Justice, compassion needed in treating AIDS patients

Caring for patients with AIDS presents an emotional and ethical challenge for care givers. Not only do AIDS patients have great medical needs but they also must cope with the attitudes of a society that has stigmatized them. Stigma complicates the health care decisions that must be made, since many patients with AIDS may not have a supportive family or friends to assist with care. In these situations the health care facility becomes the patient's home and health care workers become the patient's family. Care givers therefore have a unique opportunity to affirm the dignity and goodness of AIDS patients by assuring them confidentiality and treating them with compassion. When decisions about life-sustaining treatments must be made, the care giver's duty is to respect the patient's choice of treatment. Prolonging a patient's dying should not be considered an option if it is done only as a means of healing the family's grief; if patients cannot trust providers to honor their requests to discontinue treatments that become useless or inhumane, they may hesitate to seek helpful treatment. Although a voluntary approach to caring for patients with AIDS may be preferable, employees' resistance to caring for patients usually can be dispelled through education. If a mandatory approach to care is taken, the standards of participation should apply to all--including physicians, administrators, and managers.