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PubMed1993

Human immunodeficiency virus infection confronts the law, ethics and society.

The full panorama of the AIDS problem is filled with contradictions. There are those who consider the AIDS sufferers--primarily gays and intravenous drug abusers--as "the bad group". Yet, there are also innocent victims: recipients of blood and blood products and the unknowing sex partners. Regardless of the circumstances under which they contracted the disease, many AIDS sufferers are hated because they are perceived as menaces. Such feelings are triggered by raw emotions, hysteria, anxiety, insecurity, fear, even phobias and paranoia in those who do not have, and who often do not understand the disease. This frequently results in discrimination and bias that may be aggravated by scientific and societal ignorance. Education of those who do and do not have AIDS is hampered by underlying economic problems: poverty, indigence and low social status, as well as taboos regarding discussion of sex and contraception. No disease in this country has created a greater dilemma among the public or the professions concerned with and involved in its care and management, as AIDS. A study of the magnitude of the problem and its impact reveals that it is beset by a "damned if you do, and damned if you don't" result, with the bottom line ultimately involving the benefit versus risk rule. An overview of the AIDS problem reveals particular areas of medical, societal, legal and ethical-moral concern that frequently overlap.

Acquired Immunodeficiency Syndrome↗
PubMed1996

Cost-effectiveness of HIV screening in acute care settings.

BACKGROUND: Although screening inpatients for human immunodeficiency virus (HIV) in acute care hospital settings has been recommended, the cost-effectiveness of screening is not known. OBJECTIVE: To estimate the cost-effectiveness of a voluntary screening program in acute care hospitals and associated clinics. RESULTS: During the first year, an HIV screening program implemented in acute care hospital settings in which the seroprevalence of HIV infection is 1% or more would result in the identification of approximately 110,000 undetected cases of HIV infection. The program would result in expenditures of approximately $171 million for testing and counseling, and expenditures of approximately $2 billion for incremental medical care for the patients identified as having HIV infection during the first year of screening. When the seroprevalence of HIV is 1%, the cost-effectiveness of screening is $47,200 per year of life saved. When the effect of early identification of HIV infection on the patient's quality of life also is considered, screening is less cost-effective. Screening-induced reductions in risk behavior improve the cost-effectiveness of screening by preventing the transmission of HIV.

Acute Disease↗
PubMedDate not supplied

Birth control in India: the carrot and the rod?

The fall of the Indira Gandhi government seems to validate the prediction made six years ago by demographer Frank Notestein that any attempt by a developing country to force its people to use birth control methods "would be more likely to bring down the government than the birthrate." This author, however, interviewing couples seeking sterilization, contraception and abortion, as well as the doctors, nurses and administrators who provided the service, just weeks before the upset election, found that family planning was very much wanted and needed by the people, and was being provided in an efficient and humane way. Thus, pressing the population panic button was probably not only unnecessary, but a tragic mistake on the part of the Gandhi government.

Adolescent↗
PubMed1996

Racial and ethnic differences in students' attitudes and behavior toward organ donation.

Donor authorizations tend to be especially low among African Americans and other minority and ethnic groups. This study assessed and compared the beliefs, attitudes, and rates of participation regarding organ donation among a sample of racially and ethnically mixed university students. A 64-item survey questionnaire regarding organ/tissue donation issues was administered to 683 undergraduate students from different racial and ethnic backgrounds at a state-assisted university in the Midwest. The findings from the study indicated that African-American students differ significantly from white students in their attitudes and beliefs toward organ donation, while Asian-American, Hispanic, and international students were similar to white students in their attitudes and beliefs regarding organ donation. However, a greater percentage of African-American students have granted permission for organ donation compared to African Americans in the general population.

Adolescent↗
PubMedDate not supplied

Worshiping autonomy.

Explore the source record for details and available documents.

Beneficence↗
PubMed1996

Attitudes to prenatal testing and notification for HIV infection in Nairobi, Kenya.

Four hundred antenatal clinic attendants were surveyed for their attitude to testing and notification for HIV infection test results. The participants were systematically sampled from the antenatal clinic at the Kenyatta National Hospital, Nairobi, and interviewed using a closed-ended structured questionnaire. All the attendants had heard of HIV, and only 5(1.3%) did not know how Acquired Immunodeficiency Syndrome (AIDS) presents. Fifty one percent of them had no objection to their blood being tested for HIV. In fact, 52.5% thought, wrongly, that blood was routinely tested for HIV at the hospital's antenatal clinic. More than one third (35.8%) of respondents wished their permission to be obtained before the testing and 95% wished to be informed of the test result. Acceptability of testing was 33.8%, for Named Voluntary Testing, 62.0% for Universal Testing and 1.0% for Anonymous Testing. All the women said they would want to use a method of contraception, principally tubal ligation, if found HIV seropositive and 63.7% would seek a termination of pregnancy. In this study population, acceptability and expressed willingness to know HIV test results and willingness to let a spouse/sexual partner know the result was high. This paper makes recommendations that HIV testing be made available at the ANC, together with competent pre and post-test counselling.

Adolescent↗
PubMed1997

Interest in physician-buyout packages grows as more doctors contemplate retirement.

Provincial governments are turning to voluntary retirement programs, buyouts and phase-outs to help manage physician supply. Demographic data show that in 1996 nearly 27% of Canada's active physicians were aged 55 or older and that the average age of retiring physicians was 68. Although 1 goal of such programs is to give willing older physicians the financial ability to retire, provinces also hope to do away with some billing numbers.

Aged↗