AIDS and Needles: Public Health- Essay Writing Assignment



Internal Code: MAS657Essay Writing Assignment:Case Study:AIDS and NeedlesBecton Dickinson, one of the largest manufacturers of medical supplies, dominates the US market in disposable syringes and needles. In 2005, a nurse, Maryann Rockwood (a fictional name), used a Becton Dickinson 5cc syringe and needle to draw blood from a patient known to be infected with HIV (Human immunodeficiency virus). Ms. Rockwood worked in a clinic that served AIDS patients, and she drew blood from these patients several times a day. After drawing the blood on this particular day, she transferred the HIV-contaminated blood to a sterile test tube by sticking the needle through the rubberstopper of the test tube, which she was holding with her other hand. She accidentally pricked her finger with the contaminated needle. She is now HIV positive. A few years earlier, in 2000, Becton Dickinson had acquired exclusive rights to a patent for a new syringe that had a moveable protective sleeve around it. The plastic tube around he syringe could slide down to safely cover the needle. The Becton Dickinson 5cc syringe used by Maryann Rockwood in 2005, however, did not yet have such a protective guard built into it. The AIDS epidemic has posed peculiarly acute dilemmas for health workers, including doctors and nurses. Doctors performing surgery on AIDS patients can easily prick their fingers with a scalpel, needle, sharp instrument, or even bone fragment and can become infected with the virus. The greatest risk is to nurses, who, after routinely removing an intravenous system, drawing blood, or delivering an injection to an AIDS patient, can easily stick themselves with the needle they were using. Needlestick injuries occur frequently in large hospitals and account for about 80 percent of reported occupational exposures to HIV among health care workers. It was conservatively estimated in 2005 that about 64 health care workers were then being infected with HIV each year as a result of needlestick injuries. Although the fear of HIV had heightened concerns over needlestick injuries, HIV was not the only risk posed by needlestick injuries. Hepatitis B can also be contracted through an accidental needlestick. In 2000, the Centre for Disease Control (CDC) estimated, on the basis of hospital reports, that each year at least 12,000 health care workers are exposed to blood contaminated with the Hepatitis B virus, and of these 250 die as a consequence. Due to underreporting, however, the actual numbers may be higher. In addition to Hepatitis B, needlestick injuries can also transmit numerous other viral, bacterial, fungal,and parasitic infections, as well as toxic drugs or other agents that are delivered through a syringe and needle. The total statistics on needlestick injuries in 2005 are disturbing, although the exact incidence of contamination is unclear. It was estimated that each year, in the United States alone, between 800,000 and 1 million needlestick injuries occurred in hospitals – of these, between 60,000 and 300,000 resulted in Hepatitis B infection. By on estimate, the risk of contracting HIV from a known contaminated needle could be as high as 1 in 1000, and the risk of contracting Hepatitis B, a serious and often life-threateningcondition, could be as high as 1 in 6. These estimates would imply that as many as 600 to 1000 health care workers were at risk of contracting HIV and as many as 100,000 were at risk of contracting Hepatitis B. Several agencies stepped in to set guidelines for nurses, including the American NursingAssociation, the CDC, the Environmental Protection Agency (EPA), and the Food and Drug Administration (FAD), who all developed such guidelines. The most comprehensive guidelines were issued by the Occupational Safety and Health Administration (OSHA), who on December 6, 2001, required hospitals and other employers of health workers to (a) make sharps containers (safe needle containers) accessible to workers, (b) prohibit the practice of recapping needles by holding the cap in one hand and inserting the needle with the other, and (c) provide information and training on needlestick prevention to employees.Question:1. Describe the facts you feel underpinned the ethical dilemma in the case.2. Who was the decision-maker in the selected case, and what conflicting demands did they have to accommodate?3. What was the initial ethical dilemma faced by the decision-maker in this case?4. Using the Utilitarian, Kantian, Rights, and Distributive Justice approaches to ethical decision-making, provide an analysis of the ethical dilemma.5. Present and justify the final recommendation you would have made to the decision-maker in this case had they asked you for advice on how to resolve their initial ethical dilemma.


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