Legal and eEthical issues in Health Care

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Legal and ethical issues in Health Care

Introduction

SEQ CHAPTER \h \r 1 A young woman , Martha , is pregnant . She attends the antenatal clinic , where a nurse takes her health history and runs a series of tests , such as blood , urine and blood pressure . The nurse offers her an HIV test . Martha declines , as there seems to be no requirement for one . She is also aware of the complexities in obtaining a mortgage if she has this test

The blood sample taken

by the nurse is sent to a laboratory for analysis for hemoglobin content , and syphilis . At the similar time a small amount of blood from this sample is placed in an unnamed test tube which is then sent to a central laboratory to be tested for HIV . The nurse is to her the secret blood sample has been tested and found to be HIV antibody positive and this is recorded at the national surveillance center

Martha 's pregnancy continues normally and she delivers a healthy baby The baby has a heel prick blood test (Guthrie Test , which is regularly performed on newborns to detect phenylketonuria (PKU ) and hypothyroidism . In this case it comprises a test for HIV . The PKU and hypothyroidism tests are linked to the baby 's identity and are done with Martha 's knowledge , but the HIV test is secret and is done without her consent or knowledge

Antibodies to HIV are detected , although it cannot be known whether these are 'maternal ' antibodies flowing in the baby 's bloodstream temporarily , ultimately to disappear , or whether the baby in fact has HIV infection . Anyhow , although this HIV antibody positive result contributes to more epidemiological evidence collecting about HIV , no benefit has accrued , or can accumulate , either to the baby or the mother from the test at this stage

Martha was not informed regarding of the HIV tests and was not given the chance to either decline or give her consent . Consequently appropriate socially and health benefits cannot be offered to Martha , as she has no knowledge yet of her baby 's or her own HIV antibody status

The time passes by and Martha begins to feel ill . After much consideration and conversation , her physician offers her an HIV test The time waiting for the result is burdened with anxiety and the physician is apprehensive too . The test is positive , and so is a test on the baby 's blood

In the meantime , a national surveillance system is in operation , and doctors are encouraged to report AIDS cases to a central surveillance unit . This is a deliberate system which began in 1982 , and Martha 's physician fills in the appropriate form and sends it to the surveillance center . Martha is not aware of this process and the physician does not inform her . He does not think twice about it , after all , he reports numerous illnesses such as cytomegalovirus and Legionnaires ' disease on a voluntary base . That is , these are not notifiable diseases...