Human immunodeficiency virus infection: physicians' responsibilities
Article Abstract:
It is highly likely that an obstetrician-gynecologist will come in contact with a patient carrying the human immunodeficiency virus (HIV). Physicians are now faced with complicated moral and ethical considerations surrounding the ever-increasing acquired immunodeficiency syndrome (AIDS) epidemic. When physicians enter the medical profession, they make a commitment to the care for the sick. Refusal to care for AIDS patients not only goes against this commitment but transfers the increased patient burden to colleagues. Physicians should use scientific and epidemiological evidence when assessing their own risk of becoming infected, rather than basing decisions on irrational fears. A statement made by the Committee on Ethics of the American College of Obstetricians and Gynecologists contends that the physician's risk of acquiring the HIV infection is small when proper precautions are employed. Physicians are obligated to remain up-to-date on all AIDS topics so that patients are provided with proper counseling. A breach of confidentiality can have serious personal consequences for the AIDS patient, and threatens the doctor-patient relationship. A physician who is HIV-positive has the same rights to privacy and confidentiality as any patient, but is obligated to 'do no harm' to the patient he cares for. Although there are no reported cases of HIV being transmitted from a physician to a patient, the HIV-infected physician has an obligation to avoid procedures involving increased risk to the patient. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: Obstetrics and Gynecology
Subject: Health
ISSN: 0029-7844
Year: 1990
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Successful pregnancy after ZIFT in a patient with congenital cervical atresia
Article Abstract:
Congenital cervical atresia is a condition in which the cervix (neck of the uterus) fails to develop or develops abnormally, resulting in the absence of a normal opening between the uterus and vagina. The case history of a patient with this condition, but a normal uterus, fallopian tubes, and ovaries, is presented; after reconstructive surgery at the age of 15, the patient began to experience cyclic bleeding with the use of oral contraceptives. Pregnancy was attempted when she was in her early twenties: attempts at in vitro fertilization (in which the egg and sperm are joined under laboratory conditions, then implanted into the uterus) were unsuccessful. Consequently, zygote intrafallopian transfer (ZIFT, in which the fertilized egg is transferred to the fallopian tube) was attempted and resulted in pregnancy. A cerclage (placement of a loop around the lower part of the uterus) was performed after 14 weeks' gestation. The patient delivered a healthy boy via cesarean section. Some problems in reconstructing a cervix in cases of congenital cervical atresia are briefly discussed. Patients with this condition who want to become pregnant will be greatly helped by techniques such as in vitro fertilization, ZIFT, and gamete intrafallopian transfer (in which sperm and egg are placed in the fallopian tube in proximity to one another). (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: Obstetrics and Gynecology
Subject: Health
ISSN: 0029-7844
Year: 1990
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