DECISION-MAKING PROCESSES, ETHICAL DILEMMAS AND MODELS OF CARE IN HIV AIDS HEALTH-CARE PROVISION

The data reported here is part of a larger study exploring the impact of HIV/AIDS on health care professionals. In this segment of the study, participants (16 nurses, 5 doctors and 3 social workers), from three hospital AIDS units were interviewed about the difficulties inherent in their work. Analysis of the transcript data indicated that the areas causing the greatest conflict and concern were those surrounding the management of dying patients. A category identified in the data was the disagreement about patient treatment. Non-medical staff in one unit reported stress, frustration and conflicts about the decision-making process with dying patients and expressed their discontent with the biomedical model of health care delivery. In contrast, staff in the other two units, reported satisfaction with the management of patients and relief that patients were not 'pushed' to be treated. Accordingly, a model of care which focuses on the patient's needs and encourages a team approach to decision-making, is recommended.