Public And Professional Attitudes Toward Aids Patients by David E. Rogers Eli Ginzberg

Author:David E. Rogers, Eli Ginzberg [David E. Rogers, Eli Ginzberg]
Language: eng
Format: epub
ISBN: 9780367284633
Google: Hnx8zQEACAAJ
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Goodreads: 49789132
Publisher: Routledge
Published: 1989-10-01T00:00:00+00:00

Incentives

In addition to the legal sanctions discussed above, there are incentives created by the law. Health-care workers will refuse to treat HIV-seropositive patients because they do not want to contract the virus, suffer disability, face personal economic ruin, and die. They fear both the physical as well as the economic costs of the accident. Perhaps their fear can be lessened somewhat if they are not asked to bear the economic burden of the accident. The law can and does shift the costs of an occupational accident. Thus, in exploring further the means to maintain access to health care, we should review the available mechanisms for shifting the costs of AIDS as an occupational disease.

Health workers who contract HIV in the workplace will likely be seropositive for life, will probably develop AIDS, and could be disabled for a long period before dying.71-74 There will be tremendous costs associated with these accidents both in economic and in emotional terms.75 Once these people die, their dependents will need financial support whether or not they, too, have been infected. The question of who will bear these costs is vitally important to guaranteeing access to health care. If those who could be infected at the hospital are expected to bear the costs of accidents, they may seek employment elsewhere; this would drive up labor costs for hospitals and create new incentives for hospitals to discriminate against seropositive individuals. If physicians believe they and their families will not be financially protected should an occupational HIV infection occur, they too will insist on testing patients or may refuse to care for those who are seropositive.

The costs of accidents have traditionally been shifted from the injured to other "deep pockets" by insurance and the tort law.76 In the case of workplace injury, however, a no-fault administrative approach, called workers' compensation, supplants tort law in most jurisdictions.77,78 Many health-care workers, including support staff, nurses, and doctors employed by hospitals will probably be eligible for workers' compensation benefits. Workers' compensation is generally available to all employees in a given state who suffer an injury at the workplace.79 Although some courts have questioned whether professionals can be employees, most have decided that all salaried workers, including doctors, are eligible.80 In addition, courts have confronted diseases very similar to HIV infection in the past and awarded compensation. The best examples are Hepatitis Β virus infection and tuberculosis.81-84

The big problem with workers' compensation is that the benefits are not adequate, especially in occupational disease cases.85 A further problem with death benefits, and indeed all workers' compensation benefits, is that they are tied to the amount the person is earning at the time of injury. This will affect student nurses and physicians who are members of the housestaff who could expect higher incomes after completion of training.86

Another problem is that there is usually no way to supplement workers' compensation benefits through other sources of compensation. Most states' laws require that such benefits be the sole source of compensation for an injured worker. In these

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