Health and Social Care Case Study: Ethical Dilemma of HIV Disclosure

This case study presents an ethical dilemma faced by Dr. Gomez, a healthcare professional treating Bob, an HIV-positive patient who refuses to disclose his status to his partner, Sue, who is pregnant. The case explores the conflict between patient confidentiality, the doctor's duty to protect Sue and the unborn child, and Bob's autonomy. The assignment delves into the ethical issues arising from this situation, including the violation of privacy, the balance between beneficence and non-maleficence, and the application of ethical theories such as deontology, utilitarianism, and virtue ethics. It also considers the perspectives of different stakeholders—Bob, Sue, and the unborn child—and examines potential conflicts. The analysis emphasizes the importance of ethical decision-making frameworks, relevant codes of conduct, and the potential consequences of various choices. The assignment further highlights the role of compassion, trust, and the doctor-patient relationship in navigating complex ethical challenges within the context of health and social care.

Running head: HEALTH AND SOCIAL CARE
HEALTH AND SOCIAL CARE
Name of the Student
Name of the University
Author Note

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Case study:
Bob has been to his local trust hospital in the Genito urinary clinic, where he has been
notified by Dr Gomez that he is HIV positive. Dr Gomez advices him to inform his partners
about his status. In the previous 18 months, Bob has been started the therapy. Bob was with his
present partner Sue, and in the next 2 months they'll have a child. He was even engaged in
relationship with other sexual partners before the current relationship with Sue. Dr Gomez has
made it apparently clear during frequent trips to the clinic that Bob has not told him that he is
HIV. Dr Gomez is conscious of the advent of the child and informs Bob whether sue is HIV-
positive and whether the child is at danger so that therapy can begin if needed.Bob continues
stubbornly to refuse and declares that he will halt his therapy if informed to Sue about his
condition without his permission.
Ethical issues:
The ethical issues in relevance to the above case study cannot be only focused on the
issues faced by the doctor. The victim, Bob, has also faced a dilemma against what step he
should take about his life, whether he should tell that to his partner or keep it within himself.
Although, Bob decided to not share and inform about the same to his partner, Sue and also others
and was too stubborn with his decision. However, the ethical dilemma faced by the doctor gained
prime importance here. In professional field, doctors come across a lot of complicated issues and
dilemmas. First of all, it is the primary responsibility of a doctor to keep everything confined to
the room and not share those patient’s details with others. A doctor cannot compromise with the
confidentiality of the patient and it is also the responsibility of a doctor to provide treatment and
quality care to the patient and ensure the patients are aware of their disease and protect them and

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associated people. The above case study is an illustration of the ethical dilemmas a doctor
usually faces in these cases. There was a continuous conflict between confidentiality and
protecting autonomy of the patient and to consider treatment and protect the patient and his
upcoming child. The patient told the doctor that he will not come for treatment if the doctor
makes his partner, Sue, aware of his condition. Therefore, another issue that was raised was
whether to choose what is right or ethical and moral or to stick to his business. While practicing,
medical professionals also consider the benefits he gets while practising in terms of money.
Therefore another issue caught our attention was losing a patient that eventually will have an
impact on the doctor’s business.
First of all, the main issue in relevance to the above case study is confidentiality. Doctors
need to protect privacy of the patient by maintaining confidentiality. The patients must be treated
in such a manner that they do not feel hesitate for an open communication with the doctor. The
medical information needed including the background history of the patient for further treatment
must be disclosed creating trust between the doctor and the patient. It is the responsibility of the
doctor to provide a comfortable atmosphere and a bond of trust. Universal Declaration of Human
Rights in Article 12 states that nobody is arbitrarily interfered with his privacy, family, home or
correspondence, nor his honour and reputation attacked. Everybody shall have the right, against
this intervention or attack, to protect the law. Therefore, if Dr Gomez disclosed the fact to Sue,
there would be a breach in the laws violating on the right to privacy. However, Dr. Gomez '
nature is to conduct the injustice done to Sue, his wife and baby that they expecting, according to
his emotion. In addition, this case highlights the issue of disclosure related to confidentiality and
the associated benefit of the individuals involved.

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The situation gives rise to the ethical dilemma faced by the doctor as whether to protect
confidentiality of the patient or to support the morality and judge the situation upon emotions,
values and ethics he has developed. If the doctor performed in favour
Dr. Gomez should not only do it for his patient Bob, but also deliberate about the benefit
of Sue and the child they expect. Dr Gomez must look at the implications of disclosing sensitive
data that could lead to changing patients ' actions. If ethical issues are considered to have gained
priority, that would not have removed the emotional and moral reasoning within the doctor.
There was a constant debate going on inside the doctor on the professional ethics versus morality
and ethics within himself. The issue noticed here is violation of laws of autonomy or treating the
patient with respect and dignity. The information that is shared should not be revealed unless the
patient approves. Bob, the victim here cannot be deliberately forced to take an important decision
that would completely change his life.
Different people involved here:
Other victims who will be equally affected in the case are Sue, Bob’s partner along with
the baby who has not been born yet. Sue would view this situation in a different perspective and
treat it as a threatening to her and the baby. On knowing the fact that her partner, Bob is HIV
positive and she knew nothing about it will create a trust issue with her and Bob. This will also
direct her in losing trust on the doctor and she may not continue her treatment from the doctor.
However, moral challenges should be studied using the following: deontology, ethnic virtue and
utilitarianism in the social and healthcare context (Playford, Roberts and Playford, 2014). These
theories help to encourage decision-making when ethical issues arise.

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Outcomes / effects may not only warrant the ways to accomplish them in deontological
strategy. In a utilitarian strategy, results determine for the biggest means and the biggest
advantage anticipated. Deontology is centred on patients, while utilitarianism is centred on the
society (Playford, Roberts and Playford, 2014). Each approach has its own substantial benefits
and inconveniences in medical exercise, even if they contradict each other (Mandal, Ponnambath
and Parija, 2016). Decision is chosen in a utilitarian strategy based on the highest advantage to
the largest number of people. This strategy could damage certain people, but the net result is the
most advantageous strategy. Deontology is a duty ethic when a deed morality depends on the
nature of the action, i.e. damage, and regardless of its effects is inappropriate. A philosopher,
Immanuel Kant launched this notion and thus generally known as Kantian Deontology (Van
Staveren, 2007). Virtue ethics is based on what is morally correct and what a virtuous person
would do. It expects individuals to behave by implementing the decision-making structure
(Baumane-Vitolina, Cals and Sumilo, 2016).
Potential Conflicts:
Every doctor is supposed to maintain the highest moral norms in all medical professions.
The principles of ethics are identical although the difficulties and dilemmas may vary slightly
from other fields of medical research to more complicated ones. Hippocratic principles of first
patient interest sometimes seem to have the need to advance understanding, and this generates
the need for patient-specific ethical values. Three fundamental principles are highlighted in all
global ethical rules of medical science: respect for people, profit for people and contribute to the
wellbeing of individuals, justice for the individual and equity in the allocation of benefits.
Respect for the individual means respect for the autonomy of the individual as to respect his or

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her choice and decision. The ability for autonomy may conflict with what is anticipated to
achieve the ethical benefit of beneficence (Manjulika Vaz, 2019).
For the selected ethical challenge, virtue ethics is the greatest scholarly context. The
doctor must conduct a patient's emotional reaction and the objective of the decision should be
considered again, even though Dr. Gomez might feel that the person in question is disappointed
by the fact that he is not following Sue and the baby's care and frustration, it is normal that
people are sensitive in reacting. Many believe that the ethical dilemma can be resolved, as it
becomes more problematic as it is present according to individual beliefs, ways they are raised
up and morality. Utilitarian advocates fundamentally for a remedy that seems easy. This suggests
that the reaction of moral difficulties can influence the way one has build the foundation on age,
sex, religion and sexuality.

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Conclusion:
The decision-making process should not be focused on individual morals when there is
an ethical dilemma at risk; however, standard of behaviour and ethics should be implemented
depending on the base line of the job. Virtue may be implemented in a manner that shows
compassion for the efficient consideration of the well-being of others by their inspiring
encouragement and openness. Dr. Gomez will consider how his patient acts and how brave he
can be to disclose his wellness condition. Compassion, however, cannot be favoured to an
individual in this situation who, in the next two months, has to do with Sue and the kid, who is at
danger and who requires therapy. However, the basic work between a person and a physician
connection should be trustworthy in such a manner that facilities are susceptible; a patient can
provide data and issues of his / her own. Bob have already revealed certain data in this situation,
such as his previous social relationships, his present connection, and the children they expect.
Bob still relies on his doctor even in this challenging circumstance, even if the choice of the
patient is hard to modify, exposing his sexual health without influencing his trust-based
connection with Sue. In accordance with paragraph 5(GMC) of the General Medical Council,
good medical practice (2013) says that physicians should bring into consideration patient’s
opinions, provide an accurate response and respond to patient’s questions. Thus in the case, the
doctor ought to believe the kid they expects to be in danger, considering that both Sue and the
baby may be affected which implies that it will be necessary to disclose Bob's wellness position.

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References:
Baumane-Vitolina, I., Cals, I. and Sumilo, E., 2016. Is Ethics Rational? Teleological,
Deontological and Virtue Ethics Theories Reconciled in the Context of Traditional Economic
Decision Making. Procedia Economics and Finance, 39, pp.108-114.
Furler, J. and Palmer, V. (2010). The ethics of everyday practice in primary medical care:
responding to social health inequities. Philosophy, Ethics, and Humanities in Medicine, 5(1), p.6.
Hayry, M., 2013. Liberal utilitarianism and applied ethics. Routledge.
Herring, J., 2014. Medical law and ethics. Oxford University Press, USA.
Mandal, J., Ponnambath, D. and Parija, S. (2016). Utilitarian and deontological ethics in
medicine. Tropical Parasitology, 6(1), p.5.
Mandal, J., Ponnambath, D. and Parija, S. (2016). Utilitarian and deontological ethics in
medicine. Tropical Parasitology, 6(1), p.5.
Manjulika Vaz, K. (2019). Ethical challenges & dilemmas for medical health professionals
doing psychiatric research. [online] PubMed Central (PMC). Available at:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4001329/ [Accessed 6 Jul. 2019].
Playford, R., Roberts, T. and Playford, E. (2014). Deontological and utilitarian ethics: a brief
introduction in the context of disorders of consciousness. Disability and Rehabilitation, 37(21),
pp.2006-2011.
Van Staveren, I. (2007). Beyond Utilitarianism and Deontology: Ethics in Economics. Review of
Political Economy, 19(1), pp.21-35.

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General Medical Council (2017) Moral Medical Practice 2013.avaiable at
https://www.gmc-uk.org/guidance/ (accessed: December 16, 2017)