Document 0521
 DOCN  M9490521
 TI    Ethics in actual surgery. The surgeon and HIV seropositive and AIDS
       patients.
 DT    9411
 AU    Eyskens E; Department of Surgery, University Hospital Antwerp, Edegem,;
       Belgium.
 SO    Acta Chir Belg. 1994 May-Jun;94(3):189-90. Unique Identifier : AIDSLINE
       MED/94346185
 AB    Surgeons feel threatened by the risk of contamination when operating on
       HIV-seropositive or AIDS patients. Observations on the likelihood of
       contamination in literature are most divergent due to variables in
       seropositive prevalence, in frequency of contamination risk and in
       distinction between HIV seropositive and AIDS patients. Except in
       emergency the surgeon may refuse to treat a patient. Screening
       seropositively for selection is hampered by the inconsistency of false
       positives and false negatives depending on the method used and on costs
       appropriate to large scale controls. Exclusion of patients from
       treatment is unethical. Referring them to other colleagues on ground of
       contamination risk is ethically unjustified. Denial of care to a HIV
       infected patient may be justified when the operative risk is considered
       too high and the expected benefit too low because of the precarious
       condition of the patient and his shortened life expectancy. However the
       surgeon and his team need not to expose themselves to even a limited but
       real risk of contamination. Therefore the surgeons have to reconsider
       their surgical strategy and technique in order to keep chances of
       contamination as low as possible. A search for safer working methods for
       all operations and without any discrimination with regard to the patient
       is needed and should be taught to the surgical team.
 DE    Acquired Immunodeficiency Syndrome  Disease Transmission,
       Patient-to-Professional/*PREVENTION &  CONTROL  *Ethics, Medical  Human
       *HIV Seropositivity  Refusal to Treat  Safety  *Surgery  JOURNAL ARTICLE

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