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PubMed1986

Ethical dilemmas in nursing.

Nurses are increasingly realising that they can offer relevant information and participate in decision-making involving ethical issues. However, inter-professional communications are frequently inadequate, and do not permit exchange of opinions. The consequences are often frustrating and upsetting for nurses whose care is affected by others' policies. This paper explores these issues using some clinical examples.

Adult↗
PubMed2006

Disclosure of HIV status to sex partners and sexual risk behaviours among HIV-positive men and women, Cape Town, South Africa.

BACKGROUND: The HIV epidemic continues to amplify in southern Africa and there is a growing need for HIV prevention interventions among people who have tested HIV positive. METHODS: Anonymous surveys were completed by 413 HIV-positive men and 641 HIV-positive women sampled from HIV/AIDS services; 73% were <35 years old, 70% Black African, 70% unemployed, 75% unmarried, and 50% taking antiretroviral treatment. RESULTS: Among the 903 (85%) participants who were currently sexually active, 378 (42%) had sex with a person to whom they had not disclosed their HIV status in the previous 3 months. Participants who had not disclosed their HIV status to their sex partners were considerably more likely to have multiple partners, HIV-negative partners, partners of unknown HIV status and unprotected intercourse with non-concordant sex partners. Not disclosing their HIV status to partners was also associated with having lost a job or a place to stay because of being HIV positive and feeling less able to disclose to partners. CONCLUSIONS: HIV-related stigma and discrimination are associated with not disclosing HIV status to sex partners, and non-disclosure is closely associated with HIV transmission risk behaviours. Interventions are needed in South Africa to reduce the AIDS stigma and discrimination and to assist people with HIV to make effective decisions on disclosure.

Adult↗
PubMedDate not supplied

Calculating the risks and benefits of disclosure in African American women who have HIV.

OBJECTIVE: To identify the processes involved in and the patterns of disclosure of their HIV diagnosis reported by African American women. DESIGN: Qualitative descriptive. SETTING: Southeastern United States; nurse visits in the homes of the participants. PARTICIPANTS: Forty-eight African American women who were HIV-positive and were primary caretakers of young children. MAIN OUTCOME MEASURE: Field notes were analyzed using content analysis. RESULTS: Once the women learned they had HIV, they were faced with the issue of determining "what is at stake" in telling others of their diagnosis. This dilemma was characterized by the threat of stigma, feelings of shame, and the concurrent need for support. The women determined a calculus of disclosure in determining to whom and when to reveal their HIV diagnosis. This calculus involved a careful evaluation of the risks and benefits involved in disclosing their illness. Risks of telling were fueled by societal and experienced stigma associated with HIV, whereas the benefits were primarily fueled by personal needs. The calculus of disclosure was a recursive process, with decisions made and remade over time. Disclosure patterns ranged from secretive to full disclosure. CONCLUSIONS: Issues related to stigma and therefore to disclosure of a diagnosis of HIV are highly relevant to HIV-positive African American women. Nurses have an important role in supporting women regarding their disclosure decisions.

Adult↗
PubMed1992

Ethical issues in the care of cancer patients.

Nearly all the topics considered by medical ethics generally present themselves to those caring for cancer patients. Although most attention may be given to questions of resource allocation and limiting treatment, other issues are of equal importance. Providing respect and compassion for patients may be even more important. The day-to-day treatment of the patient that recognizes the practical autonomy of the patient and legitimizes the patient's involvement in deciding about his or her own care may do more to preserve the integrity of the patient as a person than anything else that happens to someone who accepts the cancer diagnosis. The physician who can accept the patient's judgment and participation and who can help the patient find positive meaning in what can be a personally and socially devastating disease experience has enacted a highly laudatory ethical standard of patient care.

Beneficence↗
PubMed1983

The ethical position of the attending physician in Phase III of clinical investigations.

The ethical position of the attending physician in Phase III of a clinical trial differs from his position in the other two phases. In Phase II he normally presupposes that the new drug has a priority as regards one or more therapeutic properties compared with the already known drug, which he uses as the control. Phase III is based on the results of the Phase II investigations; thus the drug has been proven to be effective therapeutically before Phase III begins. The patients have to be informed about the properties of the drug to be tested. The position of the physician informing them is explained and discussed with respect to the differences between the new and the old drug.

Clinical Trials as Topic↗