Do we need an ethical framework for hospital infection control?

Abstract

Strategies for the control of the spread of infection in hospitals may lead to constraints on individual autonomy, freedom of movement, or contact with others. Codes of (ethical) practice for healthcare professionals tend to emphasise responsibilities to individual patients. Ethical frameworks for public health focus on groups of individuals (populations), the majority of whom are relatively healthy and empowered. Hospital infection control professionals must take account of both of these perspectives, sensitive to the care of infected and potentially infectious individuals, while protecting the vulnerable and relatively dependent population of hospital patients from further compromise to their health. A number of frameworks for an ethics of public health have been proposed over the last few years but there are sufficient differences in ethical considerations between collective interventions that aim to protect and promote the health of the public and interventions taken in the context of hospital infection control to justify a distinctive ethics of hospital infection control. Professional bodies may be best placed to lead the development of such a framework.

Isolating infectious patients: organizational, clinical, and ethical issues

“…Isolated patients experience more depression, anxiety, adverse events and make more complaints than the general patient population (28). The findings of this study corroborate earlier research showing they do not tolerate isolation well (29) They may resent the loneliness of enforced incarceration, relatives having to wear PPE especially if staff do not adhere to infection prevention precautions and impact of isolation on opportunities for rehabilitation outside the room (e.g. physiotherapy).…”

Evidence‐Based Infection Control In Clinical Practice: If You Buy Clothes for the Emperor, Will He Wear Them?

“…Clearly, health care providers have ethical and legal responsibilities to minimize risks for infectious disease transmission in health care settings. The ethical responsibilities regarding infection control for human patients have received increasing attention in the past decade . Some of this increased attention has been driven by efforts of the U.S. Centers for Disease Control and Prevention (CDC) during the past 40 years to gather and report standardized information about HCAI rates, and by other groups that have established and revised guidelines for best‐practice prevention efforts .…”

Control of Antimicrobial Resistance Requires an Ethical Approach

“…Isolating patients, while useful for containing the spread of infection, brings its own ethical considerations ( Abad et al, 2010 ). Screening patients has also been subjected to ethical debate, especially when it constitutes an invasive assault on a patient (e.g., genital swabbing) ( Millar, 2009 ). Why inflict such a procedure on a patient if it is not going to benefit that patient?…”