Disclosing HIV status: ethical issues explored

Article Abstract:

Events throughout the country are cited that point to the public's growing fears of infection with human immunodeficiency virus (HIV, associated with AIDS) by health care workers. Since initial reports that one patient of an HIV-infected Florida dentist was infected by him, concern has mounted; a law in this is under consideration that would require disclosure by HIV-infected health care workers of their status to a medical board. The ethical aspects and possible implications of such rulings are considered. Admitting that one is infected with HIV would lead to compassion, care, and help in a perfect society, whereas disclosure in our society brings ostracization. Irrational fears of the dangers of transmission from health care worker to patient abound, and public trust in the safety of donated blood, transplanted organs, and hospital safety procedures has been eroded. People's fears are intensified by the certainty that HIV infection leads to death. The American Medical Association (AMA) and the American Dental Association (ADA) have explicitly stated their views that physicians and dentists are ethically obligated to treat people infected with HIV. In early 1991, both the AMA and ADA recommended that HIV-infected health professionals stop performing invasive procedures or inform their patients that they are infected. Opponents to this recommendation cite the disastrous consequences of disclosure for the professional's career and financial security, and the difficulty of deciding which procedures are hazardous. According to one recent report, three-fourths of the dentists surveyed believed that patients should be told if their dentist was HIV-infected. Several recommendations are presented, including: (1) development of safer instruments and procedures; (2) development of reimbursement procedures to finance health care for HIV-infected people; (3) mandatory reporting of HIV-positive health care workers to a panel of experts; and (4) the requirement that HIV-infected patients inform their doctor or dentist of their status. (Consumer Summary produced by Reliance Medical Information, Inc.)

Ethical aspects, Communicable diseases, HIV patients, Identification and classification, Dentist and patient, Dentist-patient relations, Disease reporting

---

Neuroleptic malignant syndrome in Parkinson's disease after withdrawal or alteration of dopaminergic therapy

Article Abstract:

Neuroleptic malignant syndrome, NMS, is a rare cluster of symptoms seen in patients treated with psychiatric drugs known as neuroleptics. Several cases of NMS associated with the withdrawal of medications used to treat Parkinson's disease are reported. Typical features of NMS are fever, rapid pulse, excess sweating, fluctuating blood pressures, rigidity and tremor, and coma or stupor. Because some of these symptoms, such as tremor, can cause muscle damage, the patients often have high levels of creatine kinase in their blood (this enzyme is released by damaged muscle). The syndrome has generally been associated with drugs that block the uptake of the brain chemical dopamine, but the drugs that treat Parkinson's disease are meant to replace dopamine, and it is their withdrawal that produces the syndrome. NMS is treated with agents that replace dopamine, such as the drug bromocriptine. In two of the three cases described, the physicians caring for the patients rejected the diagnosis of NMS suggested by consultants, because of their own unfamiliarity with the fact that NMS can be associated with drugs other than neuroleptics. For this reason, the suggestion is made that the syndrome be renamed acute dopamine depletion syndrome, to broaden the medical professions's understanding of the clinical spectrum of the disease. (Consumer Summary produced by Reliance Medical Information, Inc.)

Case studies, Diagnosis, Complications and side effects, Drug therapy, Parkinsonism, Neuroleptic malignant syndrome, Bromocriptine

---

Similar abstracts:

• Abstracts: Safety and efficacy of pramipexole in early Parkinson disease: a randomized dose-ranging study. Pramipexole vs Levodopa as Initial Treatment for Parkinson Disease: A Randomized Controlled Trial
• Abstracts: Ovarian remnant syndrome: experience at Jackson Memorial Hospital, University of Miami, 1985 through 1993
• Abstracts: Metastasizing thymoma and myasthenia gravis: favorable response to glucocorticoids after failed chemotherapy and radiation therapy
• Abstracts: Pregnancy and congenital heart disease. Genital tract abnormalities and female sexual function impairment in systemic sclerosis
• Abstracts: Typhoid fever, ciprofloxacin, and renal failure. Endotracheal compared with intravenous administration of atropine

This website is not affiliated with document authors or copyright owners. This page is provided for informational purposes only. Unintentional errors are possible.