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感染艾滋病毒的医护人员:对公众的威胁还是公众的牺牲品?

HIV-infected health care professionals: public threat or public sacrifice?

作者信息

Daniels N

机构信息

Department of Philosophy, Tufts University, Medford, MA 02155.

出版信息

Milbank Q. 1992;70(1):3-42.

PMID:1316992
Abstract

The ethical controversy surrounding the Centers for Disease Control (CDC) and American Medical Association (AMA) guidelines for restricting the practice of HIV-infected health professionals appears to hinge on whether we give priority to the rights of infected workers or patients. We cannot simply dismiss the concerns of patients as irrational, despite the low risks of transmission. Nor can we avoid the dispute about rights by claiming with the AMA that professionals have obligations to refrain from imposing "identifiable risks," however low, on patients. Nevertheless, allowing the full exercise of patient rights, either by giving patients the opportunity to know the risks they face and to switch providers, or by removing infected providers (compulsory switching), would make each of us worse off. This gives us adequate reason to reject these guidelines and to emphasize other infection control measures.

摘要

围绕美国疾病控制与预防中心(CDC)以及美国医学协会(AMA)关于限制感染艾滋病毒的医疗专业人员从业的指导方针所引发的伦理争议,似乎取决于我们是将优先地位给予受感染工作人员的权利还是患者的权利。尽管传播风险很低,但我们不能简单地将患者的担忧视为不合理而不予理会。我们也无法像美国医学协会所主张的那样,通过宣称专业人员有义务避免给患者带来“可识别的风险”(无论风险多低)来回避关于权利的争议。然而,无论是通过让患者有机会了解他们所面临的风险并更换医疗服务提供者,还是通过移除受感染的医疗服务提供者(强制更换)来让患者充分行使权利,都会让我们每个人的情况变得更糟。这让我们有充分的理由拒绝这些指导方针,并强调其他感染控制措施。

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