The root problem of rendering care to patients with infective cases is the normative stigma established in the nature of disease and within the society. According to Servellen (1997), during the times of the HIV epidemic, termination of care is considered professionally inappropriate; hence, care provided towards these HIV patients became detrimental to the patient’s health due to the reluctance and exaggerated care measures implemented by these providers (p. 327).
With the advent of modern day infection control, health care providers are now able to render care safely and free from the risks of infection; however, the prevailing stigma of disease still risks the judgment and competency of the provider to participate in the health care delivery. Nonetheless, according to Levenson (2007), health care providers must be the first to resolve the issue of disease stigma by understanding and acquiring appropriate understanding in the nature of the patient’s infectious disease (p. 221).
If established contract of care becomes compromised during the process of health care delivery, termination is considered as an alternative unless negotiations and resetting of contracts are made possible. In the ethical study of Zollo, Mary and Derse (1997), they have explored whether the risk of physical harm brought by the patient’s infectious state (HIV/AIDS) outweighs a patient’s right to treatment.
According to the study, the risks experienced by the provider in handling patients with infectious diseases are justified dangerous on the basis of institution’s failure to comply in Infection Control Guidelines (e. g. Occupational Safety and Health Act of 1970, CDC’s Infection and Prevention Control Guidelines, etc) imposed by the disease control agencies, such as Centers for Disease Control and Prevention (CDCP) and Occupational Safety and Health Administration (OSHA).
Under these circumstances, patient-provider relationship is terminated with proper recommendation and endorsement from the institution and consent from the patient. However, staffs employed by institutions with proper protective suits and apparatus to aid their staffs in providing care for infectious patients are expected to perform proper care measures in adherence to the both duty of care and patient’s right to treatment (Bosek and Savage, 2007 p. 229).
According to the study of Marelich and Murphy (2003), patients with infective conditions, such as HIV/AIDS infection require the utmost sincerity and emotional considerations from their provider. Hence, terminating patient-provider relationship or reluctance of care may eventually result in the development of patient’s negative feelings towards care process.
However, if the patient is determined to refuse adherence or participation due to the provider’s reluctance to care or compromised competencies, the established patient-provider relationship is placed under candidate termination.
According to Servellen (1997), providers participating in a patient-provider relationship may request the termination of partnership care if the following conditions are satisfied, proven and acknowledged by the patient: (1) the medical or nursing procedure carries physical risks to either the provider or the patient (e. g. risks of infection due to contagious disease granted physical apparatus for preventions are not present, etc. ), (2) rendered care violates patient’s rights to autonomy and self-determinations, and (3) religious or moral issues followed by either of the two parties (p. 335). As explained by Carter, Levetown and Foley 2004), the provider must render continuous care despite the patient’s incompliant behavior as long as endorsement with reliever of care has not yet occurred (p. 120).