Doctors do not have the right to refuse to treat patients, the Israeli Medical Association's ethics committee said Tuesday, countering arguments in favor of doctors' discretion when receiving HIV patients.
A month ago, some committee members opposed a stipulation that doctors always be required to treat HIV carriers. The committee made Tuesday's policy declaration after a special meeting on the issue.
"The physician is obligated, morally and ethically, to treat every patient who has a medical problem within [the doctor's] area of expertise and professional abilities," the panel said. "Discrimination shall not be practiced among patients, including those motivated by the nature of the illness."
According to Avinoam Reches, who heads the ethics committee, "The manner in which society relates to AIDS patients and HIV carriers sometimes includes deep emotional baggage, along with superstitions, ignorance and alienation. The entire medical community has responsibility to prevent such attitudes from seeping into the medical world and influencing the relationship between doctors and those patients."
Reches added that treating AIDS patients and HIV carriers does not pose an unreasonable risk of infection to doctors who take appropriate precautions.
During the latest committee debate, doctors who treat infectious diseases asked that the statement not single out HIV patients so as not to further stigmatize them. The statement therefore stressed doctors' obligation to treat all patients, without specific reference to AIDS or HIV.
The head of the Israel AIDS Task Force, Dr. Yuval Livnat, welcomed yesterday's declaration and said his organization would continue trying to eradicate the discrimination that stems from insufficient knowledge about the HIV virus.
The IMA's ethics committee is composed of 35 doctors from a range of specialties. An earlier session, in which reservations were expressed on a blanket obligation to treat all patients, was convened due to a complaint by the Israel AIDS Task Force in the case of an HIV carrier who needed surgery on his nose. Three surgeons refused to perform the surgery because he had HIV.
At the earlier committee session, several members supported the doctors' right to refuse to operate on the patient, arguing that despite doctors' oath committing them to treat everyone, doctors are not required to treat AIDS patients if they believe it would endanger their own lives.
At the time, Reches told Haaretz that in "extreme circumstances," doctors could use discretion on whether to assume "tangible risks."
Limitations on doctors' obligations to treat all patients run contrary to the stance of the World Medical Association, which in 2006 ruled that HIV carriers are entitled to equal medical care and physicians are not entitled to refuse treatment.
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