HIV/AIDS prevalence causes a threat to the well-being and longevity of humanity. The high rates of disease transmission and the severity of its outcomes, which comprise comorbidities and mortality, impose acute ethical conflicts. Massive preventive and controlling programs are initiated worldwide to prevent the spread of the infection and protect people’s health. The efficacy of these interventions is based on the promotion of personal responsibility for health that should be a daily priority for everyone regardless of risk intensity.
However, the issue of health responsibility raises the conflict between health and confidentiality. On the one hand, everyone should be responsible for one’s health, thus ensuring that he or she does not cause any threat to other members of society. On the other hand, when it comes to health issues, people have their right to the confidentiality of disease-related information. Nevertheless, respecting the privacy and confidentiality of HIV-positive individuals imposes a threat to their sexual partners. It is vital to find a rational resolution of this ethical dilemma to find a compromise.
Responsibility for Health
The framework of disease prevention and health promotion utilizes the concepts of social, environmental, and personal responsibilities as the keystones of establishing equity and quality of healthcare for all. However important the responsibility of government and medical workers might be, it is impossible to ensure the same level of health protection for all layers of diverse societies. The disparities in healthcare are caused by many factors, including income, culture, mental health issues, addictions, illiteracy, and many others (Sharfstein 720). Therefore, the promotion of personal responsibility is essential in the medical sphere.
In my opinion, I, as a lawful citizen and as an intelligent human being, must bear responsibility for my lifestyle daily. The health condition depends on my positive and negative activities which are the result of my daily choices. For example, every day I choose if I eat a salad or smoke a cigarette, or if I take drugs or do sports. Similar choices are crucial when they concern risky behaviors leading to severe infectious diseases. That is why, the issue of personal responsibility is most acute when it comes to the HIV and AIDS epidemic because in this case, the health of others is at stake.
Both, global and local programs aimed at HIV and AIDS treatment and prevention are utilizing all possible methods to stop the epidemic and protect people from the spread of the illness. Such organizations as the Centers for Disease Control and Prevention (CDC), World Health Organization (WHO), and others apply all possible methods and tools to improve the situation related to HIV/AIDS. They promote safe sex and a healthy lifestyle, raise awareness about HIV transmission paths, to provide equal opportunities for all people to be time tested and exposed to treatment (Bond et al. 427-429).
Such institutions initiated massive HIV testing for large population groups aimed at the detection of positive individuals and their treatment providers. Also, a lot of effort is applied to ensure the confidentiality of the individuals under treatment due to the biased attitudes and stigmatizing related even to the presence of a person at an HIV center (Dapaah and Senah 2). Therefore, the preservation of confidentiality for HIV/AIDS patients is crucial. However, there might occur specific circumstances under which it might be compromised, thus imposing an ethical dilemma concerning the opposition of health and confidentiality.
The issue of conflict between the values of health and confidentiality arises more visibly when an HIV-positive person withholds the information about his or her condition and proceeds to engage in sexual intercourse with partners. Such actions impose significant hazards for those interacting with the HIV-positive patient and being unaware of the threat. On the one hand, “confidentiality is a basic concept in medical ethics and protecting confidentiality is considered as physicians’ duty” (Noroozi et al. 50).
However, on the other hand, a medical worker must respect the right of sexual partners of such a patient to be protected from the harmful effect on their health and ultimately the quality of life. Thus, an HIV-positive person who is aware of his or her condition should take responsibility for his or her actions before those whom he or she places at risk.
Moreover, the issue under discussion depends on the cultural background from which a person comes. I, as a representative of Chinese culture, might suggest that the concepts of family unity, personal confidentiality, and overall respect are regarded as core values and could not be violated under any circumstances. However, if a Chinese person is tested HIV-positive, an ethical dilemma will arise, and its resolution will be even more complicated due to ethnic and cultural considerations. For example, a person with a Chinese background will be unlikely to uncover any extramarital sexual relationships to ensure the safety of the partners because infidelity is culturally condemned.
Possible Ways of Dilemma Resolution
Despite the complexity of the problem, there are potential ways and tools capable of resolving it. It is essential to review the legal side of the argument and develop a specific procedure enabling the opportunities of partners of an HIV-positive individual to be informed about the danger (Noroozi et al. 52-53). Under the circumstances when it is impossible to know the exact number of partners and obtain any account about the people who engage in sexual interaction with a patient, alternative interventions are needed.
In general, the promotion of personal responsibility for health must be carried out based on the articulation of the priority of the health of humanity in the situation when AIDS causes a significant threat (Center for Disease Control and Prevention). In other words, it is vital to make HIV-positive people understand that it is possible to maintain a decent lifestyle and ensure the safety of those around them. Thus, additional funding should be provided to research the legal sphere and implement promotion activities to resolve the conflict between confidentiality and health.
If I were to resolve such a conflict in a daily situation, I would prioritize the health of a partner over the confidentiality of an HIV-positive patient, but I would not violate the legal rights of the patient. To succeed at this, I would need to provide informational and educational consulting with the patient to articulate the hazards the unawareness of the sexual partners could cause to their health and maybe to the health of others.
I would apply cultural sensitivity and validate my ideas with research about the prevalence of the disease, the mortality rates because of AIDS, and the statistical data of the speed of the epidemic. In case of a successful implementation of such communicational techniques, a patient would be willing to share confidential information about his or her health condition, thus maintaining a responsible action toward others.
In summary, personal responsibility for health is a crucial concept in the framework of the HIV/AIDS epidemic because it is the only possible way to ensure the prevention of the fast spread of the infection. However, when applying this notion to practice, healthcare providers encounter multiple ethical dilemmas which bring core moral values to conflict. One of such ethical problems is the collision of confidentiality of HIV-positive individuals and the health safety of their unaware sexual partners. The resolution of this dilemma could be found in the promotion of personal responsibility and the review of legal issues related to the problem.
Bond, Virginia, et al. “Good Health and Moral Responsibility: Key Concepts Underlying the Interpretation of Treatment as Prevention in South Africa and Zambia Before Rolling Out Universal HIV Testing and Treatment.” AIDS Patient Carte and STDs, vol. 30, no. 9, 2016, pp. 425-434.
Center for Disease Control and Prevention. “Division of HIV/AIDS Prevention: HIV in the South Meeting Notes.”. 2017. Web.
Dapaah, Jonathan Mensah, and Kodjo A. Senah. “HIV/AIDS Clients, Privacy and Confidentiality; The Case of Two Health Centres in the Ashanti Region of Ghana.” BMC Medical Ethics, vol. 17, no. 41, pp. 1-10.
Noroozi, Mahshad, et al. “To Tell, or Not to Tell; Confidentiality in an Iranian HIV Positive Patient: A Viewpoint.” Journal of Family and Reproductive Health, vol. 11, no. 1, 2017, pp. 50-55.
Sharfstein, Joshua M. “Common Ground on Responsibility for Health.” The Milbank Quarterly, vol. 95, no. 4, 2017, pp. 718-721.