Communicable Diseases: Legal and Ethical Issues - Research Paper Example

? Communicable Diseases: Legal and Ethical Issues of Affiliate Executive Summary In most instances conflict emerge between legal and ethical issues in healthcare provision and between the interest of the patient and the rights of the health worker. The law maintains that the health worker should always keep any information about the patient confidential. However, ethical issues arise when such information involves communicable diseases that might put other people that come in contact with the patient at risk. The law also requires that all persons with disability be treated equally. However, ethical concerns arise when such a person has a communicable disease. These legal issues also raise the question of the conflict between the interest of the patient and the right of the health worker. However, medicine has always preferred to use ethical provisions instead of laws and to ensure that the patient’s interests always prevail. Introduction In the contemporary world where response and management of communicable diseases has received significant attention, there have been legal and ethical issues arising from the safety of the medical practitioners who handle such outbreaks of communicable diseases. In addition, there are people who deliberately place others at risk by not taking the necessary medical steps when they are aware that they have a communicable disease (Bernat, 2008). In a medical institution, handling and management of communicable diseases is very important because the practitioners have to ensure the safety not only of the staff but also of other patients within the hospital. As a result, there have been legal and ethical guidelines that have been proposed to ensure that even when medical personnel are trying to manage communicable diseases, they can also ensure their own safety and safety of other patients. Studies have been conducted to identify the legal and ethical position of the medical personnel and to come up with guidelines that can uphold their legal rights, and ensure that the activities they engage in are within acceptable ethical standards. Medical practitioners often find themselves in a dilemma when faced with situations that compel them to respond and at times put their own lives at risk. Health has always been approached as a personal matter for long not considering the risk an individual might put others when they do not take care of their health (Killion, 2006). The issue becomes more serious when it involves a dangerous communicable disease that can lead to death or suffering. The paper will look at some of the legal and ethical issues that might arise with regard to the management of communicable diseases by health practitioners, and individuals who deliberately place others at risk due to negligence. Discrimination According to the Rehabilitation Act of 1973, persons with communicable diseases such as TB are considered to be handicapped and discriminating against them as a result of the disease amounts to discriminating a person with disability. A medical practitioner, who contracts a communicable disease such as TB or Hepatitis, cannot be removed from their workplace unless it is determined that there is no way the risk such a person poses to other people can be mitigated. In addition, the American disability Act of 1990 also improved the capacity of disabled people to access services and to enjoy privileges similar to persons that did not have disabilities. Although this legislation significantly improved how persons and medical practitioners with communicable diseases were treated, there were still issues arising with regard to the risk that such people placed on the people they interacted with (Lemon, 2008). For instance, when a medical practitioner known to have TB is allowed to continue working in a health institution there is no 100% surety that such a person will comply with the health provisions that prevent the spread of TB. Despite the need to avoid discriminating people on the basis of their disabilities due to ethical reasons, there is also the need for the law to protect other people from the danger that can be posed by such a person According to Pozgar (2010), factors that should be placed into consideration before allowing such a person to interact with other people include the severity and the mode of transfer of the communicable disease. Looking at these issues will provide a balance between the ethical and legal rights accorded to people with communicable diseases and the capacity of health care providers to ensure safety of medical practitioners and other patients. In essence, despite the fact that it is unethical to discriminate against an individual on the basis of their disease it is also important to look wider safety and health of the general society. Right to Privacy Physicians are usually prevented from disclosing patient information to other parties by the doctor to patient confidentiality clause. In most situations medical practitioners find themselves in a dilemma between fulfilling their ethical obligation and upholding legal provisions when it comes to dealing with a patient with a communicable disease. For instance, when a doctor realizes that a patient has a drug resistant strain of TB. Such a doctor is under the legal obligation to keep the information confident between them and the patient. In addition, the doctor will also be morally obligated to inform other people in contact with the patient that they risk contracting the disease when they interact with the individual. If the doctor informs all people in contact with such a patient, such a doctor might risk prosecution on the basis that they violated their legal obligation to keep the information confidential. However, the doctor will also be putting other people at risk when they fail to tell them that they might contract the communicable disease when they continue associating with the TB patient. A doctor is bound not only by a sense of duty but also ethical obligation to always ensure that people are not only cured from diseases, but are also protected from contracting diseases (Killion, 2006). However, the doctor cannot just disclose private information concerning a patient without obtaining the consent of the patient due to the clause that provides for patient doctor confidentiality. The doctor patient confidentiality concept even prevents the doctor from disclosing medical information about the patient to close family members. In such a situation, the family members might be exposed to a disease that might have been prevented when necessary medical measures were taken. According to Brown (2007), the aspect of disclosing or failing to disclose private information of the patient should be decided by looking at the utilitarianism aspect of the situation and the competing moral obligations. For instance, when dealing with a patient with TB living in a community. The doctor will have acted in the general good of the whole community by informing them of the medical condition of the individual instead f keeping the information private and act in the general good of one person. Informed Consent Informed consent with regard to communicable diseases arises in a situation where a medical practitioner has a communicable disease and fails to tell a patient. In a medical institution, there are numerous risks that a patient is exposed to and it is always assumed that there is no need to tell the patient of these numerous risks. In essence, the assumption is that patients only need to be told the risks that they inquire about but the practitioner should not waste time in explaining the numerous risks to the patient. However, the provision raises the ethical issue of the right of the patient in knowing whether they are exposed to additional danger as a result of a practitioner attending to them having a communicable disease. Although currently there are no legal provisions that compell a medical practitioner to inform the patient that the medical practitioner has a communicable disease that might be otherwise transferred to the patient, doctors argue that practitioners are held under the ethical obligation to disclose to the patient. Disclosing to the patient allows the patient to make informed decision on whether they want to continue being attended to by the pracitioner or they want other alternatives. In addition, many cases involving informed consent have always been decided in favor of the fact that the patient has the right to know so that they can make informed decision. For instance, in the case of Cantebury v. Spence. In the case the court outlined that a risk is a situation where a reasonable patient would opt for other options when they are made aware of the medical condition of the practitioner (Ayers, 1998). Ayers outlines that the principle guideline with regard to such cases would be to put the interest of the patient ahead of other interests. For instance, a health worker with TB could be attending to the patient and the medical condition of the health worker is such that they do not put the patient at risk from the medical perspective. However, the patient might still feel at risk when being attended to by such a health worker. Therefore, the patient has the right to know the medical condition of the health worker so that they can make informed decision on whether to continue with the proposed mode of treatment. The ethical emphasis in this case is allowing the patient to make informed decision based on the information provided to them about a health worker. Therefore, one should disregard the medical condition of the health worker but act according to the health concerns raised by the patient. In essence, the patient’s ability to make informed decision is of greater priority. The Interest of the Patient Vs the rights of the Healthcare Provider In most situations where the healthcare provider has a communicable diseases, ethical issues always arise with regard to the interest of the patient and the rights of the healthcare provider. For instance, when the healthcare provider has HIV it has been argued that it is not ethical to force the healthcare provider to disclose their HIV status because that would expose them to stigmatization by the patients and the society in general. However, one should also look at the health risks that the healthcare provider might put the patient in terms of contracting HIV. The behavior of the HIV virus is still not known conclusively and with the heightened capacity of the virus to mutate there might be a possibility of the virus changing its modes of tranmission. Such considerations compell health care providers to look into the safety of patients as they attempt to protect the dignity of a healthworker with HIV. By allwoing the healthwoker to continue to freely interact with patients, a health institution might demonstrate insensitivity towards the patient. In a health institution, the primary focus is the well being of the patient. Therefore, once again the interst of the patient should override any ethical concerns raised when it comes to the dignity of the healthworker. The provision might seem to be unfair but it acts to ensure that the focus of the care is in the well being of the patient. There is also the additional concern of knowing whether a healthworker has a communicable disease or not due to legal provisions. According to Fremgen (2006), testing a person for HIV without their consent is illegal. Therefore, the healthworker can still decide to keep such an information from the patient thereby raising ethical issues with regard to the voilation of the rights of the patient to such information. Conclusion There are many legal and ethical issues facing healthwokers in the contemporary world as they dedicate themselves in ensuring the well-being of patients. Most of these legal issues pertain to the relationship between the healthworker and the patient. In some instance, the legal and ethical issues conflict and healthworkers are usually at a dilemma of the approach to use to ensure that they do not violate any legal and ethical provisions. Ethical and legal issues arise when healthworkers are dealing with communicable diseases. The issues that arise include issues pertaining to the privacy of the healthworker and the patient, discrimination of the healthworker on the basis of their medical condition and informed consent by the patient with regard to disclosure of the medical condition of the healthworker. In some instances, legal provisions conflict with ethical concerns but most healthcare systems prefer to adopt ethical provisions. In addition, the patient’s interests are usually primary and in most instances it will override the healthworker’s interests. References Bernat, J. L. (2008). Ethical Issues in Neurology. Philadelphia: Lippincott Wilkins. Killion, S. W. (2006). Quick Look Nursing: Legal and Ethical Issues. New York: Jones & Bartlett. Lemon, S. M. (2008). Ethical and Legal Considerations in Mitigating Pandemic Disease. New York: Wiley. Pozgar, G. D. (2010). Legal and Ethical Issues for Health Professionals. New Jersey: Wiley. Read More