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utilitarian medical ethics
utilitarian medical ethics
utilitarian medical ethics
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This paper presents an ethical analysis of the mandatory newborn HIV testing law enacted in New York State. The law was passed as an effort to decrease maternal transmission of HIV, by treating infants born to HIV positive mothers immediately after birth with AZT. Newborn testing was promoted by the legislative and medical community following the overwhelmingly positive response from HIV infected pregnant women who were given AZT in the ACTG 076 clinical trials. Pregnant mothers who were given AZT had a markedly lower transmission rate than mothers who had not received it. This paper examines this newborn testing policy from a Utilitarian perspective to ascertain if the goals of the policy are feasible. The potential advantages, as well as the failures of using this policy are discussed. Implementations to improve the policy are also presented.
Ethical Dimensions of Mandatory HIV Testing of Newborns
in New York State: A Utilitarian Perspective
Description of Policy
In June of 1999 all hospitals in the state of New York were notified by the New York State Department of Health that beginning August first, 1999, a radical new approach to HIV screening was to be initiated. According to the policy, "for those women without prenatal HIV test results who decline HIV testing during delivery, hospitals are required to conduct expedited HIV testing of all newborns" (New York State Department of Health, June, 1999). This policy was the consequence of a heated debate in the legislature over the results of anonymous HIV screening performed on pregnant women in the state of New York (Cameron, 2002). New York State had been engaged in anonymous testing of newborns since the late 1980s, and this testing consistently reve...
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...d November 24, 2004, from http://www.philosophers.co.uk/cafe/phil_jul2001.htm
Turner, B. J., Newschaffer, C. J., Zhang, D., Fanning, T., & Hauck, W. W. (1999). Translating clinical trial results into practice. Annals of Internal Medicine, 130(12), 979-986.
West, H. R. (n.d.). Utilitarianism. Retrieved 11162004, from Encyclopedia Britannica Web Site: www.utilitarianism.com/utilitarianism.html
Wolf, L. E., Lo, B., Beckerman, K. P., Dorenbaum, A., Kilpatrick, S. J., Weintrub, P. S., et al. (2001). When parents reject interventions to reduce postnatal human immunodeficiency virus transmission. Archives of Pediatric and Adolescent Medicine, 155(8), 927-933.
Zulueta, P de (2000). The ethics of anonymised HIV testing of pregnant women: a reappraisal . Journal of Medical Ethics, 26, 16-21.
HIV has had a dramatic effect on the history screening and testing of blood donations. Since May 1985 all blood donated in the United States received testing for HIV antibodies, p 354. Still there are cases of negligence when the collection of blood is done. In 1983, a blood center knowing that blood from homosexual and bisexual men should not be accepted. The blood center even had a written policy stating that donors who volunteer that they are gay should not be allowed to give. In the case of, J.K & Susie L. Wadley Research Inst. v. Beeson, Mr. B a patient received several units of blood from the blood center during his surgery. Mr. B later going back to the hospital for being sick tested positive for HIV and his wife tested positive. At trial, damages of $800,000 were awarded to Mr. B’s widow. Failing to follow their policy cost a significant amount of money. Patients...
This case presents a very delicate situation that presents many legal and ethical questions. Do you tell your brother his partner has HIV? I would tell my brother, but the how and when, may vary based on circumstance. From a professional ethical standpoint, it would be unethical to disclose the patient’s HIV status without consent. It would violate the patient’s right to confidentiality, as it is the patient’s choice whom information may be shared with (Beemsterboer, 2010, p. 50). It could also be argued that it is a violation of the principle of nonmaleficence. By providing the patient’s HIV status to people unbound by HIPAA, you are putting the patient at risk of discrimination. This could cause mental anguish or psychological issues, therefore, in essence, inflicting harm on the patient. The most valued application of nonmaleficence is, “One ought to not inflict harm” (Beemsterboer, 2010, p. 42). This would outweigh the ethical argument that you are also preventing harm to your brother, another less important application of nonmaleficence (Beemsterboer, 2010, p. 42). There is one professional ethical principle that I would argue was being applied. This being the principle of paternalism, stating that healthcare providers should do what they deem best for the patient according to their ability and judgment (Beemsterboer, 2010, p. 47). If the patient had a sexual encounter with the brother, and did not inform him of her HIV status, she may be arrested for reckless endangerment according to Pennsylvania law. A case where an HIV-positive person did not disclose their status to their sexual partner was brought before the Pennsylvania Superior Court. According to Pennsylvania law, “Disclosure of HIV status is a defense ag...
Potter, J. E., White, K., Hopkins, K., Amastae, J., & Grossman, D. (2010). Clinic Versus Over-
There are still many issues that the government has been trying to address. One barrier that continues to exist is the stigma of HIV/AIDS. People avoid getting tested and sick individuals would wait until they were extremely ill before seeking treatment. The government has countered social stigma through a public health campaign to promote HIV testing. As more people participated in testing, public attitudes started changing (Glassman, 2016, p.28). Still, many traditionally at risk groups continue to be vulnerable. Female sex workers, young adults, and men who have sex with men, have lower rates of HIV testing and have less knowledge about HIV prevention (Glassman, 2016, p.28). Addressing these populations will require additional social
(Allen et al., 2000) The Acquired Immune Deficiency Syndrome (AIDS) is a clinical situation that requires the ethical principle Justice to be implemented. AIDS can be transmitted by sexual activity, intravenous (IV) drug use, and passed from mother to child. Due to the judgments and fears from the general population and some healthcare professionals, patients who have this disease may find themselves suffering from discrimination in many ways of their lives. This discrimination comes from the stigma placed by the factors in which AIDS is mainly spread. These factors are poverty, homelessness, illiteracy, prostitution, human-trafficking, which create the labels like the “drug user” or “homosexual”.
Ethical violations committed on underprivileged populations first surfaced close to 50 years ago with the discovery of the Tuskegee project. The location, a small rural town in Arkansas, and the population, consisting of black males with syphilis, would become a startling example of research gone wrong. The participants of the study were denied the available treatment in order further the goal of the research, a clear violation of the Belmont Report principle of beneficence. This same problem faces researchers today who looking for an intervention in the vertical transmission of HIV in Africa, as there is an effective protocol in industrialized nations, yet they chose to use a placebo-contro...
With the emergence of HIV over thirty years ago, it has been estimated that more than half a million people have died from AIDS in the United States. As of 2006, approximately 2.2 million people in the United States are HIV positive with roughly 50,000 new infections per year. The most alarming statistic is that 20% of people that are HIV positive are unaware, making them susceptible to passing on the infection unknowingly. Public health programs have been working since the emergence of HIV to educate the populations, trying to give them the knowledge and the tools to protect themselves from infection. As more information has been collected about the transmission of HIV and the relevant social behaviors of susceptible populations leading to transmission, public health programs have been adjusting their messages and methods.
As the HIV virus pandemic arose, so did the voices of a plethora of distinct individuals- victims who were infected with this life long curse. However, these victims were unaware of their intimate partner’s sickly condition. In this case, the partner failed to disclose that he/she was HIV positive. As a result, in 1990, the tables started to turn. The victims, who were unaware of the risk they were taking with their partner, finally became the center of attention. (Wallace, 2005) Since 2004, in California, it has been considered a felony when the infected person recognizes that he/she is HIV positive, when he/she has not informed his/her partner, and when he/she intends to pass it on. (California department of Health Services, 2004) Even though the establishment of the law was based on good intentions for the sake of potential victims, problems were solved as new ones began. Some people support the law because it benefits the partner who is at risk. Others in society argue that the la...
Percival, S. L., Thomas, J. G., Slone, W., Linton, S., Corum, L., & Okel, T. (2011). The efficacy
One of these issues is the moral and ethical issue of genetic testing. Genetic testing is a controversial topic that affects patients, fetus to adult. For the sake of keeping this article from being too broad, I will focus on prenatal and fetal genetic testing. Proponents of genetic testing argue that it is a form of preventative medicine, allowing the parents to be prepared or make decisions about a child before the child is born. They may point out that with knowledge of defects or disabilities while child is in utero, medical staff can be ready to act immediately at birth to save the infants life. Place states that genetic testing gives prospective parents a choice in having a child with a disability or birth defect (as cited in Farrelly, et al., 2012). Malik points out that
Gates, E. A. "Ethical Considerations in Prenatal Diagnosis." US National Library of Medicine. Web. 31 Mar. 2014. .
Sexually transmitted diseases (STD) now referred to as sexual transmitted infections (STI) because some people can be infected and infecting others but never show signs of the disease. Of the estimated 12 million new cases of STD/STIs, women are diagnosed with two-thirds of those cases each year in America. Contrary to popular belief, oftentimes, women are exposed to STD/STIs after just one contact with an infected partner. STD/STIs are of particular anguish among women because of the severe and life-threatening difficulties during pregnancy (Ford & Shimers – Bowers, 2009). STIs have become a significant public health problem, especially among minorities. STIs are highly prevalent among African American and Hispanic women and they cause maternal and perinatal morbidity (CDC, 2008). STIs can be the blame for a several adverse outcomes during pregnancy including abortion, premature birth, stillbirth, and low birth weight. Additionally, STIs has been proven to orchestrate the transmission of HIV and the prevalence of STIs varies among different groups of people. Thus there is a need for local community knowledge of the epidemiology of STIs by looking at and monitoring the prevalence of etiological agents.
The case of Doctor David Acer and his HIV infected patients reads as a question of ethical and legal dilemmas as well as a murder mystery. According to authorities, Dr. Acer either knowingly or unknowingly infected five of his patients with the strain of the AIDS virus he himself was infected with (Altman, 1993). Whether or not Dr. Acer was guilty of intentionally infecting his patients is not able to be answered beyond any reasonable doubt, however the ethical questions it presents merit discussion.
Ghosh, A. (2010). Mayo Clinic internal medicine board review. Rochester, MN.: Mayo Clinic Scientific Press.
Udo Schuklenk, PhD, and Anita Kleinsmidt, LLB, LLM, Rethinking Mandatory HIV Testing During Pregnancy in Areas With High HIV Prevalence Rates: Ethical and Policy Issues, American Journal of Public Health , Vol 97, No. 7, 1179-83, July 2007