Physicians AIDS and occupational risk. Historic traditions and ethical obligations

Zuger, Abigail; Miles, Sondra

doi:10.1016/0168-8510(90)90354-g

Cited by 7 publications

(16 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…It is well known that physicians' historic behavior in epidemics has been erratic (Zuger and Miles 1987). However, lack of a consistent tradition does not mean that a coherent history does not exist.…”

Section: Part I: History Of the Duty To Treat In Epidemicsmentioning

confidence: 99%

“…Throughout the plagues of Europe many physicians stayed with their patients (Amundsen 1977), but many others fled cities and avoided treating plague victims (Zuger and Miles 1987;Sharp 1988). Even medical heroes fled; both Galen and Sydenham famously fled plagues in their respective eras, following the prescription then commonly given to patients -cito, longe, tarde: "leave fast, go far, and return slowly" (Jonsen 2000).…”

Section: Part I: History Of the Duty To Treat In Epidemicsmentioning

confidence: 99%

“…If he were to become ill, he wrote, "it would be as much your duty not to desert me in that situation, as it is mine not to desert my patients" (Zuger and Miles 1987). This analogy to marriage -the physician-patient relationship as a contract, with an explicit vow of fidelity -was to become formalized in 1847 with the founding of the American Medical Association around a new Code of Medical Ethics.…”

Section: Part I: History Of the Duty To Treat In Epidemicsmentioning

confidence: 99%

“…However, since the statement on epidemics was now relegated to being a mere interpretive note on a principle, it received very little subsequent attention. Indeed, recent historians have incorrectly asserted that the statement on epidemics disappeared in 1957 (Zuger and Miles 1987;Arras 1988;Sharp 1988;O'Flaherty 1991;Halevy and Brody 1994). In fact, the statement was removed in 1977, when it and several other statements were quietly "withdrawn" from the Code under the explanation that they were "historical anachronisms" (Council on Ethical and Judicial Affairs 1977).…”

Section: Autonomy Antibiotics and A Weakened Duty To Treatmentioning

confidence: 99%

See 3 more Smart Citations

When Pestilence Prevails … Physician Responsibilities in Epidemics

Huber¹,

Wynia²

2004

The American Journal of Bioethics

View full text Add to dashboard Cite

The threat of bioterrorism, the emergence of the SARS epidemic, and a recent focus on professionalism among physicians, present a timely opportunity for a review of, and renewed commitment to, physician obligations to care for patients during epidemics. The professional obligation to care for contagious patients is part of a larger "duty to treat," which historically became accepted when 1) a risk of nosocomial infection was perceived, 2) an organized professional body existed to promote the duty, and 3) the public came to rely on the duty. Physicians' responses to epidemics from the Hippocratic era to the present suggests an evolving acceptance of the professional duty to treat contagious patients, reaching a long-held peak between 1847 and the 1950's. There has been some professional retrenchment against this duty to treat in the last 40 years but, we argue, conditions favoring acceptance of the duty are met today. A renewed embrace of physicians' duty to treat patients during epidemics, despite conditions of personal risk, might strengthen medicine's relationship with society, improve society's capacity to prepare for threats such as bioterrorism and new epidemics, and contribute to the development of a more robust and meaningful medical professionalism.

show abstract

Section: Part I: History Of the Duty To Treat In Epidemicsmentioning

confidence: 99%

Section: Part I: History Of the Duty To Treat In Epidemicsmentioning

confidence: 99%

Section: Part I: History Of the Duty To Treat In Epidemicsmentioning

confidence: 99%

Section: Autonomy Antibiotics and A Weakened Duty To Treatmentioning

confidence: 99%

See 2 more Smart Citations

When Pestilence Prevails … Physician Responsibilities in Epidemics

Huber¹,

Wynia²

2004

The American Journal of Bioethics

View full text Add to dashboard Cite

show abstract

“…5 The behavior of physicians during the bubonic plague in London from May to December 1665, is well documented. Zuger and Miles recently described this historical record in great detail?…”

mentioning

confidence: 99%

Historical precedent and the obligation to treat aids patients

Imperato¹

1989

J Community Health

View full text Add to dashboard Cite

Fight or Flight: The Ethics of Emergency Physician Disaster Response

Iserson

Heine

Larkin

et al. 2008

Annals of Emergency Medicine

108

View full text Add to dashboard Cite

Most disaster plans depend on using emergency physicians, nurses, emergency department support staff, and out-of-hospital personnel to maintain the health care system's front line during crises that involve personal risk to themselves or their families. Planners automatically assume that emergency health care workers will respond. However, we need to ask: Should they, and will they, work rather than flee? The answer involves basic moral and personal issues. This article identifies and examines the factors that influence health care workers' decisions in these situations. After reviewing physicians' response to past disasters and epidemics, we evaluate how much danger they actually faced. Next, we examine guidelines from medical professional organizations about physicians' duty to provide care despite personal risks, although we acknowledge that individuals will interpret and apply professional expectations and norms according to their own situation and values. The article goes on to articulate moral arguments for a duty to treat during disasters and social crises, as well as moral reasons that may limit or override such a duty. How fear influences behavior is examined, as are the institutional and social measures that can be taken to control fear and to encourage health professionals to provide treatment in crisis situations. Finally, the article emphasizes the importance of effective risk communication in enabling health care professionals and the public to make informed and defensible decisions during disasters. We conclude that the decision to stay or leave will ultimately depend on individuals' risk assessment and their value systems. Preparations for the next pandemic or disaster should include policies that encourage emergency physicians, who are inevitably among those at highest risk, to "stay and fight."

show abstract

Physicians AIDS and occupational risk. Historic traditions and ethical obligations

Cited by 7 publications

References 0 publications

When Pestilence Prevails … Physician Responsibilities in Epidemics

When Pestilence Prevails … Physician Responsibilities in Epidemics

Historical precedent and the obligation to treat aids patients

Fight or Flight: The Ethics of Emergency Physician Disaster Response

Contact Info

Product

Resources

About