tailieunhanh - Báo cáo khoa học: "Re-examining ethical obligations in the intensive care unit: HIV disclosure to surrogates"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về ngành y học đề tài: Re-examining ethical obligations in the intensive care unit: HIV disclosure to surrogates. | Available online http content 11 2 125 Commentary Re-examining ethical obligations in the intensive care unit HIV disclosure to surrogates Anthony T Vernillo1 Paul R Wolpe2 and Scott D Halpern3 1 New York University College of Dentistry Department of Oral and Maxillofacial Pathology Radiology and Medicine New York New York 10010 USA 2University of Pennsylvania Departments of Psychiatry Medical Ethics and Sociology and Center for Bioethics Philadelphia Pennsylvania 19104 USA 3Division of Pulmonary Allergy and Critical Care Medicine Center for Clinical Epidemiology and Biostatistics Center for Bioethics University of Pennsylvania School of Medicine Philadelphia Pennsylvania 19104 USA Corresponding author Anthony Vernillo atv1@ Published 18 April 2007 This article is online at http content 11 2 125 2007 BioMed Central Ltd Critical Care 2007 11 125 doi cc5720 Abstract Physicians treating newly incapacitated patients often must help navigate surrogate decision-makers through a difficult course of treatment decisions while safeguarding the patient s autonomy. We offer guidance for intensive care physicians who must frequently address the difficult questions concerning disclosure of confidential information to surrogates. Three clinical vignettes will highlight the ethical challenges to physician disclosure of a critically ill patient s HIV status. Two key distinctions are offered that influence the propriety of disclosure first whether HIV infection represents a primary cause for the patient s critical illness and second whether the surrogate may be harmed by failure to disclose HIV status. This balanced consideration of the direct duties of physicians to patients and their indirect duties to surrogates and third-party contacts may be used as a framework for considering other ethical obligations in the intensive care unit. We also provide a tabulation of individual US state laws relevant to disclosure of HIV status. Introduction .