By T. Thirumoorthy
Patients fear injury at the hands of their doctors. Doctors fear catching their patients’ illnesses.
Commentary
Doctors are human. We fear catching an infection from our patients. During the early stages of the AIDS* epidemic, instances of hesitation in providing the standard of care surfaced in clinical practice. This happened again with SARS*, and recently during the Ebola* epidemics. The fear is at once repugnant and reasonable.
Doctors are sometimes to blame. We have a professional duty to avail ourselves of protective measures when we care for patients with infectious diseases. This duty wars with the imperative of meeting immediate patient needs. At times we have refused or inadvertently omitted to use recommended precautionary and preventive measures.
It is uncommon, but not unknown, for doctors to catch a blood borne infection by accidental blood spillage or from sharps injuries. When such an event occurs, we have an ethical and legal duty to present ourselves for evaluation, occupational advice, and to comply with appropriate prophylaxis when indicated. Healthcare organisations must create pathways for easy access to medical help, and a non-punitive culture for reporting.
Younger doctors who are in the early stages of clinical experience often harbor fears of contagion and may not know how to share these fears. It is important to establish a special place in the explicit curriculum of medical education where ethical concerns and legal duty of care can be discussed.
——-A/Prof T. Thirumoorthy
*The Epidemics
The AIDS epidemic first surfaced in 1981 as a cluster of rare pneumonias in six previously healthy homosexual men.
Severe acute respiratory syndrome, or SARS, is a viral disease. An outbreak in Southern China in 2003 eventually led to secondary outbreaks in Hong Kong, Taiwan, Singapore and Canada.
The West African Ebola Epidemic of 2013-2016 is the most widespread Ebola Epidemic in history.
A/Prof T. Thirumoorthy is the Group Chief Medical Officer with a private healthcare group, and who also teaches at Duke-NUS Medical School. He is a dermatologist and the founder director of the SMA Centre of Ethics and Professionalism.
The commentary and vignette were reproduced with permission from the book “Being Human, Stories from Family Medicine” edited by Cheong Pak Yean and Ong Chooi Peng and published in 2021 by the College of Family Physicians Singapore.
Pictures of illness experiences were drawn by NUS medical students in workshops conducted from 2012-2017 by A/Prof Cheong Pak Yean. Senior family physicians subsequently shared vignettes and commentaries based on the pictures.
