contaminated with blood from a patient infected with the human immuniodiciency virus
(HIV). She had been direct by her supervising physician, Dr. Joyce Fogel, to gather up
some medical debris containing the needle. She settled her lawsuit against New York
City hospitals for
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.35 million.12 Said Prego, "This case is about safety for health care
workers in the workplace or lack of it as in my case. It's very important to draw the
attention of hospitals, so they realize there's a problem here they need to address."13
This was the first lawsuit in the country in which a health care worker who contacted
AIDS on the job sued a hospital for negligence and was awarded damages.
(b) This case and its outcome point up the ethical responsibility of the
hospital to institute practical measures to ensure the safety of its health care workers.
Can hospitals come up with workable safety measures? (In fact, it is not the hospital's
problem alone. More research on materials and methods to protect caregivers is
required. Also, doctors need to play an active role in establishing and reviewing safety
and efficiency policies.) The ethical responsibility to provide a safe working
environment may seem off the topic, but in fact, it shows how two ethical requirements
can be at loggerheads. Does the health care provider have the right to refuse care if all
the work environment safety issues have not been resolved? The answer to this ethical
dilemma is murky, at best.
d. The Patient's Risk of Contracting Acquired Immunodeficiency
Syndrome From Health Care Providers. The state of New Jersey is recommending
mandatory testing of all health care providers on the heels of the 1990 Florida case in
which a dentist with AIDS infected three of his patients. Dale Massey, a social worker
at the University of Pennsylvania, who is involved in handling AIDS cases, had a
personal experience involving a doctor with AIDS. When she scheduled a routine
checkup with Dr. Waxman, her personal physician of several years, she was told he
was very ill and that another physician would see her. Having professional familiarity
with such cases, she deduced that Dr. Waxman must have AIDS. When Dr. Waxman
died 6 months later, his illness figured prominently in his obituary. Friends and
colleagues knew about his condition, but his patients at the George Washington
University Medical Center were never told. Dr. Waxman stopped seeing patients 9
months before he died, but prior to that, he was still involved in patient care and
surgery. As a patient, Massey felt misgivings about Dr. Waxman's participation in
procedures such as deliveries in which a lot of blood is involved. She contends that the
hospital was irresponsible in not telling patients.14
(1) Dr. Gail Povar, Head of the Ethics Committee at George Washington
University Medical Center, maintains that the hospital behaved ethically and responsibly
in withholding this information from patients. "The risk of death in a medical encounter
is far less than the risk of death on the highway."15
(2) Informing a patient would make the risks appear greater than they really
are. Of the 160,000 AIDS cases reported, the case of the Florida dentist is the only one
in which a health care provider infected a patient with the AIDS virus. "If the Patient
should be told of the AIDS risk, should the patient, also be told of greater risks that exist
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