AIDS and Ethical Treatment of Infected Patients

Essay by lcdavenportUniversity, Master'sA, January 2010

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IntroductionThis paper will examine the ethical issues related to HIV/AIDS testing, treatment, and research. Key issues analyzed include confidentiality, informed consent, and end of life, research design, conflict of interest, vulnerable populations, and vaccine research. Although many examples are drawn from the United States, these issues are also explored from a global perspective. Major U.S. and international legal statutes, regulations, and guidance documents provide the context for the analysis and recommendations.

Overview of Ethical PrinciplesThere are three widely recognized principles in American bioethics that apply to both clinical and research ethics: respect for persons, beneficence, and justice. Respect for persons entails respecting the decisions of autonomous persons and protecting persons who lack decision making capacity and therefore are not autonomous. It also imposes an obligation to treat persons with respect by maintaining confidences and keeping promises. Beneficence imposes a positive obligation to act in the best interests of patients or research participants.

It often is understood to require that the risks of research be minimized and that the risks be acceptable in light of the potential benefits of research. Finally, justice requires that people be treated fairly. It is often understood to require that benefits and burdens be distributed fairly within society. (Lo, 2000)Although the ethical principles are useful guidelines that help to focus discussion, they cannot be mechanically applied. Nor are they absolute; exceptions to the principles may be appropriate in particular cases. Furthermore, they often conflict. Accordingly, these ethical principles must be interpreted in the context of specific cases. (Beauchamp, 1994) Although appeal to these three principles is the dominant approach in American bioethics, other approaches have been suggested and vary dramatically according to different trains of philosophic thought:•The utilitarian perspective embodies the idea that acts should be evaluated according to their consequences.

•The deontological approach stresses that...