Addressing the conflict between partner notification and patient confidentiality in serodiscordant relationships: How can Ubuntu help?

摘要

This study evaluates the conflict between patient confidentiality and partner notification in sero-discordant relationships, and argues the thesis that based on a theoretical formulation ofUbuntu,a health provider is obliged to facilitate friendly relationships in which individuals are true subjects and/or objects of communal friendship. In serodiscordant relationships, the health professional can fulfil this obligation by notifying "others" (particularly a partner with whom anHIVpositive patient has a "present" and "actual relationship") of their spouse'sHIVseroconversion, since without such relevant information a partner (subject) of anHIVpositive patient cannot "appropriately" care for the patient's condition (object). There is a need to move away from the medical traditional emphasis that has for so long put primacy on doctor-patient confidentiality as is the case with the Health Professions Council of South Africa Guidelines (Booklet 12) which favours patient confidentiality over partner notification. Given empirical evidence to support effectiveness of partner notification amongst sero-discordant couples, there is thus, a need to focus emphasis on latter. This shift is necessary for achieving the United Nations' Sustainable Development of Goal of endingHIV/AIDSepidemic by 2030. I proposed in this study that African ethics, specificallyUbuntu,will do a better job than current ethical frameworks at ensuring that partner notification receives more emphasis in the care of serodiscordant couples. If this framework is integrated into ethical guidelines and codes, it would significantly enhance the care of serodiscordant couples, as well as further boost global effort at endingHIV/AIDSepidemic by 2030.