Managing the public health risk of a 'sex worker' with hepatitis B infection: legal and ethical considerations
David Bourget (Western Ontario)
David Chalmers (ANU, NYU)
Rafael De Clercq
Jack Alan Reynolds
Learn more about PhilPapers
Journal of Medical Ethics 37 (10):623-626 (2011)
This paper examines the ethical issues faced by health workers managing a fictional case of a female sex worker who is hepatitis B positive with a high level of virus but is asymptomatic. According to guidelines she does not require treatment herself, but is potentially highly infectious to others. Recent legal cases in the UK show it can be criminal to pass on HIV or hepatitis B infection sexually if the risk is known and the partner has not been informed. However, there is no statute or case law showing that health workers are required to intervene to prevent such a potential ‘crime’, particularly when the partners are unknown, as in this case. The health workers could respond in various ways. They could do nothing, thus making further infection probable. They could advise the sex worker to use condoms and to inform her clients. They could treat the sex worker to reduce her level of infectivity, although there is no benefit to her. They could disclose the sex worker's status, although breaking confidentiality is a serious matter ethically and may be of no benefit to the unknown client group. Regulating prostitution might help; but sex workers with infection may work off licence. This paper discusses the clinical, moral and ethical issues associated with such a scenario and concludes that the most beneficial course is to target clients, through health education, to recognise the potential risks of infection from a sex worker and to take suitable precautions including immunisation against hepatitis B
|Keywords||No keywords specified (fix it)|
|Categories||categorize this paper)|
Setup an account with your affiliations in order to access resources via your University's proxy server
Configure custom proxy (use this if your affiliation does not provide a proxy)
|Through your library|
References found in this work BETA
No references found.
Citations of this work BETA
No citations found.
Similar books and articles
Marisa Reddy Randazzo & Michelle Keeney (2009). Threats Against Public Officials : Considerations for Risk Assessment, Reporting, and Intervention. In James L. Werth, Elizabeth Reynolds Welfel & G. Andrew H. Benjamin (eds.), The Duty to Protect: Ethical, Legal, and Professional Considerations for Mental Health Professionals. American Psychological Association.
David Shaw (2008). Dentistry and the Ethics of Infection. Journal of Medical Ethics 34 (3):184-187.
Barry Rosenfeld, Joanna Fava & Michele Galietta (2009). Working with the Stalking Offender : Considerations for Risk Assessment and Intervention. In James L. Werth, Elizabeth Reynolds Welfel & G. Andrew H. Benjamin (eds.), The Duty to Protect: Ethical, Legal, and Professional Considerations for Mental Health Professionals. American Psychological Association.
Claire Martinet-Edelist (2003). Feedback Circuits in Hepatitis B Virus Infection. Acta Biotheoretica 51 (4).
Yanguang Wang (2000). A Strategy of Clinical Tolerance for the Prevention of Hiv and Aids in China. Journal of Medicine and Philosophy 25 (1):48 – 61.
Matthew K. Wynia (2007). Ethics and Public Health Emergencies: Encouraging Responsibility. American Journal of Bioethics 7 (4):1 – 4.
Debbie Thorne LeClair (1998). Integrity Management: A Guide to Managing Legal and Ethical Issues in the Workplace. University of Tampa Press.
J. Rossi & M. Yudell (2012). The Use of Persuasion in Public Health Communication: An Ethical Critique. Public Health Ethics 5 (2):192-205.
R. Macklin (2010). Intertwining Biomedical Research and Public Health in HIV Microbicide Research. Public Health Ethics 3 (3):199-209.
Benjamin Freedman (1991). Violating Confidentiality to Warn of a Risk of HIV Infection: Ethical Work in Progress. Theoretical Medicine and Bioethics 12 (4).
Matthew K. Wynia (2007). Public Health, Public Trust and Lobbying. American Journal of Bioethics 7 (6):4 – 7.
Juliet Tizzard (2004). Sex Selection, Child Welfare and Risk: A Critique of the HFEA's Recommendations on Sex Selection. Health Care Analysis 12 (1):61-68.
Sean A. Valles (2012). Heterogeneity of Risk Within Racial Groups, a Challenge for Public Health Programs. Preventive Medicine 55 (5):405-408.
M. Millar (2013). 'Zero Tolerance' of Avoidable Infection in the English National Health Service: Avoiding the Redistribution of Burdens. Public Health Ethics 6 (1):50-59.
Joanne Csete & Jonathan Cohen (2010). Health Benefits of Legal Services for Criminalized Populations: The Case of People Who Use Drugs, Sex Workers and Sexual and Gender Minorities. Journal of Law, Medicine and Ethics 38 (4):816-831.
Added to index2011-09-22
Total downloads7 ( #180,536 of 1,096,858 )
Recent downloads (6 months)1 ( #273,368 of 1,096,858 )
How can I increase my downloads?