International Journal of HIV/AIDS Prevention, Education and Behavioural Science
Volume 2, Issue 4, December 2016, Pages: 36-41
Received: Nov. 2, 2016;
Accepted: Nov. 17, 2016;
Published: Jan. 18, 2017
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Dimitrios Theofanidis, Nursing Department, Alexandreio Technological Educational Institute of Thessaloniki, Thessaloniki, Greece
Antigoni Fountouki, Blood Bank Department, St Paul’s Hospital, Thessaloniki, Greece
Introduction: Patient rights, as part of fundamental human rights, are protected and guaranteed both by international and national legislation. Individual rights of a patient are concerned with privacy and freedom protection and are also covered by urban and penal legislation provisions. With regard to health care, patient rights are closely connected to specific policies which include the administration and organisation of health care provision. Aim: The purpose of this position paper is to outline nursing deontology and patients’ rights by discussing critically the case of confidentiality and consent of individuals with HIV/AIDS and related issues involved. Method: A critical debate is undertaken using resources from national and international literature. Results and Discussion: The results of this critical discussion paper are organized in six distinct sections which cover holistically the topic under debate, as follows: Nurses and individuals; Nurse and practice; The current situation in Greece; Patient consent with HIV/AIDS; Medical confidentiality and HIV/AIDS and Ethical implications of HIV/AIDS patients in hospital. This typology ensures that a true nursing perspective is presented regarding the rights of patients with HIV/AIDS both nationally and internationally. In this respect, it was deemed essential that results of this paper incorporate discussion as well as part of a critical comprehensive overview of a complex and challenging health care topic. Conclusions: The ethical, legal and moral dilemmas regarding patients with HIV/AIDS remain controversial and challenging. Respect for patients' confidentiality is a fundamental principle in medical ethics, and also a legal duty that health care providers owe to all their patients. However, the respect of absolute confidentiality has been subject of debate particularly in the case of patients with HIV/AIDS. Currently in Greece, disclosing one's HIV/AIDS status is particularly difficult because the condition is still negatively associated with homo-sexuality or particularly promiscuous behavior. This can bring extra stigma and discrimination against patients infected with HIV/AIDS irrespective of its cause.
Rights of Patients with HIV/AIDS: A Nursing Perspective, International Journal of HIV/AIDS Prevention, Education and Behavioural Science.
Vol. 2, No. 4,
2016, pp. 36-41.
United Nations: Universal Declaration of Human Rights. 1948, Rep. No. GA Res. 217 (III), UN GAOR, 3d Sess. Supp. No. 13, UN Doc A/810:71.
United Nations: International Covenant on Civil and Political Rights. 1966, Rep. No. 999 U.N.T.S, 171: entered into force 23 March 1976.
Nixon S, and Forman L. Exploring synergies between human rights and public health ethics: A whole greater than the sum of its parts. BMC International Health and Human Rights.2008; 8:2-9.
Wilson J. Towards a normative framework for public health ethics and policy. Public Health Ethics. 2009; 2(2):184–94.
Trono D, Van Lint C, Rouzioux C, Verdin E, Barre-Sinoussi F, Tae-Wook C, et al. HIV persistence and the prospect of long-term drug-free remission for HIV infected individuals. Science. 2010;329:174–180.
Durand C, Segev D, and Sugarman J. Realizing HOPE: The Ethics of Organ Transplantation From HIV-Positive Donors Ann Intern Med. 2016;165(2):138-142.
Kennedy C, O’Reilly K, Medley A, Sweat M. The impact of HIV treatment on risk behavior in developing countries: a systematic review. AIDS Care. 2007; 19:707–720.
Mystakidou K, Panagiotou I, Katsaragakis S, Tsilika E, and Parpa E. Ethical and practical challenges in implementing informed consent in HIV/AIDS clinical trials in developing or resource-limited countries. SAHARA 2009; 6(2):46-57.
Puhan M, Van Natta M, Palella F, Addessi A, and Meinert C: Excess mortality in patients with AIDS in the era of highly active antiretroviral therapy: temporal changes and risk factors. Clin Infect Dis 2010;51(8):947–956.
Greek Presidential Decree, (2001) Nursing Deontology Code, 25/7/2001;167: 2531-2542.
Joshi D, O'Grady J, Dieterich D, Gazzard B, and Agarwal K. Increasing burden of liver disease in patients with HIV infection. Lancet. 2011; 377(9772):1198–209.
Politis X. HIV/AIDS:Public Health and Human rights. Athens, 2012.
Katz IT, Essien T, Marinda ET, Gray GE, Bangsberg DR, and Martinson N. Antiretroviral refusal among newly diagnosed HIV-infected adults. AIDS 2011;25(17):2177–2181.
Andrewin A, and Chien L. Stigmatization of patients with HIV/AIDS among doctors and nurses in Belize. AIDS Patient Care. 2008; 22(11):897-906.
Lopez-Bastida J, Oliva-Moreno J, Perestelo-Perez L, and Serrano-Aguilar P. The economic costs and health-related quality of life of people with HIV/AIDS in the Canary Islands, Spain. BMC Health Serv Res 2009; 9:55–63.
Hamilton HE, Gordon C, Nelson M, Cotler SJ, and Martin P. How physicians describe outcomes to HCV therapy: prevalence and meaning of ‘cure’ during provider-patient in-office discussions of HCV. J Clin Gastroenterol. 2008;42:419–424.
Katlama C, Deeks SG, Autran B, Martinez-Picado J, Van L, and Rouzioux C. Barriers to a cure for HIV: new ways to target and eradicate HIV reservoirs. Lancet. 2013;381:2109–2117.
Tucker JD, Volberding PA, Margolis DM, Rennie S, Barre-Sinoussi F. Words Matter: Discussing Research Towards an HIV Cure in Research and Clinical Contexts. JAIDS. 2014;3:110-121.
Wildfire A, Stebbing J, and Gazzard B. Rights theory in a specific healthcare context: “Speaking ill of the dead”. Postgrad Med J. 2008; 83(981):473–477.
Chen J. Can we use the ‘C’ word with confidence? Cure for chronic hepatitis C. Gastroenterology. 2011;140:766–778.
Essack Z, Koen J, Barsdorf N, Slack C, Quayle M, Milford C, Lindegger G, Ranchod C, and Mukuka R. Stakeholder perspectives on ethical challenges in HIV vaccine trials in South Africa. Dev World Bioeth. 2010;10(1):11-21.
Sendi P, Brouwer W, Bucher H, Weber R, and Battegay M. When time is more than money: The allocationof time between work and leisure in HIV-infected patients. Soc Sci Med 2007; 64(11):2355–2361.
Dixon-Mueller R. The sexual ethics of HIV testing and the rights and responsibilities of partners. Stud Fam Plann. 2007;38:284-296.
Balint J. Should confidentiality in medicine be absolute? Am J Bioeth2008;6:19-20.
Njozing B, Edin K, Sebastián M, and Hurtig A.(2011) If the patients decide not to tell what can we do?"- TB/HIV counsellors' dilemma on partner notification for HIV. BMC International Health and Human Rights. 2011; 6:14-19.
Orisakwe E, Ochiogu S, and Ocholla P. Perceptions of the HIV counselling and testing programme by patients in a rural regional hospital in South Africa. South African Family Practice, 2015; 57(6):373-379.
Petrini C, and Gainotti S. A personalist approach to public-health ethics. Bull World Health Organ. 2008; 86:624-629.
UNAID. Global reference group on HIV/AIDS and human rights. Issue paper. Current debates on HIV testing and counselling. Geneva:UNAIDS. 2013:1–2.
World Health Organisation: Towards universal access: scaling up priority HIV/AIDS interventions in the health sector. 2010, Geneva, Switzerland: WHO.
Deacon BJ. The biomedical model of mental disorder: a critical analysis of its validity, utility and effects on psychotherapy research. Clin Psychol Rev. 2013;33:846–61.
Mamotte N, Wassenaar D, Koen J, and Essack Z. Convergent ethical issues in HIV/AIDS, tuberculosis and malaria vaccine trials in Africa: Report from the WHO/UNAIDS African AIDS Vaccine Programme's Ethics, Law and Human Rights Collaborating Centre consultation, 10-11 February 2009, Durban, South Africa. BMC Med Ethics. 2010; 9:11:3.
Oliva J. Labour participation of Spanish people living with HIV between 2001–2004. Health Econ 2010; 19: 491–500.
World Health Organisation: Guidance on provider-initiated HIV testing and counselling in health facilities. 2007, Geneva, Switzerland: WHO.