Legal and ethical duties of a health care provider justify the contract of duty established in a patient-provider relationship. The legal contract can be terminated as long as involved parties possess appropriate grounds for the termination of care. Unlawful establishment of termination of relationship and endorsement of care immediately grant the patient the right to file a suit against the institution and/or provider for tort of abandonment under breach of duty. Moreover, the patient may suffer from psychological and emotional torture due to the termination of care.
b. Problem and its Background Infectious diseases, such as Human Immunodeficiency Virus (HIV) infection, immediately place the patient on a depressive and devastated well-being. During these cases, established patient-provider relationship is considered critical throughout the course of treatment. According to Kelly (1995), both nursing and clinical care provided for HIV and infectious diseased patients must be as comprehensive as possible, providing the appropriate diagnostics, preventive care services and health care promotion (p.
13). Once the patient-provider relationship is established, these health care conditions and responsibilities must be met as part of the ethical conducts and duties of health care delivery. According to Servellen (1997), one of the most controversial concerns of the modern provider-patient relationship is the often misunderstanding of accountability, responsibility and liability of care measures towards the patient (p.
334). Termination of patient-provider relationships is confronted by a question of conflict between the duty of care for the provider and rendering indiscriminate quality care among patients with infectious diseases (Servellen, 1997 p. 334). Under this condition, the health care provider must render curative, preventive and promotional care in response to fulfilling the ethical principle of role fidelity.
Legal considerations of providing care and duty of obligation of the provider towards the patients start when the health care professional enters into a relationship with a patient. However, in cases of infectious diseases, such as patients with Acquired Immunodeficiency Syndrome (AIDS), health care providers are given an option on whether to set a contract and provider care for these patients. By the ethical duty of care, health care providers are mandated to establish a contract and render appropriate care for these patients.
However, by professional conduct, not all providers are capable of handling such patients confidently, which may require termination of patient-provider relationship on the latter part. According to Mason (2004), termination of care can only be considered ethical and appropriate if (1) “the patient has already achieved the maximum benefit of the procedure according to provider’s clinical judgment, or (2) when the patient has already achieved cure from the procedure” (p. 307).
With appropriate legal grounds and basis for termination according to institutional guidelines, the provider may terminate the established contract of care and endorse the patient to another health care provider. According to Scott, Ed and Scott (2005), “termination of the provider-patient relationship is justified when the patient makes a knowing, voluntary election to end the relationship, either unilaterally or jointly with the provider” (p. 162). However, the guideline controversy raises the issue of ethical breach of duty and its implications for patients with infectious diseases.