV positive person and their spouse come see them then the doctor can help advise them on healthy ways that they can live together with the disease, a person’s life isn’t necessarily over after contracting HIV, they just need support.

Protecting the confidentiality of HIV patients is a very important task for doctors and the doctor should only tell other people as a last resort, it’s a known fact that doctors are supposed to always remain vigilant about protecting their patients from anything that would do them harm. I propose that doctors do right by the patients with HIV by protecting their confidentiality and never telling anyone about it, but give the patient a choice as well as warn them against keeping their condition secret; the patient ultimately gets to make the choice to tell people.

I propose that the opposition understand my views about the sacred nature of patient-doctor confidentiality and trusting that person to do the right thing by telling people they infected, the opposition needs to understand that a doctor releasing sensitive information about a patient is wrong not to mention that it is unethical to violate that HIV patient’s confidentiality.

The opposition also needs to understand that people need to take acceptable risks involving not listening to warnings from other people, the opposition needs to understand that the preservation of any one person is necessary in order to protect others.

Now, I can also entertain some of the thoughts and views of the opposition about their concept of the greater good. For example, doctors are doing the right thing by telling the patient’s peers that they have HIV in order to save them from possibly catching the disease and starting an epidemic; the last thing that a doctor needs is having their entire office lobby filled with people who are diagnosed with the same disease caught from the same person. It’s kind of ironic how I was proposing that the opposition listen to my views on how wrong it is for a doctor to act unethical in their own best interest. Now, I see that doctors have a job to do and when they violate the confidentiality of their HIV patients, they are not doing it from a medical perspective; they are doing it from the human perspective in that they don’t want to be another victim of HIV. I can see how the opposition would propose that I see things from their view because they are being human by drawing a line at stopping a possible epidemic, the opposition sees how important it is for a doctor to just concentrate on their job because an average person shouldn’t have to deal with more than they can handle. I can bring myself to excuse the fact that doctors have to do what they have to do to protect themselves, that’s no crime and it doesn’t make the doctor thoughtless.

In conclusion, the confidentiality of HIV patients should be protected at all costs because their dignity, self-respect as well as their self-esteem not to mention their peace of mind are on at stake and those are a human’s most valuable treasures; that’s something no one should ever live without. Doctors are THE vicars of virtue and are held to that standard because from the moment they take their Hippocratic Oath, they are sworn to protect everything about their patients and that includes their HIV status.

It’s a known fact that the patient is the only one who has the power to determine who knows about their condition and who they want to keep it from, if the HIV patient doesn’t want their information released to their parents but to their partner only then doctor has to fulfill the patient’s wishes against their better judgment which would be to tell those concerned. Confidentiality with HIV positive patients is still an issue of immense debate, but it can’t argued that the HIV positive person owes their victims the truth about their condition as well as tell them about having HIV.

The respect of persons clearly backs up how a doctor is supposed to conduct themselves not to mention the justice ethic states that HIV positive people are entitled to fair treatment, their confidentiality should remain confidential.

However, a doctor revealing their HIV positive patient’s information in order to save thousands of other people become a necessity because there are people out there who don’t care who they infect; short term gratification is usually on the minds of those with HIV.

It can be argued that there are dozens of people seeking treatment for their HIV but the confidentiality can stay between the doctor and other HIV patients by encouraging them to join support groups to help them cope with the disease, a person with HIV doesn’t have to go it alone if they don’t have to; some would prefer not to if they can help it.

HIV and Confidentiality is an issue of much debate but at the end of the day, people are people, and the confidentiality about their HIV should always be kept private always. While it’s true that healthcare professionals have a job to do and to maintain a certain degree of ethics, mandatory HIV reporting laws say that the healthcare provider should protect the doctor from any legality that might surface.

Privacy and Confidentiality should be practiced by all healthcare providers, the healthcare providers are taking on the responsibility of not just protecting the confidentiality of the HIV individual. Doctors have ethical standards that they live by because it governs the biggest part of their job which is their Hippocratic Oath, the Hippocratic Oath is what separates a doctor who care about following the rules and doctors who violates the rules by violating their patient’s confidentiality. Overall, HIV and Confidentiality are critical issues that have one solution, protection of personal information is important and that information is central to a person living in peace.

References

Barnett, J. (2015). Ask the Ethicist: Is there a Duty to Warn When Working with HIV-Positive Clients? Retrieved October 28, 2015, from http://societyforpsychotherapy.org/ask-the-ethicist-duty-warn-working-hiv-positive-clients/

Fitzpatrick, L. (2012, July 10). HIV and Disclosure: A Doctor’s Moral Dilemma. Retrieved October 28, 2015, from http://www.pbs.org/wgbh/pages/frontline/social-issues/endgame-aids-in-black-america/hiv-and-disclosure-a-doctors-moral-dilemma/

Smith, N. (2012, January 16). Social Worker’s Code of Ethics and HIV or AIDS Disclosure: A Hypothetical Case Study. Retrieved October 28, 2015, from http://www.articlemyriad.com/social-workers-code-ethics-hiv-aids-disclosure-hypothetical-case-study/

Symington, A. (2013, November 1). HIV status: Who needs to know? Retrieved October 28, 2015, from http://www.canadian-nurse.com/en/articles/issues/2013/november-2013/hiv-status-who-needs-to-know