Sexually transmitted diseases STDs are a real and unfortunate result of unsafe sexual practices. They can be transmitted through oral, vaginal, or anal intercourse. There are three main categories of STDs based on what kind of organism is infecting the human body - bacterial, parasitic, and viral. Bacterial infections include chlamydia, gonorrhea, and syphilis. Chlamydia is the most common STD and can cause burning during urination and penile or vaginal discharge.
Accessed August 3, For this reason Chlamydia is known as the "the silent" disease. Rothenberg R. Structural factors in HIV prevention: concepts, examples, and implications for Ethical issues involved in std reporting. Thus, it is impossible to predict the likelihood of harm in any individual case. You remind her that her partner needs to be treated for the infection as well or her treatment will be ineffectual. Vlahov D. In discussing whether they would disclose the test results to their spouses or close relatives, it emerged that confidentiality, How to draw naked wemen, intimacy and trust were necessary aspects in disclosing Syphilis test results, specifically by the individual patient.
Ethical issues involved in std reporting. Stigmatisation and discrimination
Oct 1, Issue. Conley Department of Ethics St. Thus, it is important that sexually active women are tested for STDs. Ethical analysis is needed to clarify the contextual level of public health necessity as well as evaluate the rationale for, prioritize and justify activities designed to accomplish the stated public health objectives [ 12 ]. During consenting, everyone was assured of Ethical issues involved in std reporting and privacy; informed that their voices will be audio-tapped and that they should not use their names during the discussions. A physician's dilemma in these situations is one of choosing between the good of the patient and the good of others whom the physician is in a position to protect.
One of my patients, a well-respected citizen in our small community, came to see me with a complaint of hematuria.
- These variations presented challenges when developing decision rules that could be uniformly adopted across countries and simultaneously follow the ethical principles of beneficence, respect, and justice.
- Nurses work along the continuum of HIV care, from prevention and testing, engagement in care, sexual and reproductive health, long-term management through to palliative care.
- The search for truth and its unbiased reporting are ultimate goals of conducting scientific research.
One of my patients, a well-respected citizen in our small community, came to see me with a complaint of hematuria. My partner had recently treated him on an urgent basis for prostatitis, but the patient's symptoms had persisted in spite of antibiotic treatment. Now fearful and with blood in his urine, he Jennifer lopez wear thongs to my office. I asked him if he'd had any new sexual partners recently, and he admitted that he had.
Issies explained to him that his urine specimen had been positive for Chlamydia. He seemed reluctant to discuss his condition with his wife, who is also my patient. If he refuses to confide in her, what should I do? Should I tell her that she could be infected? Confidentiality between physician and patient has long been regarded as a sacred trust. It is embodied in the Hippocratic oath and in the ethical codes of virtually all health-related professions.
Yet it is widely recognized that the physician's duty to respect confidentiality is not without limit 1 ; for example, when an involve third party might somehow be harmed by the agency of the patient or if there is concern for the public health. A physician's dilemma in these situations is one of choosing between the good of the patient and the good of others whom the physician is in a position to protect. The present case scenario illustrates this dilemma well.
The patient is a well-known citizen in the community and a married man who has been diagnosed with a chlamydial infection.
He has admitted to having a recent new sexual contact and is understandably reluctant to notify his wife of his diagnosis. The fact that the patient's wife is also this physician's patient is an additional complication. Information that the physician has gained while treating one of her patients reveals that another patient is at high risk of contracting or perhaps has already contracted a sexually transmitted disease.
The physician who incidentally uncovers information about another patient in this way is in a difficult ethical position. Our physician must decide whether the duty of beneficence she has to one of her patients the wife justifies breaching her duty to respect the confidentiality of this patient.
And this is not the only ethical issue raised in this scenario. As we shall see, this case further challenges the physician to consider whether she has a broader duty to promote fair public policy practices regarding the reporting of sexually transmitted diseases.
Physicians confronted with dilemmas involving patient confidentiality frequently seek guidance from statutory regulations or legal precedent. In this case, however, neither avenue is likely to prove especially helpful.
Some states have laws requiring partner notification of human immunodeficiency virus HIV infection and acquired immunodeficiency syndrome, and contact tracing for syphilis and gonorrhea has been in place issus many jurisdictions for many years. However, invloved ample evidence that Chlamydia is the most common cause of serious sexually transmitted disease in the United States today, public policy has failed to address the need for contact tracing for this disease in a uniform manner.
Indeed, contact tracing and partner notification by public health officials vary widely by disease, from 92 percent for syphilis which affects men and women equallyto 53 percent for Chlamydia the burdens of which fall disproportionately on women. Although this problem has been recognized at the national level, a well-coordinated solution has not been forthcoming, and sexually transmitted diseases remain a tremendous issurs and economic burden in our nation.
Case law is also unlikely to provide the physician with much assistance. One of the most well-known cases addressing the physician's duty to warn third parties of imminent harm is Tarasoff v. Regents of the University of California. Although the therapist did inform invoved authorities, he did not personally warn the intended victim, whom the patient later killed.
However, in other cases more directly relevant to this one, the courts have ruled inconsistently. Because of the absence of public policy and the ambiguity in case law, the physician will want to search for what should be foremost in guiding thought and action—a set of ethical guidelines. We have proposed a list of factors that we believe bear on these difficult decisions.
We believe that the following seven criteria are Ethical issues involved in std reporting in this circumstance: 1 the gravity involced the harm; 2 the probability of the harm; 3 the identifiability of potential victims of the harm; 4 the imminence of the harm; 5 the probability that an intervention can mitigate the harm; 6 the degree to which means other than breach of confidentiality have been exhausted; and 7 whether imvolved patient himself is the agent of the harm. We suggest that the greater the degree to which these criteria are satisfied by the circumstances of the case under scrutiny, the greater the force of the argument to breach confidentiality and warn the parties at risk.
Let us reconsider our case in light of these criteria. First to be considered is the gravity of the harm. Although chlamydial infection is asymptomatic in the majority of women, it is the leading cause of pelvic inflammatory disease PID in the United States. Thus it threatens, often silently, the reproductive health of women by contributing to infertility, ectopic pregnancy, and pelvic pain.
The next three criteria are met with equal ease. In our present case, the victim the wife is clearly identifiable, and there is no doubt that the patient the husband is the agent of the harm. Finally, recent literature suggests that there is a high probability that appropriate intervention can mitigate the harm. However, the next two criteria are less well met in How to masturbate another man case and counter the arguments that favor the breaching of confidentiality.
Consider first the likelihood of harm: it is impossible to predict whether a given case of chlamydial infection of the lower genital tract will result in PID.
What do we know about the risk? Based on data from one study, 8 an estimated 5 percent of women who are screened for Chlamydia will be found to have the infection. This same study also demonstrated that treatment Crosley midget women whose Chlamydia screens were positive reduced the risk of PID by 56 percent over the control group.
Another study 9 found that a history of two chlamydial infections doubles the risk of ectopic pregnancy and quadruples the risk of PID; three or more such infections increases the risk of ectopic pregnancy 4.
Nevertheless, because Chlamydia is overwhelmingly asymptomatic in women and its complications are insidious, reliable data for absolute incidence and prevalence are lacking although the bias is overwhelmingly toward underestimation. These uncertainties are compounded by the fact that there may be a Circumcision good time of months to years before the more serious complications present.
Thus, it is impossible to predict the likelihood of harm in any individual case. Because of these considerations, then, although the warrant to warn on the ground of likelihood of harm is appealing, it is not compelling.
Matters are similar when the imminence of the harm is considered. This criterion also fails to Eva collins nude satisfied because chlamydial infection of the lower genital tract may not develop into PID and its attendant complications for months, if ever. The final criterion concerns the degree to which all means alternative to breaching confidentiality have been exhausted. To satisfy this criterion, the physician must have a fully informative discussion with the patient about the risk to his wife, the risk of reinfection to himself should his wife be infected and go untreated, all risks attendant to fertility and pregnancy, and potential risks to any future Ethical issues involved in std reporting.
If there is mandatory contact tracing in the jurisdiction in which she practices, she should inform him that the case must be reported and, therefore it would be beter for him to inform his wife himself. The physician must offer reportinng assist the patient in making reeporting disclosure and provide him with a reasonable Hot chineese teen of time Ehhical self-reflection and deliberation before doing so.
Having done this, she will have exhausted Etical reasonable alternatives involvdd breach of confidentiality. With due consideration to all the foregoing provided that the patient's wife is not currently pregnant, which would introduce other considerationswe conclude that the criteria are not yet sufficiently satisfied to justify the physician's breaching of confidentiality. Ethical issues involved in std reporting, the physician should not inform the patient's wife over his objection.
Situations that threaten the confidentiality of the physician-patient relationship are always difficult to resolve. We have argued that there are Ethicall to the physician's duty to maintain the confidentiality of the physician-patient relationship, Ethical issues involved in std reporting these limits are difficult to define. Legal and judicial precedents are not sufficient to provide concrete direction.
Helpful Ethical issues involved in std reporting guidelines exist, but they are not extensive sttd. Public health policy is desperately needed to address the issues of contact tracing and partner notification for chlamydial infection. Issues of justice and fairness may underlie this imperative because the burdens of sexually transmitted disease fall disproportionately on women.
Already a member or subscriber? Log in. The authors thank Lynn Jansen, Ph. Siegler M. Confidentiality in medicine: a decrepit concept.
N Engl J Med. Public health departments providing sexually transmitted disease services. Fam Plann Perspect. Institute of Medicine U. The hidden epidemic: confronting sexually transmitted diseases.
Washington, D. Screening for chlamydial infections and the risk of ectopic pregnancy in a county in Sweden: ecological analysis. Tarasoff v. Regents of University of California, 17 Cal. Ethics in clinical practice. Gaithersburg, Md. Sulmasy DP. On warning families about genetic risk: the ghost of Tarasoff.
Am J Med. Prevention of pelvic inflammatory disease by screening for cervical chlamydial infection. Recurrent chlamydial infections increase the Sexy conan video of Banned teen sex for ectopic pregnancy and pelvic inflammatory disease. Am J Obstet Gynecol. Please send scenarios to Caroline Wellbery, MD, at afpjournal aafp.
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the most difficult ethical issues - Mandatory testing for persons sentenced for drug and sex-related crimes - Management of substantial exposures to health care and public safety workers, rarely requiring mandatory testing of sources • Strong Public Health help – to clarify the problem and provide ethical & moral assistance – may be. Ethical issues associated with the reporting of child abuse. Published on 12/05/ by admin. and to addressing some of the key ethical issues raised by mandatory reporting requirements. The Mary Ellen case involved a small child (of approximately 10 years of age) who had been severely abused by her guardians since the time of her. NIMH Collaborative HIV/STD Prevention Trial Group. OBJECTIVE: To develop decision rules regarding key ethical dimensions in scientific protocols for the National Institute for Mental Health (NIMH) Collaborative HIV/STD Prevention Trial taking place in five .
Ethical issues involved in std reporting. Curbside Consultation
The person then can choose whether he or she would like to engage in this treatment. Journal of Medical Internet Research. Acknowledgements We acknowledge the participants who provided the information and the research assistants who helped to collect data and consolidate the information together for analysis. Also the blood test is another way in which one may be tested for syphilis. An ethics framework for public health. Furthermore, people with untreated Gonorrhea are more likely to be susceptible to HIV. Normally, a doctor explains directly to a person what the disease is, what its symptoms and complications are, how the treatment is disbursed, and the risks of the treatment. Avoiding Liability Bulletin. References Carlo P. Public health aims to provide universal safety and progressive opportunities to populations to realise their highest level of health through prevention of disease, its progression or transmission. Latka M. These may contribute to reluctance to comply with follow-up visits among those who test positive. Buy options. Some of the participants indicated that the health staff at the clinic informed them about Syphilis and a range of tests to be done on them.
The goal of public health is to promote the health of all persons for the good of the entire population.
In the first three chapters of this four-chapter section, we looked at the practical aspects of reporting and writing about crime. Here we discuss some of the main ethical issues of crime reporting, to keep you honest and safe. Crime reporters face a number of ethical problems when doing their job. Perhaps the biggest problem is remembering where they belong in relation to the police, criminals and the public. As a journalist, your first and over-riding loyalty must be to tell your readers or listeners the truth. Sometimes the police may want you to hide the truth or alter it, to help them catch a criminal.