傳染病照護的選擇性歧視：醫師及牙醫師的愛滋病專業倫理觀與照護意願

丁志音; 涂醒哲

doi:10.6288/TJPH2004-23-01-05

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P45 - 58

医药卫生 > 预防保健与卫生学
医药卫生 > 社会医学

DOI： 10.6288/TJPH

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传染病照护的选择性歧视：医师及牙医师的爱滋病专业伦理观与照护意愿

Selective Discrimination in the Health Care of Infectious Diseases: Professional Ethics and Willingness to Treat AIDS Patients among Physicians and Dentists

丁志音(Chih-Yin Lew-Ting) ；涂醒哲(Shing-Jer Twu)

台湾公共卫生杂志； 23 卷 1 期 (2004 / 02 / 01) ， P45 - 58

繁体中文 DOI： 10.6288/TJPH2004-23-01-05

爱滋病；专业伦理；照护意愿；选择性歧视； AIDS ； professional ethics ； willingness to treat ； selective discrimination

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摘要 │ 参考文献 (42) │ 被引用文献 (6) │ 国际计量

摘要〈TOP〉

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Objective: In the era of continuous attack from newly emerging infectious diseases, this paper, by taking AIDS as an example, aims to explore the medical professionals’ responses to the challenges of an epidemic. Particularly emphasized are individuals’ ethical values and willingness to treat people with HIV and AIDS (PWAs) among physicians and dentists. Methods: Structure questionnaires were mailed to practicing physicians and dentists in 1995 and 1996, respectively. The final physician sample consisted of 1482 and dentist sample 1685 respondents after excluding 220 physicians and 94 dentists who reported having experience in treating PWAs. For each professional group, bivariate analysis and logistic regression were used to explore the effects of perceived care-related worry and anxiety and professional attributes on ethical values and willingness to treat. Results: A lack of AIDS clinical knowledge was commonly found among both groups of medical professionals. They showed very negative, un-altruistic reactions to AIDS and PWAs, such as rejecting the value for ethical responsibility and being reluctant to treat PWAs. An obvious tendency of selective discrimination was observed. Only 25.2% physicians and 18.1% dentists were willing to treat all PWAs. The percentages of those unwilling to treat any PWAs were 9.7% and 53.0%, respectively. In between were those who were only willing to treat the uninformed (27.7% vs. 14.5%), and who were still willing to treat some of the high risk individuals (37.5% vs. 11.6%). Among the high risk groups, the most unaccepted category was IV drug users. The extremely negative reactions mainly came from the fear of infection and psychological discomfort towards PWAs. Sense of professional belongingness, AIDS knowledge and type of practice, all characterizing professional attributes, played relatively less significant roles. Conclusion: In the face of uncertainty inherent in the emergence of new infectious diseases, the medical professionals’ worry and anxiety might go beyond scientific reasoning and professional values, and their responses may be against the expectations of the society. With the increasing threat posed by infectious diseases, medical education should urgently pay greater attention to the prevention of occupational risks which are inherent in clinical settings. Likewise, the critical roles physicians are expected to play during the time of epidemic are to be emphasized.

参考文献 ( 42 ) 〈TOP〉

(1991).Bredfeldt RC, Dardeau FM, Wesley RM, et al.AIDS: Family physicians` attitudes and experiences,32,71-5.
(1992).Shapiro MF, Hayward RA, Guillemot D, Jayle D.Residents experiences in, and attitudes toward, the care of persons with AIDS in Canada, France, and the United States,268,510-5.
(1987).Hendee WR, Rapoza NP, Rindidi RC, ci al.The American Medical Association`s program on Human Immunodeficiency Syndrome,258,1519-20.
(1991).Gerbert B, Maguire BT, Bleecker T, ci al.Primary care physicians and AIDS,266,2837-42.
(1996).Brachman P Jr, Kozarsky P. Cetron M, et al.Knowledge and attitudes of hospital-based physicians and trainees about HIV infection in the United States, Cancada, India, and Thailand,156,761-6.

被引用文献 ( 6 ) 〈TOP〉

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