In HIV treatment and prevention, confidentiality raises an ethical health promotion-related issue by creating the dilemma between safeguarding the privacy of the patient and protecting people who could be at high risk, for example, spouses. Upholding patients’ confidentiality signifies that their positive status should remain secret without being discussed by any person beyond the connection of mutual trust. A breach of such confidentiality by health professionals may not only result in shame and stigmatization among patients but may also cause seclusion from the family. Attributable to the possibility of facing rejection, most new HIV-positive patients prefer to maintain their status confidential, which raises an ethical concern regarding the protection of the well-being of the people at risk.
Summary of the Issue
The failure to respect and uphold the principle of confidentiality might result in HIV-infected patients losing confidence in caregivers for the fear that the status may be discussed with others. Such a situation weakens the realization of a positive relationship between patients and health professionals. Sometimes conflicts occur when patients reveal their HIV status to a caregiver or counselor while refusing to unveil such a situation to their sexual partners. This circumstance generates a classic occurrence of two ethical principles being in a conflict. The health professional gets into the dilemma of either following the patients’ decision and maintaining the confidentiality or infringing their privacy to prevent harm to spouses at risk and whose HIV status is possibly negative. While ethical principles of patients’ autonomy necessitate upholding confidentiality by forbidding revelation of their status, medical ethics require physicians to protect the welfare of the spouse by providing them with critical information that will help them evade infection.
Thoughts on the Role of Health Care Professionals
Although it is good for doctors and counselors to maintain confidentiality, there at times arises the need to share information for the well-being of others. Both the principles of confidentiality and beneficence should be cautiously assessed, and every case handled with extreme watchfulness of ethical judgement. Attributable to the role of promoting the health and well-being of people, medical professionals should infringe confidentiality based on the need to provide information necessary to prevent likely harm. Moreover, health care professionals should establish campaigns to enhance awareness concerning HIV and elimination of stigmatization as a means of promoting the quality of care and prevention of new infections
Specific Theories
The utilitarianism theory focusses on the impact of ethical decisions. The ethical code in this theory that supports disclosure of confidentiality to protect others’ welfare is that the implication of an approach is the most significant determinant of the practice either being right or not. The proponent of the utilitarianism theory affirms that the best alternative maximizes utility by proceeding past an individual’s scope to value the welfare of others. Additionally, Kantian ethics is a theory based on the ethical code that a policy can only be moral when its maxim, the opinion on which it is based, is duty to the ethical law, and emanates from a feeling of obligation. Accordingly, the disclosure of HIV positive status to an intimate partner is vital to health promotion since many people who have HIV/AIDS intentionally engage in unprotected sex with their partners devoid of disclosure hence exposing them to infection.
Conclusion
Attributable to the likelihood of facing rejection, most new HIV-positive patients prefer to uphold their status private, which raises an ethical concern concerning the protection of the well-being of the people at risk. Although ethical values of patients’ autonomy require upholding privacy by forbidding revelation of their status, medical ethics necessitate physicians to protect the well-being of the spouse by offering them critical information that will enable them evade infection. Both the utilitarianism theory and Kantian ethics support disclosure of privacy to protect others’ welfare.
Reference
Khac Hai, N., Lawpoolsri, S., Jittamala, P., Thi Thu Huong, P., & Kaewkungwal, J. (2017). Practices in security and confidentiality of HIV/AIDS patients’ information: A national survey among staff at HIV outpatient clinics in Vietnam. PloS one, 12(11), 1-10.