Elizabeth Crock: Bolton Clarke HIV Program, Melbourne Acknowledgements: Donna Tilley: Western Sydney Local Health District, Sydney (first edition) This chapter introduces ethical principles and decision-making in practice and highlights key ethical issues that can arise in the care of people living with HIV. Introduction and background What is the purpose of nursing and midwifery ethics? Stigmatisation …
Ethical frameworks for nursing and midwifery practice provide guidance on identifying ethical issues, making ethical decisions, and taking action. The International Council of Nurses (ICN) Code of Ethics for Nurses is the guiding document for ethical decision-making for nurses in Australia (6). The code identifies ethical standards and values agreed to by the profession. It is …
The most profound ethical problem that arises in the field of HIV is stigma and its repercussions, and it therefore warrants addressing first. The word stigma comes from the Greek word meaning a mark of disgrace or shame (9). Stigmatisation can lead to discrimination resulting in unequal or unjust outcomes (10). HIV-related stigma is defined by the …
Stigmatisation and discrimination are barriers to people accessing HIV testing and treatment and are associated with poor mental and physical health outcomes (18). Fear of discrimination due to negative past experiences can deter people with HIV from accessing services. Stigma can also be internalised – a person feels shame about themselves (based on the stigma), …
There is a lack of high-quality evidence on reducing HIV-related stigma in healthcare, and a need for randomised controlled trials using validated instruments that can measure stigma and discrimination (18). Nyblade et al note that interventions to address HIV-related stigma in nursing and midwifery practice need to focus on individual, environmental and policy levels (19). …
Healthcare staff may claim they have a ‘right to know’ a patient’s HIV status to ‘protect themselves or others from infection’. There is no legal ‘right’ for a health professional to know a person’s medical diagnosis. Further, it is well established that the consistent use of Standard Precautions is the best way to protect staff …
Disclosure of HIV status within health care and the ‘right to know’ Read More »
The principle of confidentiality is closely related to the concept of privacy and is both a legal and an ethical requirement (3). While laws about confidentiality and ethical obligations apply to people with all health conditions, confidentiality in HIV nursing and midwifery has acquired a greater significance, highlighting pre-existing weaknesses within the healthcare system. Ethical …
Informed consent is a central ethical and legal principle in the provision of health care, including nursing and midwifery care. The requirement to obtain informed consent applies to all health interventions with certain well-defined exceptions (such as life-threatening situations) (2). The requirement for consent to be ‘informed’ is justified on the ethical grounds of: avoiding …
Nurses can promote the rights of PLHIV by encouraging and supporting them to plan for their future care needs and treatment wishes, especially regarding end-of-life care and quality of life. The meaning of ‘quality of life’ is personal and unique to everyone, encompassing physical, psychological, and social domains. It is now included as a goal …
Quality of life, advance care planning and end-of-life decision-making Read More »
Nurses are increasingly involved in biomedical HIV prevention including the provision of pre-exposure prophylaxis (PrEP). PrEP is the use of antiretroviral drugs taken by HIV-negative people to prevent HIV infection (see PrEP for Prevention and Biomedical prevention add link section of this resource). As with any clinical innovation, the ethical implications of PrEP are important …
Emerging issues and their ethical implications – Pre Exposure Prophylaxis Read More »
Developing a sustainable HIV, Viral Hepatitis and Sexual Health Workforce
Acknowledgement of Country
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