Can "presumed consent" justify the duty to treat infectious diseases? An analysis
Identifieur interne : 003153 ( Main/Exploration ); précédent : 003152; suivant : 003154Can "presumed consent" justify the duty to treat infectious diseases? An analysis
Auteurs : Murat Civaner [Turquie] ; Berna Arda [Turquie]Source :
- BMC Infectious Diseases [ 1471-2334 ] ; 2008.
Abstract
AIDS, SARS, and the recent epidemics of the avian-flu have all served to remind us the debate over the limits of the moral duty to care. It is important to first consider the question of whether or not the "duty to treat" might be subject to contextual constraints. The purpose of this study was to investigate the opinions and beliefs held by both physicians and dentists regarding the occupational risks of infectious diseases, and to analyze the argument that the notion of "presumed consent" on the part of professionals may be grounds for supporting the duty to treat.
For this cross-sectional survey, the study population was selected from among physicians and dentists in Ankara. All of the 373 participants were given a self-administered questionnaire.
In total, 79.6% of the participants said that they either had some degree of knowledge about the risks when they chose their profession or that they learned of the risks later during their education and training. Of the participants, 5.2% said that they would not have chosen this profession if they had been informed of the risks. It was found that 57% of the participants believed that there is a standard level of risk, and 52% of the participants stated that certain diseases would exceed the level of acceptable risk unless specific protective measures were implemented.
If we use the presumed consent argument to establish the duty of the HCW to provide care, we are confronted with problems ranging over the difficulty of choosing a profession autonomously, the constant level of uncertainty present in the medical profession, the near-impossibility of being able to evaluate retrospectively whether every individual was informed, and the seemingly inescapable problem that this practice would legitimize, and perhaps even foster, discrimination against patients with certain diseases. Our findings suggest that another problem can be added to the list: one-fifth of the participants in this study either lacked adequate knowledge of the occupational risks when they chose the medical profession or were not sufficiently informed of these risks during their faculty education and training. Furthermore, in terms of the moral duty to provide care, it seems that most HCWs are more concerned about the availability of protective measures than about whether they had been informed of a particular risk beforehand. For all these reasons, the presumed consent argument is not persuasive enough, and cannot be used to justify the duty to provide care. It is therefore more useful to emphasize justifications other than presumed consent when defining the duty of HCWs to provide care, such as the social contract between society and the medical profession and the fact that HCWs have a greater ability to provide medical aid.
The online version of this article (doi:10.1186/1471-2334-8-29) contains supplementary material, which is available to authorized users.
Url:
DOI: 10.1186/1471-2334-8-29
PubMed: 18325112
PubMed Central: 2311313
Affiliations:
Links toward previous steps (curation, corpus...)
- to stream Pmc, to step Corpus: 000296
- to stream Pmc, to step Curation: 000296
- to stream Pmc, to step Checkpoint: 000E43
- to stream Ncbi, to step Merge: 001B96
- to stream Ncbi, to step Curation: 001B96
- to stream Ncbi, to step Checkpoint: 001B96
- to stream Main, to step Merge: 003248
- to stream Main, to step Curation: 003153
Le document en format XML
<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Can "presumed consent" justify the duty to treat infectious diseases? An analysis</title><author><name sortKey="Civaner, Murat" sort="Civaner, Murat" uniqKey="Civaner M" first="Murat" last="Civaner">Murat Civaner</name><affiliation wicri:level="1"><nlm:aff id="Aff1"><institution-wrap><institution-id institution-id-type="GRID">grid.34538.39</institution-id><institution-id institution-id-type="ISNI">0000000121824517</institution-id><institution>Department of Medical Ethics,</institution><institution>Uludag University School of Medicine,</institution></institution-wrap>Bursa, Turkey</nlm:aff><country xml:lang="fr">Turquie</country><wicri:regionArea>Bursa</wicri:regionArea></affiliation></author><author><name sortKey="Arda, Berna" sort="Arda, Berna" uniqKey="Arda B" first="Berna" last="Arda">Berna Arda</name><affiliation wicri:level="1"><nlm:aff id="Aff2"><institution-wrap><institution-id institution-id-type="GRID">grid.7256.6</institution-id><institution-id institution-id-type="ISNI">0000000109409118</institution-id><institution>Department of Medical Ethics,</institution><institution>Ankara University School of Medicine,</institution></institution-wrap>Ankara, Turkey</nlm:aff><country xml:lang="fr">Turquie</country><wicri:regionArea>Ankara</wicri:regionArea></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">18325112</idno><idno type="pmc">2311313</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2311313</idno><idno type="RBID">PMC:2311313</idno><idno type="doi">10.1186/1471-2334-8-29</idno><date when="2008">2008</date><idno type="wicri:Area/Pmc/Corpus">000296</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000296</idno><idno type="wicri:Area/Pmc/Curation">000296</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">000296</idno><idno type="wicri:Area/Pmc/Checkpoint">000E43</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Checkpoint">000E43</idno><idno type="wicri:Area/Ncbi/Merge">001B96</idno><idno type="wicri:Area/Ncbi/Curation">001B96</idno><idno type="wicri:Area/Ncbi/Checkpoint">001B96</idno><idno type="wicri:Area/Main/Merge">003248</idno><idno type="wicri:Area/Main/Curation">003153</idno><idno type="wicri:Area/Main/Exploration">003153</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Can "presumed consent" justify the duty to treat infectious diseases? An analysis</title><author><name sortKey="Civaner, Murat" sort="Civaner, Murat" uniqKey="Civaner M" first="Murat" last="Civaner">Murat Civaner</name><affiliation wicri:level="1"><nlm:aff id="Aff1"><institution-wrap><institution-id institution-id-type="GRID">grid.34538.39</institution-id><institution-id institution-id-type="ISNI">0000000121824517</institution-id><institution>Department of Medical Ethics,</institution><institution>Uludag University School of Medicine,</institution></institution-wrap>Bursa, Turkey</nlm:aff><country xml:lang="fr">Turquie</country><wicri:regionArea>Bursa</wicri:regionArea></affiliation></author><author><name sortKey="Arda, Berna" sort="Arda, Berna" uniqKey="Arda B" first="Berna" last="Arda">Berna Arda</name><affiliation wicri:level="1"><nlm:aff id="Aff2"><institution-wrap><institution-id institution-id-type="GRID">grid.7256.6</institution-id><institution-id institution-id-type="ISNI">0000000109409118</institution-id><institution>Department of Medical Ethics,</institution><institution>Ankara University School of Medicine,</institution></institution-wrap>Ankara, Turkey</nlm:aff><country xml:lang="fr">Turquie</country><wicri:regionArea>Ankara</wicri:regionArea></affiliation></author></analytic><series><title level="j">BMC Infectious Diseases</title><idno type="eISSN">1471-2334</idno><imprint><date when="2008">2008</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Background</title><p>AIDS, SARS, and the recent epidemics of the avian-flu have all served to remind us the debate over the limits of the moral duty to care. It is important to first consider the question of whether or not the "duty to treat" might be subject to contextual constraints. The purpose of this study was to investigate the opinions and beliefs held by both physicians and dentists regarding the occupational risks of infectious diseases, and to analyze the argument that the notion of "presumed consent" on the part of professionals may be grounds for supporting the duty to treat.</p></sec><sec><title>Methods</title><p>For this cross-sectional survey, the study population was selected from among physicians and dentists in Ankara. All of the 373 participants were given a self-administered questionnaire.</p></sec><sec><title>Results</title><p>In total, 79.6% of the participants said that they either had some degree of knowledge about the risks when they chose their profession or that they learned of the risks later during their education and training. Of the participants, 5.2% said that they would not have chosen this profession if they had been informed of the risks. It was found that 57% of the participants believed that there is a standard level of risk, and 52% of the participants stated that certain diseases would exceed the level of acceptable risk unless specific protective measures were implemented.</p></sec><sec><title>Conclusion</title><p>If we use the presumed consent argument to establish the duty of the HCW to provide care, we are confronted with problems ranging over the difficulty of choosing a profession autonomously, the constant level of uncertainty present in the medical profession, the near-impossibility of being able to evaluate retrospectively whether every individual was informed, and the seemingly inescapable problem that this practice would legitimize, and perhaps even foster, discrimination against patients with certain diseases. Our findings suggest that another problem can be added to the list: one-fifth of the participants in this study either lacked adequate knowledge of the occupational risks when they chose the medical profession or were not sufficiently informed of these risks during their faculty education and training. Furthermore, in terms of the moral duty to provide care, it seems that most HCWs are more concerned about the availability of protective measures than about whether they had been informed of a particular risk beforehand. For all these reasons, the presumed consent argument is not persuasive enough, and cannot be used to justify the duty to provide care. It is therefore more useful to emphasize justifications other than presumed consent when defining the duty of HCWs to provide care, such as the social contract between society and the medical profession and the fact that HCWs have a greater ability to provide medical aid.</p></sec><sec><title>Electronic supplementary material</title><p>The online version of this article (doi:10.1186/1471-2334-8-29) contains supplementary material, which is available to authorized users.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Moloughney, Bw" uniqKey="Moloughney B">BW Moloughney</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Kaimenyi, Jt" uniqKey="Kaimenyi J">JT Kaimenyi</name></author><author><name sortKey="Ndung U, Fl" uniqKey="Ndung U F">FL Ndung'u</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Quach, L" uniqKey="Quach L">L Quach</name></author><author><name sortKey="Mayer, K" uniqKey="Mayer K">K Mayer</name></author><author><name sortKey="Mcgarvey, St" uniqKey="Mcgarvey S">ST McGarvey</name></author><author><name sortKey="Lurie, Mn" uniqKey="Lurie M">MN Lurie</name></author><author><name sortKey="Do, P" uniqKey="Do P">P Do</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Khandwalla, He" uniqKey="Khandwalla H">HE Khandwalla</name></author><author><name sortKey="Luby, S" uniqKey="Luby S">S Luby</name></author><author><name sortKey="Rahman, S" uniqKey="Rahman S">S Rahman</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Fido, A" uniqKey="Fido A">A Fido</name></author><author><name sortKey="Al Kazemi, R" uniqKey="Al Kazemi R">R Al Kazemi</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Crossley, Ml" uniqKey="Crossley M">ML Crossley</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Kitaura, H" uniqKey="Kitaura H">H Kitaura</name></author><author><name sortKey="Adachi, N" uniqKey="Adachi N">N Adachi</name></author><author><name sortKey="Kobayashi, K" uniqKey="Kobayashi K">K Kobayashi</name></author><author><name sortKey="Yamada, T" uniqKey="Yamada T">T Yamada</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Chan, R" uniqKey="Chan R">R Chan</name></author><author><name sortKey="Khoo, L" uniqKey="Khoo L">L Khoo</name></author><author><name sortKey="Goh, Cl" uniqKey="Goh C">CL Goh</name></author><author><name sortKey="Lam, Ms" uniqKey="Lam M">MS Lam</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Mccartan, Be" uniqKey="Mccartan B">BE McCartan</name></author><author><name sortKey="Samaranayake, Lp" uniqKey="Samaranayake L">LP Samaranayake</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Reis, C" uniqKey="Reis C">C Reis</name></author><author><name sortKey="Heisler, M" uniqKey="Heisler M">M Heisler</name></author><author><name sortKey="Amowitz, Ll" uniqKey="Amowitz L">LL Amowitz</name></author><author><name sortKey="Moreland, Rs" uniqKey="Moreland R">RS Moreland</name></author><author><name sortKey="Mafeni, Jo" uniqKey="Mafeni J">JO Mafeni</name></author><author><name sortKey="Anyamele, C" uniqKey="Anyamele C">C Anyamele</name></author><author><name sortKey="Iacopino, V" uniqKey="Iacopino V">V Iacopino</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Tannebaum, J" uniqKey="Tannebaum J">J Tannebaum</name></author><author><name sortKey="Anastasoff, J" uniqKey="Anastasoff J">J Anastasoff</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Daniels, N" uniqKey="Daniels N">N Daniels</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Rea, E" uniqKey="Rea E">E Rea</name></author><author><name sortKey="Upshur, R" uniqKey="Upshur R">R Upshur</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Clark, Cc" uniqKey="Clark C">CC Clark</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Sibbald, B" uniqKey="Sibbald B">B Sibbald</name></author></analytic></biblStruct></listBibl></div1></back></TEI><affiliations><list><country><li>Turquie</li></country></list><tree><country name="Turquie"><noRegion><name sortKey="Civaner, Murat" sort="Civaner, Murat" uniqKey="Civaner M" first="Murat" last="Civaner">Murat Civaner</name></noRegion><name sortKey="Arda, Berna" sort="Arda, Berna" uniqKey="Arda B" first="Berna" last="Arda">Berna Arda</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
EXPLOR_STEP=$WICRI_ROOT/Sante/explor/SrasV1/Data/Main/Exploration
HfdSelect -h $EXPLOR_STEP/biblio.hfd -nk 003153 | SxmlIndent | more
Ou
HfdSelect -h $EXPLOR_AREA/Data/Main/Exploration/biblio.hfd -nk 003153 | SxmlIndent | more
Pour mettre un lien sur cette page dans le réseau Wicri
{{Explor lien
|wiki= Sante
|area= SrasV1
|flux= Main
|étape= Exploration
|type= RBID
|clé= PMC:2311313
|texte= Can "presumed consent" justify the duty to treat infectious diseases? An analysis
}}
Pour générer des pages wiki
HfdIndexSelect -h $EXPLOR_AREA/Data/Main/Exploration/RBID.i -Sk "pubmed:18325112" \
| HfdSelect -Kh $EXPLOR_AREA/Data/Main/Exploration/biblio.hfd \
| NlmPubMed2Wicri -a SrasV1
| This area was generated with Dilib version V0.6.33. |  |