Poll: As the surgeon, would you...
test the blood and not tell the patient the result (3)
8.33%
test the blood and tell the patient the result regardless of what it is (13)
36.11%
test the blood and tell the patient only if it is positive (12)
33.33%
test the blood and tell the patient only if it is negative (0)
0%
hope for the best and not test the blood (8)
22.22%
Hygeia
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#1
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#1
i'm doing an ethics project at the moment and am hoping everyone will give me some opinions and answer my poll of this hypothetical question please:

'During surgery, the surgeon sustain's a needlestick injury (her blood comes into contact with the patient's). She has reason to suspect that the patient may be HIV positive but the patient will not allow himself to be tested. Is the surgeon justified in testing him covertly while he is still under anaesthetic?'

N.B testing him without permission is illegal. also, if the surgeon does not test the blood, he/she will have to take prophylactic medicine for 6 months (the medicine has various unpleasant side effects)
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Jackathon
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#2
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#2
Is this completely hypothetical, or did you read it somewhere?
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ForeverIsMyName
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#3
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#3
Most certainly.
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Profesh
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#4
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#4
What's "comtact"?
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zzzzzoe
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#5
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#5
surely thats okay if the surgeons at risk?
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Jhawkins
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#6
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#6
I'd do the test and not tell the patient.
Although, in retrospect I would tell them if they were HIV positive.

But that's why I'm not a doctor :P
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KizD
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#7
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#7
test patient then ask him/her if he wants to know the result.
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Elles
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#8
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#8
Hmm, sorry - this is supposed to be all ethical hypothetical. But as general information about anti-retroviral prophylaxis: a four week course is the norm protocol I've come across & the side effects are normally manageable e.g. anti-emetics for nausea that is common.
Thankfully in the situations I've heard of patients have consented to testing. Though the 'Post exposure prophylaxis' may be started anyway - because it's an ASAP thing.


My answer to the poll was probably influenced by the medico-legal teaching we've had in our course!
You cannot test the patient without consent, but it wouldn't just be a case of hope for the best - once the Pt is conscious seek consent, explaining the purpose and benefits & start PEP if thought to be high risk.
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Sidhe
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#9
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#9
(Original post by Profesh)
What's "comtact"?
Oh come on that's a typo! Sheez it's bad enough there's a surge in grammar/spelling bores, but we haven't stooped so low as to start correcting typos now, surely?
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ßlαcksωαn
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#10
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#10
Wait for him to wake up, then do it, even if he denies.
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L i b
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#11
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#11
The moral and ethical thing to do would be to not test the blood.

All the same, if I was in that situation I may well.
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Jason Sparks
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#12
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#12
Well it's certainly not ethical (assualt i would call it). However, people have to make their own choices, and i believe i would test their blood if i had access to the facilities - infact, i definitely would. I would justify it that i am taking action to protect my body, and that the protection of my body is my overiding concern of most ethical situations.
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Captain Crash
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#13
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#13
Surly the thing to do is to wait for the patient to come round after surgery, explain the situation and ask for a blood test (as well asking separately if the patient wants to know the result). It the answers yes, fine. If no, go on the prophylaxis treatment.

This way you totally respect the patient's consent whilst striving to get the blood tested and a delay of a few hours won't change the ultimate course of action much.
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L i b
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(Original post by Jason Sparks)
Well it's certainly not ethical (assualt i would call it). However, people have to make their own choices, and i believe i would test their blood if i had access to the facilities - infact, i definitely would.
Well, there's the complete opposite to what you've been arguing elsewhere. Hypocrisy, thy name is Mad Sparksy.
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Jason Sparks
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#15
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#15
(Original post by L i b)
Well, there's the complete opposite to what you've been arguing elsewhere. Hypocrisy, thy name is Mad Sparksy.
I consider the need to protect one's body from HIV a greater and more value considered choice to make - indeed a more ethical choice - than the need to break the law, contribute towards a criminal economy and help normalize an unregulated product into this country, all in the name of personal liberty and wanting to get high

Fool.
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L i b
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(Original post by Jason Sparks)
I consider the need to protect one's body from HIV a greater and more value considered choice to make - indeed a more ethical choice - than the need to break the law, contribute towards a criminal economy and help normalize an unregulated product into this country, all in the name of personal liberty and wanting to get high
So, in other words, the law is unbreakable - except when you say it should be... everyone else who renders their own judgements on the matter is 'warped' and 'a fool'.
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Jason Sparks
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#17
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(Original post by L i b)
So, in other words, the law is unbreakable - except when you say it should be... everyone else who renders their own judgements on the matter is 'warped' and 'a fool'.
Use your brain instead of arguing purely at face value.

The need to protect one's body from a potential HIV attack is a much higher valued choice in which to break an ethical norm (do not assualt someone and test their blood without their consent), than the choice to break the law, take or sell drugs, contribute towards the criminal economy, normalize an unregulated product into society, and contribute towards our country's crime.

Call it consequentialist or whatever you like. It is my own personal opinion on the matter. You may believe that the need to protect oneself from HIV is tantamount to your need to get high and break the law: fair enough!

Either way i believe both compromise what our ethical obligations tell us (do not assualt and do not break the law for one's own personal pleasure)); however, i believe the former is acting with good faith not just to oneself (to protect against HIV), but towards others (if one does not test one's blood then one might need to unnecessarily gain access to expensive drugs, draining our NHS, and also it could affect one's social relations i.e. you might be afraid to have sex lest you infect someone. Such considerations just are not present with breaking the law to sell smack (there is: i'm too lazy to get a job; i will therefore sell drugs; i don't give a toss about the consequences of my actions).

I really have outlined my view. Please only respond if you genuinely are baffled by what i've put, because i'm bored of your little, childish game of 'argue points' effected by sleeping all day and becoming awake at night with nothing better to do.

That and my writing is increasingly sloppy due to sleep deprivation
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L i b
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#18
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#18
(Original post by Jason Sparks)
The need to protect one's body from a potential HIV attack is a much higher valued choice in which to break an ethical norm (do not assualt someone and test their blood without their consent), than the choice to break the law, take or sell drugs, contribute towards the criminal economy, normalize an unregulated product into society, and contribute towards our country's crime.
So in other words, what I suggested originally: you've rescinded your previous strongly held conviction, which you insulted me for telling you was a load of crap, because there is a 'higher valued choice'?

Perhaps if you did not see the world in sophomoric absolutes, this might not have occurred.

Either way i believe both compromise what our ethical obligations tell us (do not assualt and do not break the law for one's own personal pleasure)); however, i believe the former is acting with good faith not just to oneself (to protect against HIV), but towards others (if one does not test one's blood then one might need to unnecessarily gain access to expensive drugs, draining our NHS, and also it could affect one's social relations i.e. you might be afraid to have sex lest you infect someone. Such considerations just are not present with breaking the law to sell smack (there is: i'm too lazy to get a job; i will therefore sell drugs; i don't give a toss about the consequences of my actions).
So in other words: the argument is a financial one, the value of the drugs; and a sexual one, that you might be afraid to get laid. Money and shagging, eh? I see you really go for the higher moral values in life.

I really have outlined my view. Please only respond if you genuinely are baffled by what i've put, because i'm bored of your little, childish game of 'argue points' effected by sleeping all day and becoming awake at night with nothing better to do.
Oh, I'm sorry, am I keeping you up past your bed time?

I'm not remotely baffled by any of your points, I had the measure of you long ago. However, you have posted on a debate and discussion forum and, surprisingly enough, I'm going to argue with you here if you talk a load of illogical, hypocritical nonsense.
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Jason Sparks
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#19
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#19
(Original post by L i b)
So in other words, what I suggested originally: you've rescinded your previous strongly held conviction, which you insulted me for telling you was a load of crap, because there is a 'higher valued choice'?
I'm saying concisely, that i believe to have somebody's blood tested without their permission is clearly unethical and thus we find ourselves obligated to avoid such action. I'm saying too, that i can sympathize with the person who chooses to have such blood tested, due to contextual factors. Finally I am saying, that when it comes to breaking ethical codes, some instances serve higher values than others.

To break one's ethical obligation and have the blood tested, i can see serves three purposes: it avoids the misuse of highly expensive drugs that could be used for somebody actually exposed to HIV;

it serves to clarify whether the person has actually been exposed to HIV (of course this is on the assumption the other person has been exposed to HIV prior to Three months);

and finally it serves others in enabling the nurse to take immediate action, preventing the risk of say, a sexual partner from being infected.

Compared to our drug dealer who breaks his ethical obligation (not to sell heroin, as requested by the law) simply because he is too lazy to find a job, I can say that I sympathize with the nurse, in that whilst her actions are predicated by self-preservation, they tend to benefit others (a potential partner and the NHS).

This does not serve as a justification in breaking an ethical obligation, only a justification as to why i sympathize with one over the other.

(Original post by L i b)
So in other words: the argument is a financial one, the value of the drugs; and a sexual one, that you might be afraid to get laid. Money and shagging, eh? I see you really go for the higher moral values in life.
Your typical, objectional framing of any response in order to gain kudos points with what seems a pithy answer that summarises and concludes; your lazy rhetoric is obvious and exposes intellectual weakness.



(Original post by L i b)
Oh, I'm sorry, am I keeping you up past your bed time?

I'm not remotely baffled by any of your points, I had the measure of you long ago. However, you have posted on a debate and discussion forum and, surprisingly enough, I'm going to argue with you here if you talk a load of illogical, hypocritical nonsense.
More rhetoric. Nil point.

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Hygeia
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#20
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#20
[QUOTE=Elles]Hmm, sorry - this is supposed to be all ethical hypothetical. But as general information about anti-retroviral prophylaxis: a four week course is the norm protocol I've come across & the side effects are normally manageable e.g. anti-emetics for nausea that is common.
Thankfully in the situations I've heard of patients have consented to testing. Though the 'Post exposure prophylaxis' may be started anyway - because it's an ASAP thing.QUOTE]

yes it is usually a four week course for the prophylaxis but then you can't be tested and get a reliable result until 6 months after the 'exposure' so you have the stress during this time as well as the side effects which in some cases have caused people to stop taking the medication in the past
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