Professional code of conduct and ethical principles are impotent for all the health and social care professionals in order to treat the patients with quality care and support and improve their health condition successfully (Schmidt, MacWilliams and Neal-Boylan, 2017). It is necessary for the health care professionals to maintain the code of conduct and ethical rules and guidelines to encourage ethical behaviour and get proper consent from the patients for further treatment. The study helps to explore the ethical dilemma by discussing the case study of Bob, where it is possible to identify the factors that raise the ethical dilemmas in this context. After analysing the ethical dilemma, the study provides a scope to evaluate the professional code of conduct and ethical principles through which the health and social care providers can treat the patients and maximise the patient care successfully.
Case study analysis
At the Local trust hospital, Bob has attended to the genitor-urinary clinic for check up. He is under Dr. Gomez, who informs him that he is HIV positive. Dr. Gomez has developed conversation with Bob and Gomez has suggested to Bob to contact his sexual partner in order to inform them his status. Bob already start the course of treatment and for the last eighteen months, he is in a relationship with Sue. They are expecting a baby in two months time, but before this relationship, Bob had sexual partners. It becomes clear to Dr. Gomez that Bob refused to inform is partner Sue about his HIV positive status. In this serious situation, Dr. Gomez is concerned about the impending arrival of the baby and he told Bob that proper steps need to be taken to assess whether Sue is also HIV positive or not and whether the baby is at risk so that he can start necessary treatment for safeguarding Sue and her child from risk. However, Bob adamantly refused to tell Sue and said that if Sue is informed without proper consent of him, he will stop the course of treatment. This is a serious situation, where the doctor faces ethical dilemmas and it needs necessary actions and intervention so that Dr. Gomez can treat Bob and convince him to inform his partners, so that Sue and her child will get positive treatment and care from Dr. Gomez.
Ethical dilemma
There are many ethical dilemmas, engaged with this case, where the patient Bob refused to inform his partners Sue, but the doctor is willing to inform his partners so that Sue and her child will get proper treatment and care from the doctor. It is the responsibility of the health and social care professional to take care of the patients and his or her family members and assess proper disease and present condition of the patient so that he doctor and nurses an provide proper treatment and care (Kangasniemi, Pakkanen and Korhonen, 2015). In this regard, the major issue is misunderstanding between Bob ad Dr. Gomez, where DR. Gomez fails to convince Bob about informing the issue of HIV positive to his partners, Sue. It is important or the doctor to inform the issue with Sue, but Bob has problem to share his issue with his partner.
In addition to this, the treatment of HIV positive is another dilemma, where the doctor is not entitled to refuse to treat the patient. However, due to such misunderstanding, Bob has told that he will not attend Dr. Gomez of the doctor inform Sue. It is a serious ethical dilemma between Bob and the doctor, where they face problem to develop proper care plan. Though Bob has received proper treatment of HIV positive, but it is a high concern for the doctor to assess is partner Sue and diagnose positively whether she has HIV positive or not. In addition to this, Sue is expecting a baby within two months, which is another ethical dilemma, where the doctor thinks that it is important to inform her and provide necessary treatment and care so that the baby will be safe.
Confidentiality versus prevention of the spread of infection is another ethical dilemma in this case, where the patient Bob is willing to maintain confidentiality and he is not convinced by the doctor to tell her partner about the issue of HIV positive. However, the doctor is willing to focus on prevention of the spread of the diseases and he aims informing Bob’s partner Sue and convince both of them to attend for proper diagnosis and treatment, so that their life would be safe in near future. Serological screening is another ethical dilemma, without which the doctor cannot identify HIV carriers. In this present case study, Bob refused to inform his partner, but the doctor sticks to his point about screening his partners to predict heather she is also HIV positive or not. And it is urgent as per the view of the doctor to assess Sue as she is pregnant and it needs immediate treatment and care for her so that the baby would be safe. In this condition, pregnancy can be terminated so that the child would not be suffered by the same issue.
Abortion is another dilemma where the doctor is confused about it as he is not confident about the health condition of Sue. In addition to this, disclosure is another dilemma in this case, where decisions whether to disclose the diagnosis or not is the main concern of Bob and the doctor. The doctor is not willing to disclose this information to other family members or friends, but he needs to inform it to Bob’s partner, as she is expecting bay and she needs to know about this so that the infection cannot be spread further. In addition to this, suicidal dilemma is another one, where the doctor needs to convince Bob so that he does not take any suicidal attempt as well as handle the situation properly with proper intervention planning of the doctor. Moreover, it is one of the serious ethical dilemmas, whether the doctor has the legal duty o protect or war the third party engaged with Bob. These are the major ethical dilemma, for which it is difficult for the health care professionals to treat the patient with quality care and efficient services.
Identifying different people involved with the dilemma
There are different people who are engaged with the ethical dilemma in the health and social care context. The major people, engaged with the ethical dilemmas are such as health care professionals, doctors and nurses, patients, family members and front line professional workers (Franco et al., 2015). In the present case study, Bob is the patient having HIV positive and the doctor Gomez. Both are related to this dilemma. Additionally, Sue, Bob’s partner is also engaged with the dilemma and she is expecting a baby within 2 months which raise doctor’s concern about treating the patient properly. Apart from that, the front line professional’s workers are also engaged with the dilemma, where they need to manage the confidentiality and protect the information of the patient in this case.
Identifying potential conflicts
There exist potential conflicts, where the doctors and the patients are arguing with each other. The doctor is willing to inform Bob’s partner in order to ensure that whether she is also HIV positive or not and it is serious concern for the doctor as she is expecting baby within two months. On the other hand, Bob is not willing to inform his partner and he adamantly refused the doctor to inform her and told that of Dr. Gomez inform Sue, the will not come for treatment ad check up. Hereby, there is increasing conflicts among the patient and the doctor, for which it is difficult for the doctor to convince Bob for better future so that his partner and baby would be fine and safe.
Factors influencing in creating the dilemma
There are major factors which are influential to create the dilemmas in the health and social care context, and the factors are such as gender, ethnicity, culture, religion, age, sexuality, disability and other differences (Papadimos et al., 2018). In this present case of Bob, the major factor is sexuality, where Bob is having HIV positive and it is concerning for him to inform his partner about his issue. As per the religion, it is shaming for him to disclose the information in front of his partner and it will raise the dilemmas in this present case. As per the ethnicity and culture, Bob directly refused to not to inform to his partner as it is related to shame, personality, character and emotion of which the dilemmas becomes serious, where the doctor faces difficulties to treat him and his partner efficiently, which is mandatory for the doctors to raise concern and warn him and his partner from the risk of having HIV positive in near future.
Professional code of conduct in arriving moral solutions
It is the responsibility of the health and social care professional to tale active initiative to treat the patients who are suffering from HIV positive and it needs proper planning to resolve the issue so that the patients can live a normal life like others in the social communities. In this regard, Voluntary HIV testing and counselling (VHTC) is necessary intervention of the health care providers, where the doctors and the nurses are taking care of the patients and people can access prevention, treatment, care and support services from the doctors (Costello et al., 2017). Prevention is also necessary for which in this present case the doctor is concerned about Bob and his partner, so that they would live a normal life by mitigating the negative impacts of having HIV positive. In this regard, the prevention method is the combination of the behavioural, biomedical and structural process where the patient also needs to cooperate with the doctor (Reyes-Estrada, Varas-Díaz, and Martínez-Sarson, 2015). As per the above dilemma, the patient is not cooperative with the doctor for which problem arises. The doctor is willing to inform his partner so that it is possible to diagnose his partner as well to predict whether she is HIV positive or not and this is a urgent need as per the view of the doctor as Bob’s partner is expecting a baby. In this regard, both the partners need to consult with the doctor and take positive actions so that they would love a normal life and resolve the problem of having HIV positive (International AIDS society, 2014).
In this context, the professional code of conduct is necessary where the doctor and the patient can cooperate with each other for developing effective care planning. As per the code of conduct, there are knowing the human rights responsibilities, respecting dignity, getting benefits from scientific progress, access to justice, knowing the epidemic and response, meaningful participation, education, monitoring and evaluation and accountability (Elison, Verani, and McCarthy, 2015). These codes of professional conduct are necessary to treat the patient with HIV positive. Human rights responsibility is one of team which is necessary under the law of Human Rights Act 1993. In this practice, the needs and preferences of the patient require to be maximised as well under the treatment session. In this context, Dr. Gomez is also taking care of the patient Bob and he is efficient to provide proper treatment and counselling session to Bob for better health condition. It is the rights of the human being to get proper treatment and access prevention and care in the health care organisation. In getting proper treatment and care, there exists social stigma, discrimination for which the patients are suffering from accessing proper metal care service (Rose et al., 2015). In this case, Dr, Gomez did not discriminate the patient and provide efficient care and treatment to Bob for better health care and prevention of the diseases of HIV positive. In this regard, the non discrimination policies and practice are effective to provide fair treatment and care of the patient where Bob is getting proper care from the doctor for better health care. Inter personal skill of the doctor, sympathy and respecting the patient are also effective in this context to treat the patient and give them proper support to handle the situation and emotional stress. Bob is also suffering from stress and refused to inform his partner though the doctor is concerned in informing his partner Sue, as Sue is pregnant and it is necessary to acknowledge the information whether Sue is also having HIV positive or not. This is the major dilemma between Dr. Gomez and Bob, but it is necessary to resolve the dilemma and provide proper treatment and care to both of them (International AIDS society, 2014).
Respecting dignity is another important professional code of conduct, where the doctor needs to respect the patient having HIV positive. Without any discrimination and misbehaviour, the doctors need to provide proper cooperation and communicate with the patient for better prevention technique (Joe and Foster, 2017). Respecting diversity and showing sympathy to the patient are effective to treat the patient with HIV positive an apart from that, the doctors maintain equity in serving provision requires for the patient by reallocating the organisational resources and enhancing capabilities. In this regard, Equality Act 210 is appropriate to manage the professional code of conduct, where all the patients are treated equally in the heath care organisation (Khan, Liew and Omar, 2017). Dr. Gomez is also efficient in this case to treat the patient Bob and give them proper treatment and quality cares, so that he is able to overcome his problem. Maintaining confidentiality is also necessary and it is also another important professional code of conduct in treating the HIV positive patients. In this regard, the medical information, personal data and HIV status med to be kept safely so that the patients can feel valued and safe to share their information with the doctor. Dr, Gomez is also able to maintain confidentiality and support Bob proficiently to share his information about the past treatment and past life style so that the doctor can develop proper prevention planning for the patient. In this regard, the Data Protecting Act 1998 is also appropriate to manage the safety and security of the data, where the social communities can feel to access the information and services about HIV positive. This is also effective for encouraging the patients to access the treatment and care safely where they are safe under the supervision of the doctors (International AIDS society, 2014).
Additionally, informed consent is necessary in treatment the patient, where proper information is shared with the patient and it is necessary for the doctors to take approval from the patient about the treatment. Informed consent requires full disclosure of the nature and service offered with adequate comprehensive care on the part of the client or the guardian so that the voluntary decision can be made well (Rangel et al., 2017). In this present case, Dr. Gomez fails to get proper consent of the patient Bob to inform his partner which is necessary for the doctor to communicate with Sue, as Sue is expecting a baby. It is urgent for Sued to get proper support and treatment from the doctor in order to give birth of a healthy baby. Hereby, it is difficult for the doctor to take proper consent of Bob in communicating with his partner. It needs proper intervention where professional code of conduct can be maintained by Gomez and also he can interact with Sue, about the problem of HIV positive. It requires proper counselling where Bob and his partner are required to be present during the session, where the doctor can take active part to clear the misunderstanding and inform Sue about the problem. Access to justice and getting benefit of scientific progress are also necessary code of conduct to treat the patient with HIV positive where the doctor needs to ensure that the patient can get proper treatment and quality care and support for better health care. Getting the sufficient quality of medicine, making the treatment accessible, ensuring good quality care and acceptable medication treatment are necessary for the doctor to support the patient and treat them positively (International AIDS society, 2014).
Moreover, developing patient centred care is necessary under the Health and Social care Act 2012, where the doctor needs to communicate and cooperate with the patient for acknowledging their actual health needs and personal preferences, so that it is possible to empower the patient in developing the care plan. Proper empowerment of the patient as well as fulfilling their needs and preferences are effective to develop patient centred care where the patient are also cooperating for getting better treatment and care. In this regard, meaningful participation is another necessary code of conduct under the profession of treating the patients with HIV positive, where responding to the needs and priorities of the people, being more open and respecting the patients, acceptable and credible, sustaining funding and resources, changing the negative attitude of the patient and creating values of the people are important. Hereby, meaningful participation as well as providing proper education to Bob and continuous monitoring and evaluation is necessary for Dr. Gomez, where he can treat Bob and give him proper support to inform his partner so that both of them would get proper treatment and quality care to improve their standard of living.
It can be concluded that, treating the patient with HIV positive is a complex phenomenon where the doctor faces may dilemmas due to misunderstanding and mismatch between the doctor’s perspective and patient’s requirements where in this case Bob refused to inform his partner about the problem, but the doctor is willing to inform his partner as it is necessary to provide her proper treatment and care as she is expecting a baby. Hereby, it is necessary to maintain the professional code of conduct as well as provide proper mental and emotional support and counselling to inform his partner so that they would get better treatment and quality care for enhancing their wellbeing.
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