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. 1991 May-Jun;64(3):207–246.

Do physicians have an ethical obligation to care for patients with AIDS?

N R Angoff 1
PMCID: PMC2589324  PMID: 1788990

Abstract

This paper responds to the question: Do physicians have an ethical obligation to care for patients with acquired immunodeficiency syndrome (AIDS)? First, the social and political milieu in which this question arises is sampled. Here physicians as well as other members of the community are found declaring an unwillingness to be exposed to people with AIDS. Next, laws, regulations, ethical codes and principles, and the history of the practice of medicine are examined, and the literature as it pertains to these areas is reviewed. The obligation to care for patients with AIDS, however, cannot be located in an orientation to morality defined in rules and codes and an appeal to legalistic fairness. By turning to the orientation to morality that emerges naturally from connection and is defined in caring, the physicians' ethical obligation to care for patients with AIDS is found. Through an exploration of the writings of modern medical ethicists, it is clear that the purpose of the practice of medicine is healing, which can only be accomplished in relationship to the patient. It is in relationship to patients that the physician has the opportunity for self-realization. In fact, the physician is physician in relationship to patients and only to the extent that he or she acts virtuously by being morally responsible for and to those patients. Not to do so diminishes the physician's ethical ideal, a vision of the physician as good physician, which has consequences for the physician's capacity to care and for the practice of medicine.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Amundsen D. W. Medical deontology and pestilential disease in the late Middle Ages. J Hist Med Allied Sci. 1977 Oct;32(4):403–421. doi: 10.1093/jhmas/xxxii.4.403. [DOI] [PubMed] [Google Scholar]
  2. Annas G. J. Not saints, but healers: the legal duties of health care professionals in the AIDS epidemic. Am J Public Health. 1988 Jul;78(7):844–849. doi: 10.2105/ajph.78.7.844. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Brandt A. M. AIDS: from social history to social policy. Law Med Health Care. 1986 Dec;14(5-6):231–242. doi: 10.1111/j.1748-720x.1986.tb00990.x. [DOI] [PubMed] [Google Scholar]
  4. Cooke M., Sande M. A. The HIV epidemic and training in internal medicine. Challenges and recommendations. N Engl J Med. 1989 Nov 9;321(19):1334–1338. doi: 10.1056/NEJM198911093211911. [DOI] [PubMed] [Google Scholar]
  5. Coombs R. W., Collier A. C., Allain J. P., Nikora B., Leuther M., Gjerset G. F., Corey L. Plasma viremia in human immunodeficiency virus infection. N Engl J Med. 1989 Dec 14;321(24):1626–1631. doi: 10.1056/NEJM198912143212402. [DOI] [PubMed] [Google Scholar]
  6. Emanuel E. J. Do physicians have an obligation to treat patients with AIDS? N Engl J Med. 1988 Jun 23;318(25):1686–1690. doi: 10.1056/NEJM198806233182511. [DOI] [PubMed] [Google Scholar]
  7. Fineberg H. V. The social dimensions of AIDS. Sci Am. 1988 Oct;259(4):128–134. doi: 10.1038/scientificamerican1088-128. [DOI] [PubMed] [Google Scholar]
  8. Fox Daniel M. The politics of physicians' responsibility in epidemics: a note on history. Hastings Cent Rep. 1988 Apr-May;18(2):S5–10. [PubMed] [Google Scholar]
  9. Gruson Lindsey. AIDS fear spawns ethics debate as some doctors withhold care. N Y Times Web. 1987 Jul 11;:1–12. [PubMed] [Google Scholar]
  10. Kelly J. A., St Lawrence J. S., Smith S., Jr, Hood H. V., Cook D. J. Stigmatization of AIDS patients by physicians. Am J Public Health. 1987 Jul;77(7):789–791. doi: 10.2105/ajph.77.7.789. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Ladd J. Legalism and medical ethics. J Med Philos. 1979 Mar;4(1):70–80. doi: 10.1093/jmp/4.1.70. [DOI] [PubMed] [Google Scholar]
  12. Link R. N., Feingold A. R., Charap M. H., Freeman K., Shelov S. P. Concerns of medical and pediatric house officers about acquiring AIDS from their patients. Am J Public Health. 1988 Apr;78(4):455–459. doi: 10.2105/ajph.78.4.455. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Loewy E. H. Duties, fears and physicians. Soc Sci Med. 1986;22(12):1363–1366. doi: 10.1016/0277-9536(86)90100-0. [DOI] [PubMed] [Google Scholar]
  14. Musto David F. Quarantine and the problem of AIDS. Milbank Q. 1986;64(Suppl 1):97–117. [PubMed] [Google Scholar]
  15. Pellegrino E. D. Toward a reconstruction of medical morality: the primacy of the act of profession and the fact of illness. J Med Philos. 1979 Mar;4(1):32–56. doi: 10.1093/jmp/4.1.32. [DOI] [PubMed] [Google Scholar]
  16. The physician's ethical obligation to take care of patients in times of plague. JAMA. 1988 Mar 4;259(9):1325–1326. [PubMed] [Google Scholar]
  17. Zuger A. AIDS on the wards: a residency in medical ethics. Hastings Cent Rep. 1987 Jun;17(3):16–20. [PubMed] [Google Scholar]
  18. Zuger A., Miles S. H. Physicians, AIDS, and occupational risk. Historic traditions and ethical obligations. JAMA. 1987 Oct 9;258(14):1924–1928. [PubMed] [Google Scholar]

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