(2) The Army provides care to beneficiaries for HIV-positive related
problems and for AIDS. According to the Walter Reed Army institute of Research, data
gathered between November 1988 and October 1989 indicate that 220 soldiers will
become infected with the HIV each year, and that medical costs for each HIV-positive
soldier will be at least 0,000.34
(3) While HIV-positive patients cannot be refused treatment because
military doctors, surgeons, and nurses do not choose their patients; as with any
patients, there still can be subtle attitudinal differences that affect bedside manner.
Ultimately, these could constitute a subtle, yet not unimportant form of discrimination,
contrary to the spirit of the professional code of ethics. In extreme cases, it could
constitute a breach of duty to act in the best interests of a patient and to treat all
patients with the same measure of respect.
h. Living Up to an Ethical Ideal. The examples cited show that the ethical
standard (an ideal) may prescribe a certain behavior, e.g., to treat all patients uniformly,
while the reality may fall short in some cases. Why? It is because we are sometimes
faced with tough choices, or even ethical dilemmas. Then, too, we are human beings,
first; health care professionals, second. Our personal standards may conflict with our
professional (ethical) standards.
i. Sources of Morality Often in Conflict With Each other. Our health care
decisions and reactions are colored by our personal values, beliefs, and attitudes.
These are, in turn, affected by the family and culture into which we have been born.
The sources for morality are numerous (see other column) and more often than not,
these sources are in disagreement with each other, generating conflicting opinions of
what is right and wrong. Ethics provides standards to help us sort out this confusion.
SOME SOURCES FOR MORALITY
Personal experience.
Tradition.
Family experience.
Community.
Education.
Racial group.
Ethnic group.
Age group.
Geographic region.
Religion.
National identity.
National history.
National law.
Figure 1-2. Sources for morality
MD0066
1-11