Professional Confidentiality and HIV : Duty to Warn Third Parties and its Social Implications to Public Health in Nigeria

University essay from Linköpings universitet/Centrum för tillämpad etik

Author: Christian Nnamani; [2008]

Keywords: confidentiality; public health; HIV;

Abstract:

Confidentiality is considered an integral component of medical practise, yet there has been debate within the medical community as to whether there should be exceptions to the obligation to protect patient’s confidences. In the cases involving medical patients with deadly sexually transmittable disease like HIV/AIDS, physicians feel caught between two basic principles – keeping of medical confidentiality and public safety. Bioethicists would favour breaking of confidentiality when the public safety and the life of someone are endangered. However, considering the complexities and discrimination in connection with HIV/AIDS in Nigerian context, many would be tempted to discourage the notification of partners who risk being infected, through the moral obligation of 'duty to warn', but some others would argue that not notifying people of such threat to life would only help in spreading the virus to ignorant partners of an index patient. I argued that there is an overridden utilitarian principle to save others from harm, but some others cite the negative effects the breaking of medical confidentiality would have on the healthcare system as a reason not to favour partner notification. Nevertheless, people would appreciate the value of breaching confidentiality in HIV/AIDS related cases when various forms of discrimination and stigmatisations are criminalised and policies to protect the fundamental rights of people living with HIV/AIDS (PLWHA) are strictly adhered to.

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