DECISION-MAKING PROCESSES, ETHICAL DILEMMAS AND MODELS OF CARE IN HIVAIDS 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 area s causing the greatest conflict and concern were those surrounding the management of dying patients. A category identified in the data was t he 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 bi omedical model of health care delivery. In contrast, staff in the othe r 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 te am approach to decision-making, is recommended.