Ethical dilemmas in caring for patients with the acquired immunodeficiency syndrome.

Caring for patients with the acquired immunodeficiency syndrome (AIDS) raises ethical dilemmas about when to provide life-sustaining treatments such as mechanical ventilation and cardiopulmonary resuscitation. In addition, many patients become mentally incompetent and unable to participate in decisions. Homosexual men may want their lover or a friend to make decisions for them, but the patient's partner or friend cannot make these decisions unless he is legally designated. Decision-making guidelines may be hard to implement because caring for patients with AIDS is stressful. We describe three cases that illustrate the difficult ethical dilemmas and stresses of caring for these patients.