Reference no: EM132214987

Discussion: The revelation of HIV includes informing children that they live with a possibly serious and sexually infectious condition (Wiener, Battles, & Heilman, 2000). As such, parents and care providers usually disagree regarding the timing and aptness of disclosing such information to children. The American Psychological Association (APA) advocates that all children have the right to know their health status and that disclosure must be considered at the most appropriate time. Tina's case is typical of several other cases. She is 36 years old and was infected with HIV by her former boyfriend and has a history of intravenous drug use. Furthermore, she gave birth to an HIV-positive daughter who is 12 years old now but she does not want her daughter to know neither of them have HIV. Caregivers and children's children frequently fear that disclosing HIV information to their children could distress them. On the other hand, healthcare providers often support such disclosure, owing to possible medical and mental benefits for the children.

There are many sets of ethical concerns, which arise both in support and against disclosure. These ethical issues need to be deliberated and contemplated. Thus, some of the principles, according to APA, include beneficence, non-malfeasance, respect for people's dignity and rights, justice, as well as integrity. For each one of these principles, there are reasons for both advantages and disadvantages of HIV disclosure. The principle of people's dignity and rights dictates that Tina's daughter has the right to understand her diagnosis. However, ethics suggest that minors have the capacity to give assent but not consent. Consequently, parents may have certain obligations and privileges over their children's welfare. Even though the major reason here entails letting her daughter know what is happening in her life, Tina could be said to have the right as a parent to disclose or refuse to disclose. She has the right to make decisions concerning what is in her daughter's best interest, and has the right not to disclose the information if there is no apparent danger.

Tina's daughter has the right to know diagnosis. The principle of beneficence is particularly applicable in this case, given that such disclosure could enhance the daughter's sense of autonomy, facilitating her capacity to care for herself while empowering her to overcome any form of stigmatization (American Psychological Association, 2002). As such, awareness of Tina's daughter could also help her to have control over certain issues, especially regarding herself. Compared to children who learn about their conditions at later points in life, telling Tina's daughter about her status earlier could help reduce resentment.

Nevertheless, Tina's daughter has to be protected from information that could harm and traumatize her. The principle of non-malfeasance recommends that a child has the right to be protected from painful and cruel information, which might else not be essential (American Psychological Association, 2002). Therefore, according to this principle, the daughter should not be told of her status. In this case, provided that the infection never resulted from the daughter's behavior, the principle of non-malfeasance would suggest that she must be protected from any emotional and social loads of the illness, if possible. In this case, the mother has a right to privacy about her own diagnosis, which may be threatened if her daughter learns of her own condition.

The principle of justice, on the other hand, recognizes that all people deserve fairness and justice in accessing and benefiting from the contributions of psychology and quality in services of psychologists. In this sense, this principle demands that psychologists practice rational judgment and strive to ensure that their latent biases and limitations of expertise never leads or condones wrongdoing. Regarding information disclosure, this principle also suggests that Tina's daughter might have many partners over time, and therefore, could infect them with HIV. Advocating for public health concerns, this principle also recommends that sexual partners have the right to understand risks.

From a moral perspective, children would only need to understand their status when they are sexually active, and that since children must be abstinent nonetheless, there is no point of telling them. As such, if the daughter wants to know more regarding her condition, the staff should remain neutral. Moreover, given the above considerations and Tina's reasons for not informing her daughter about the disease, the staff should not disclose such information at this time. Instead, they need to delay the disclosure, while partnering with Tina in efforts to determine the best time to perform the disclosure process.

References: American Psychological Association. (2002). Ethical principles of psychologists and code of conduct. American psychologist, 57(12), 1060-1073.

Wiener, L. S., Battles, H. B., & Heilman, N. (2000). Public disclosure of a child's HIV infection: impact on children and families. AIDS Patient Care and STDs, 14(9), 485-497.