Psychiatric and Ethical Issues in the Care of Patients With AIDS (Acquired Immune Deficiency Syndrome) (From AIDS and IV Drug Abusers: Current Perspectives, P 123-131, 1988, Robert P Galea, et al, eds. -- See NCJ-112198)

• NCJ Number: 112209
• Author(s): J W Dilley; E E Shelp; S L Batki
• Date Published: 1988
• Length: 9 pages
• Sale Source: University of Wisconsin-Madison
• Language: English
• Country: United States of America
• Note: Reprinted with changes, from 'Psychiatric and Ethical Issues in the Care of Patients with AIDS,' by James W. Dilley, Earl E. Shelp, and Steven L. Batki, Psychosomatics 27:562-66, 1986, by permission of the Academy of Psychosomatic Medicine.

Annotation

This article highlights the clinical management and ethical issues confronting psychiatric consultants when treating AIDS patients.

Abstract

The psychological and social climate surrounding an individual with AIDS incorporates several elements: (1) because the disease is new, uninformed persons can overreact to someone with AIDS, (2) because of the modes of transmission, some persons may blame the victim for the illness, (3) intravenous (IV) drug users and homosexual men are stigmatized on basis of social prejudice, and (4) AIDS is seen as a terminal disease. The quality of life for AIDS patients is severely compromised. Consultants need to be aware of the high incidence of neurologic complications in AIDS patients, since 30 to 40 percent of them develop some dysfunction. Important ethical issues that must be handled by the consultant change in the course of the illness. For a new diagnosis, confidentiality and truthful communication are important. At midstage, assessment of suicidal ideation is problematic. During the terminal phase, the patients' right to make their own treatment decisions should be respected. The dual diagnosis of IV drug use and AIDS compounds problems, where the treatment of drug use is integral to the rest of AIDS treatment. However, motivation may be difficult to develop among drug users with AIDS who may lack the orientation to future possibilities that is important for recovery in chemical dependence. Ethical problems confronting the consultant may include the question of how firm to be in setting behavioral limits for the AIDS patient. 1 exhibit and 19 references.