Blog Entry #1

Being in the healthcare industry for many years has taught me many lessons. I try to view each day as a blank slate that is written upon as the day progresses, but after reading the assignments for this week, I realized that the slate is already written on long before the day starts. Each encounter with varying stakeholders in the healthcare industry is actually a series of ethically charged steps of interaction between the expectations and outcomes of the individuals in the system. Virtues and morals are perceptions that can be intentionally or unintentionally ignored or disregarded, depending on the characteristics of ethical situations.
I was thinking of a case where a young woman was told she was HIV+ and received the post counseling that is performed in such cases. The importance of discussing HIV testing with her sexual partners/intravenous needle sharing partners was stressed as well as the fact that she did not have to disclose her own status, the clinic could make the contacts if she wished. Follow up appointments with various specialties to help her with her diagnosis were made and the woman seemed receptive and thankful for the assistance. The next few visits with various practitioners went smoothly and without incident until the woman announced she was pregnant. Ethically, you could have heard a pin drop.
I found this case very difficult from a moral and ethical standpoint. I felt we (clinic staff) had done everything we could to inform, treat, and provide for her care according to all the guidelines, rules, regulations, etc... in a responsible manner, and she had betrayed us. Not only us, but herself, her unborn child, and her partner, whom she still had not mentioned the HIV screening with.
In reality, did we, as the healthcare team, really look at this situation ethically? I don't recall discussing any of the contextual features with her, but we did discuss quality of life issues. Looking back, there were opportunities to communicate more indepth expectations of what this woman's expectations were for the remainder of her life, but we were all so focused on her diagnosis, medications, and treatment, the "art" of living was pushed aside for what the healthcare team viewed as more critical needs. Sometimes, it's easy to forget to look at the big picture when we focus on the microcosm of the world we work in. A lesson considered, indeed!
LDK