Упрощенная HTML-версия
142
bowel. It might be possible to extract the inflamed part of the bowel
operatively, which would preserve his small chance of survival. His
parents refuse to consent because they do not want Max to suffer from
the operation and they feel that his quality of life will never be suffi-
cient. As the treating physician you think that the operation should be
done, and you wonder how to deal with the parent’s refusal.
HIV infection
Mr. S is married and the father of two school children. He is
treated in your clinic for a rare form of pneumonia that is often associ-
ated with AIDS. His blood test results show that he is indeed HIV-
positive. Mr. S says that he wants to decide himself if and when he
will tell his wife about the infection. You indicate that it could be life-
saving for his wife to protect herself from infection. Besides, it would
be important for her to have an HIV test herself. In case of a positive
test result she would then have the opportunity to take drugs to slow
down the outbreak of the disease and thereby prolong her life. Six
weeks later, Mr. S comes into your clinic for a control investigation.
Answering your question he says that he hasn’t informed his wife yet.
He doesn’t want her to know about his homosexual contacts because
he fears that she would end their relationship and the family would
shatter. But to protect her he has had only “safer sex” with her. As the
treating physician, you wonder whether you should inform Mrs. S of
the HIV status of her husband against his will so that she would have
the opportunity to start treatment if needed.
Treating a prisoner
As part of your medical duties you spend one day every two
weeks seeing inmates in a nearby prison. Yesterday you treated a pris-
oner with multiple abrasions on his face and trunk. When you asked
what caused the injuries, the patient replied that he had been attacked
by prison staff during interrogation when he refused to answer their
questions. Although this is the first such case you have experienced,
you have heard of similar cases from your colleagues. You are con-
vinced that you should do something about the problem but the patient
refuses to authorize you to disclose information about himself for fear
of retaliation from the prison authorities. Furthermore, you are not cer-
tain that the prisoner has told you the truth; the guard who brought