Browsing by Author "Mkosi, Barbara Nomsa"

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    Confidentiality as value in the management of HIV/AIDS in South Africa
    (Stellenbosch : Stellenbosch University, 2000-12) Mkosi, Barbara Nomsa; Van Niekerk, Anton A.; Stellenbosch University. Faculty of Arts and Social Sciences. Dept. of Philosophy.
    ENGLISH ABSTRACT: AIDS is the most important threat to world health. Recent years have seen a dramatic spread of HIVand AIDS in South Africa. Health education directed at modifying risk behaviour appears to be the only way in which the disease can be contained. Controlling AIDS is not only by controlling the virus, but also involves tackling social, economic and political issues and putting AIDS into the broader context of sexuality and gender roles. This requires a broader understanding of this aspect of HIV-AIDS ranging from population dynamics, through to research on individual behaviour and its socio-economic impact; so that we can dispel the myths and rumours that surround AIDS and answer searching questions that will be asked by the community. In South Africa, HIV-AIDS remains a stigmatized disease. There have been calls from courageous and influential people for those who are living with HIV-AIDS to be open about their status and to destigmatise the disease. Institutions too have been drawn into the controversy about whether to remain silent or speak out. Southern African Anglican bishops, as well as some politicians declared their intention to undergo testing for HIV status in order to sensitise the public to the seriousness of the epidemic. Were AIDS not regarded as intolerable, the entire issue of confidentiality would fall away. Calls to destigmatise the disease through openness cannot stand alone. Government must put effective treatment programmes in place. In the absence of treatment, AIDS may represent only frustration and hopelessness to those who test positive; and fear, danger and resultant animosity to those who are HIV negative. The text is in four chapters. Chapter 1 focuses on confidentiality as an important principle in the management of disease. In HIV -AIDS, confidentiality is a more sensitive issue as AIDS is particularly viewed as a social stigma, accompanied by discrimination and harassment. The chapter also addresses HIV infection, transmission, counseling and screemng. Chapter 2 deals with the principles of biomedical ethics namely, autonomy, to enable the patient to determine his/her course of treatment; informed consent, designed to protect the interests of patients from exploitation and harm, and encourage health professionals to act responsibly; beneficence and nonmaleficence, to protect the welfare of others; and justice, to ensure access to health care for all. It also highlights the aspects of and limitations to confidentiality. Chapter 3 discusses broadly the ethical dilemmas pertammg to professional-patient relationships, women and HIV-AIDS, religion, prisoners and employer-employee relationships. When the AIDS epidemic started, very few people suffered from the disease, and the disease was treated with great caution and confidentiality. Today, AIDS is a pandemic and emphasis should shift from the ethic of autonomy and confidentiality, to a social ethic, which emphasizes the responsibility of minimizing the risk of spread of infection. The chapter also examines the role of the Department of Health, the participation of health professional bodies and the legal aspects relating to confidentiality in HIV-AIDS. Chapter 4 attempts to construct an argument to destigmatise HIV-AIDS by arguing the responsibility of the government to make sufficient resources available for the treatment and control of the pandemic. Health professionals are challenged to engage their expertise and skills in the service of the sick with dignity and respect. The community is encouraged to support the drive towards controlling the spread of HIV infection and enable people living with AIDS to disclose their status without fear of harassment.