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A Journal on Forensic Medicine
Minerva Medicolegale 2002 March;122(1): 13-24
Revelation of diagnosis by medical professionals in cases of cancer and AIDS. Professional ethics and medicolegal aspects
Iorio M., Maggiore E., Santovito D.
The authors introduce the definition of ethics and bioethics with reference to physiopathology and clinical practice. They illustrate the operating methods based on the fundamental principles (autonomy, charity, justice, moral integrity of the profession) of medical ethics and the sequential phases of ethical reasoning (identification, evaluation, justification, comparison, solution, divergence, general strategy). As an example of the application of ethical principals, they analyse the case of diagnostic and prognostic truth for cancer and AIDS patients. In the case of a fatal neoplasm, the revelation is defined as ''denied'' and the authors outline the problems relating to the responsibilities of the doctor, the operating methods used by the medical structure, the divergences within a team, the correct type of communication to maintain a therapeutic relationship at the difficult time when the patient becomes aware of the disease. In the case of HIV infection or AIDS, the revelation is defined as ''disguised'', given that the patient himself asks not to tell others the true diagnosis. In compliance with professional ethics and juridical norms on this specific matter (Law 135/1990, Law Decree 675/1994 and the provisions by the Commission for the protection of privacy), the authors examine the patient's rights, the doctor's duties, the exceptions to the ethical rule and possible actions taken by the professional doctor.