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Ethical Dimensions in Pediatric HIV Care

Explore the ethical challenges in caring for pediatric patients with HIV, including issues of confidentiality, disclosure, stigma, anger, child abuse evaluation, and socioeconomic considerations. Discover how to navigate these complex ethical domains to provide comprehensive care for patients like Emmanuel and support their caregivers.

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Ethical Dimensions in Pediatric HIV Care

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  1. Care for the Paediatric Patient with HIV Module 17 Zoom Activities

  2. #1: Multidisciplinary discussion Objective: Use a team-based approach to care for children with HIV (IPE)

  3. Case Emmanuel is a 26-month-old boy brought to the hospital by his mother because he has failed to gain weight. The mother was diagnosed with HIV and took ART during herpregnancy. She had an undetectable HIV RNA at delivery, and the baby initially tested negative by HIV DNA. Following delivery, she stopped taking ART and started breastfeeding immediately. When Emmanuel is brought to the hospital, he is tested again for HIV and the rapid antibody test is positive. His mother mentions she has not disclosed her own HIV diagnosis to her family and that financial difficulties have made it difficult to bring Emmanuel in for a medical evaluation. Upon examination Emmanuel appears lethargic, malnourished, and dehydrated. He can walk, but is unsteady, and has unintelligible speech.

  4. Model multidisciplinary rounds • How will you evaluate the patient and what additional information will you need to make your evaluation? • In what ways could your health profession meet the medical and/or psychosocial needs of Emmanuel and his mother?

  5. #2: Ethics discussion Objective: Discuss ethical dimensions of caring for a paediatric patient with HIV

  6. Domains of ethics • Confidentiality • Disclosure • Stigma • Anger • Household disclosures • Evaluation for child abuse • Other socioeconomic issues

  7. Ethics discussion Discuss some of the ethical issues surrounding the paediatric population living with HIV

  8. Answers • Stigma and discrimination: • Adherence • Dependence on caregivers • Evaluating for child abuse/neglect • Anger • Household disclosure

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