AIDS: Crisis in Professional Ethics

Elliot D. Cohen
Michael Davis
Copyright Date: 1994
Published by: Temple University Press
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  • Book Info
    Book Description:

    Do patients have the right to know their physician's HIV status?

    Can a dentist refuse treatment to an HIV-positive patient?

    How do educators determine whether to allow an HIV-positive child to attend school, and if they do, should the parents of other children be informed?

    Should a counselor break confidentiality by disclosing to a wife that her husband is infected with HIV?

    This collection of original essays carefully examines the difficult moral choices the AIDS pandemic has presented for many professionals-physicians, nurses, dentists, teachers and school administrators, business managers, psychotherapists, lawyers, clergy, journalists, and politicians. In the workplace, problems posed by HIV and AIDS have led to a reexamination of traditional codes of ethics. Providing systematic and reasoned discussions, the authors explore the moral, legal, and ethical issues involved in the reconsideration of policies, standards of conduct, and the practicality of balancing personal and professional ethics.

    Contributors: Albert Flores, Joan C. Callahan, Jill Powell, Kenneth Kipnis, Al Gini, Howard Cohen, Martin Gunderson, Joseph A. Edelheit, Michael Pritchard, Vincent J. Samar, Sohair ElBaz, William Pardue, and the editors.

    eISBN: 978-1-4399-0102-1
    Subjects: Philosophy

Table of Contents

  1. Front Matter
    (pp. i-iv)
  2. Table of Contents
    (pp. v-viii)
  3. Introduction
    (pp. 1-26)

    This collection of original essays addresses some of the important problems we have come to group under the short name “AIDS.” It differs from most works on AIDS in two related ways. First, its focus is on the moral choices of individual practitioners rather than no empirical research or social policy. Second, the practitioners whose problems are discusstd include—besides the more usual physicians and nurses—dentists, counselors, preschool teachers, business managers, college administrators, lawyers, clergy, journalists, and politicians. This is a contribution to the literature on professions as well as to the literature on AIDS.

    This collection began with...

  4. 1 AIDS: Moral Dilemmas for Physicians
    (pp. 27-50)
    Albert Flores

    Since its discovery a little more than a decade ago, acquired immune deficiency syndrome (AIDS) has been responsible for the deaths of over 130,000 Americans, with more than 200,000 currently diagnosed with clinical AIDS, a disease that no one has yet survived.¹ More than one million Americans are infected with the human immunodeficiency virus (HIV), a retrovirus identified in 1983 as the cause of AIDS. HIV destroys the immune system, leaving one vulnerable to opportunistic infections that are often lethal. Recently, the Centers for Disease Control (CDC) reported that AIDS is the second-leading cause of premature death among men ages...

  5. 2 Nursing and AIDS: Some Special Challenges
    (pp. 51-74)
    Joan C. Callahan and Jill Powell

    The pandernic of HIV infection has challenged society generally and the health-care system in particular. If statements such as Allen McCrutchan’s are true in general, they are particularly true of healthcare practitioners, and most true of nurses, who must provide constant, complex, and intimate physical and emotional care for persons with AIDS, and who have far more extended contact with these persons than do any other professionals.

    As the rate of HIV infection has continued to rise, so has the demand for effective nursing care for persons who are HIV positive and persons with full-blown AIDS. Given the stunning increase...

  6. 3 The Dentist’s Obligation to Treat Patients with HIV: A Patient’s Perspective
    (pp. 75-94)
    Michael Davis

    I am not a dentist, dental hygienist, dental assistant, dental clerk, dental lab technician, or even a professor of dentistry. I am a philosopher whose work with professional ethics has focused on lawyering, engineering, and other nonmedical professions. Why then do I write about dental ethics? I am a dental patient¹ Like other such patients, I might now unknowingly be carrying the HIV virus; and also like the others, I might face discrimination should my dentist learn that I am a carrier. That is the possibility that motivates this chapter. I hope to shape how dentists, their staff, and their...

  7. 4 HIV and the Professional Responsibility of the Early Childhood Educator
    (pp. 95-114)
    Kenneth Kipnis

    From 1984 to 1989, I served as a consultant to the National Association for the Education of Young Children (NAEYC). Working with Stephanie Feeney, a leading scholar in early childhood education (ECE), our task was to develop a code of ethics for the field in a way that would generate a sense of ownership among its 60,000 members. Questionnaires were used, workshops were conducted throughout the United States, articles were published inYoung Children(NAEYC’S journal), and drafts of the code were circulated for comment and review. In late 1989, the Governing Board of NAEYC approved its Code of Ethical...

  8. 5 AIDS in the Workplace: Options and Responsibilities
    (pp. 115-128)
    Al Gini and Michael Davis

    Statistics indicate that, while few of us will experience AIDS in private or family life, many will experience AIDS in the workplace. AIDS raises at least three fundamental questions for a manager: How should an employee with AIDS be treated? How should other employees be informed about AIDS and their safety and morale insured? How should the legal, ethical, and human considerations involved be balanced against the needs of business? Such questions will become more pressing as the AIDS epidemic spreads.¹ This chapter considers possible options and strategies for answering them. Let us begin with a case.

    Elaine Merkavich operates...

  9. 6 Leading by Example: AIDS Policy and the University’s Social Responsibilitiess
    (pp. 129-148)
    Howard Cohen

    The impact of AIDS on American society is pervasive. It is now generally understood that AIDS represents a health threat that transcends social class, sexual orientation, and other categories with which it was identified in its early history. Moreover, universities and colleges have, for the, most part, accepted an educational function with respect to AIDS: campuses typically sponsor programs that inform students about the disease and advocate measures to prevent transmission of the virus. On most campuses, there is widespread recognition that everyone must be prepared to deal at some time or another with someone who has AIDS.

    Each individual...

  10. 7 What Would a Virtuous Counselor Do? Ethical Problems in Counseling Clients with HIV
    (pp. 149-176)
    Elliot D. Cohen

    As the AIDS pandemic continues to escalate, counselors are increasingly confronting ethically hard cases involving clients who have HIV.¹ This chapter addresses some of these cases.

    First, three paradigmatic cases involving HIV-seropositive clients are presented. Second, a conceptual analysis of a virtuous counselor is developed, to be used as a basis for addressing these cases. The analysis proceeds first by examining “fiduciary” and “autonomy” models of counseling ethics. These models are, in turn, used as bases for developing a final model, a “human welfare” model. This last model is then applied to the cases at hand for purposes of answering...

  11. 8 The Attorney, the Client with HIV, and the Duty to Warn
    (pp. 177-196)
    Martin Gunderson

    Attorneys can be of great help to those with HIV infection. They can help with such complicated matters as estate planning and securing medical benefits. They can also help to protect the rights of HIV-infected persons who encounter various forms of discrimination. In states that have made intentionally exposing another person to HIV infection a criminal offense, attorneys may even be called on to defend persons with HIV against criminal prosecution.

    Within the context of a discussion of the impact of HIV on the professions, it is worthwhile devoting time to the legal profession because of the way it differs...

  12. 9 AIDS: A Transformative Challenge for Clergy
    (pp. 197-208)
    Joseph A. Edelheit

    For the last thirty years, significant Christian and Jewish thinkers have all argued that the unthinkable event of the holocaust has been transformative in shaping the way theology has been done. An event of unspeakable evil has required religious thinkers to find a new vocabulary and take risks in dialogue that were inconceivable before Auschwitz. It is my contention that just as the challenge presented by Metz, a noted European Christian theologian, demands a response for those who profess fundamentalist and systematic theology, a similar challenge now emerges for those who expound practical or pastoral theology because of the HIV/AIDS...

  13. 10 Journalistic Responsibilities and AIDS
    (pp. 209-228)
    Michael Pritchard

    The emergence of AIDS as a major threat to public health raises fundamental questions about the responsibilities of journalists. Any major threat to public health is sufficiently newsworthy to warrant extensive media coverage. The public depends on the media for reliable, comprehensive, and comprehensible information about such threats. Also, insofar as it is available, the media should provide information that will help the public take preventive measures to minimize such threats. All of this, we might say, is part of the public’s “right to know,” correlative to which is a journalistic duty vigorously to seek out information to which the...

  14. 11 AIDS and a Politician’s Right to Privacy
    (pp. 229-252)
    Vincent J. Samar

    What are a politician’s privacy rights in this AIDS crisis? What are his or her duties? These questions have become prominent as more and more of the public have begun to ask politicians and other persons to disclose their HIV status. On the one hand, politicians have an interest in determining what personal information is presented to the public. On the other hand, the public has an interest in learning about the health and potential influences that may affect political judgments and about how these judgments should be made. These divergent interests often come into conflict in either of two...

  15. A Bibliography on AIDS and Professional Ethics
    (pp. 253-270)
    Schair W. ElBaz and William Pardue
  16. About the Contributors
    (pp. 271-274)
  17. Index
    (pp. 275-276)
  18. Back Matter
    (pp. 277-277)