AMA Journal of Ethics theme editor Abraar Karan, MD, and MPH candidate at the Harvard TH Chan School of Public Health, interviewed Agnes Binagwaho, MD, PhD, about practical challenges Rwanda overcame and ethical questions it faced while motivating better health outcomes for its people.
The stigma associated with HIV has diminished with its spread among the heterosexual population and the development of effective treatments. This normalization may justify assuming a more traditional public health perspective about mandatory prenatal screening.
Gerald M. Oppenheimer, PhD, MPH and Ronald Bayer, PhD
The alarm generated by the AIDS epidemic left civil liberties proponents fearful that traditional public health responses might be imposed on newly susceptible or infected populations.
Assuming rigid control over patients’ health care and subjecting them to strict regimens without offering them a choice in the matter is frank paternalism. Moreover, proceeding with an invasive test without obtaining proper informed consent is malpractice.
Society values both the appropriate use of new technological and management innovations and the maintenance of a strong personal and therapeutic relationship between patients and physicians. The medical-home model may be able to accomplish both.
With heterosexual transmission the chief cause of global HIV spread, those without the power to select sexual partners, choose the timing of sexual encounters, or insist on safer sex practices are unable to protect themselves from infection.
Sabhyta Sabharwal, MPH, Jason W. Mitchell, PhD, MPH, and Victoria Y. Fan, ScD, SM
The World Health Organization and American Academy of Pediatrics recommend disclosing serostatus to sexually active adolescents. What else can be done to improve clinical outcomes and promote public health?
AMA J Ethics. 2018;20(8):E743-749. doi:
10.1001/amajethics.2018.743.
After years of funding disease-specific treatment, donation trends have shifted to support broader health systems infrastructure development. A remaining challenge is how to sustain antiretroviral therapy (ART) for patients in resource-poor regions.
AMA J Ethics. 2016;18(7):681-690. doi:
10.1001/journalofethics.2016.18.7.ecas3-1607.