Ethical beliefs refers to the beliefs of ethical

Ethical beliefs refers to the beliefs of ethical principles that include autonomy, beneficence/non-malfeasance and justice (Black, 2007; Beauchamp and Childress, 2001). It was important to identify the ethical beliefs of the students in relation to HIV/AIDS and PLWHAs in an attempt to explain their attitudes and their future dealing with this group of vulnerable population. The first part of the ethical beliefs questionnaire addressed the students’ beliefs towards HIV/AIDS testing, confidentiality/disclosure and environment of care provided for PLWHAs. Testing for HIV is essential to facilitate early diagnosis and management of the condition in order to prolong lifespan of the patient and to prevent the transmission of the disease. However, the acetylcholine receptor associated with HIV/AIDS and the confidentiality concerns have become a barrier to testing with subsequent missing of opportunities to receive early treatment (Mudhovozi et al., 2012). In this study, approximately one-third of the participants believed that it is appropriate to test a patient for HIV even without the patient’s permission. This could be attributed to the students’ intentions to know about patients’ HIV status so that they can protect themselves. Testing for HIV without consent is considered as a breach of autonomy that states that HIV testing is voluntary and it is ethically mandatory to obtain informed consent from the patient prior to it (UNAIDS, 2004; Huang and Hussein, 2004). The response of the students in regards to this item reflects that almost one third of the students’ were unfamiliar with the ethical protocol related to HIV testing. Confidentiality of HIV/AIDS patient was not being considered by more than half of the students where they agreed to inform relatives and sexual partners about the condition of the patient without patient’s consent. General Dental Council (GDC) has issued recommendation that dentists should not disclose patients’ information without consent (CouncilGDC GD, 1997). This could be due to the reason that partners’ notification is an effective strategy to prevent HIV transmission to sexual partners and to prompt treatment for those who were infected with HIV (Hogben et al., 2007). On the other hand it can be caused by the feel of obligation to notify the partners. However, partners’ notification without consent can incur undesirable consequences such as marital disharmony and divorce (VanDevanter et al., 2012; Deribe et al., 2008). Despite facing ethical dilemmas between respecting patients’ confidentiality and disclosing HIV status to their sexual partners, dental students should not breach patients’ confidentiality in their future practices. Instead, they should try to encourage or counsel HIV patients on the importance of disclosing HIV status to their sexual partner. As such, these practices protect patients’ right to privacy and decision making with regards to disclosure of patients’ HIV status (CouncilGDC GD, 1997). In regards to the environmental care offered to HIV/AIDs patients, more than half of the students reported the preference to clearly mark the rooms /beds and the charts of the patients. Literature revealed that such disclosure practices in healthcare setup may not decrease stigmatization, as stigma is affected by the way the patients contract the disease rather than having segregated units for the HIV/AIDS patients. Similar findings and preference of segregation was reported by nurses in several studies (Surlis and Hyde, 2001; Schietinger and Daniels, 1996). If the segregation and the isolation of patients were actualised in the dental practice, it may result in unethical behaviours and discriminatory practices with subsequent violation of equality and justice resulting in an infringement of HIV-infected individuals’ human rights. Another effect of segregation can be the non-disclosure of HIV status (Relf et al., 2009; Petrak et al., 2001).
Ethical beliefs towards policies in healthcare setup revealed that majority of the students felt that the healthcare professional should be informed if the patient is HIV-positive. More than half of the students reported that if health care workers are HIV-infected they should not be allowed to work in the field or carry-on invasive procedures requiring direct patient contact. Guidelines in regards to HIV-infected dentists and whether they are allowed to practice after being diagnosed with the disease is under reviewing and varies worldwide. UK advisory panel for health care workers infected with blood-borne viruses (UKAP) – under department of health UK – in 2007 banned HIV- infected dentists from treating patients as it defined all dental procedures as exposure-prone procedures (EPPS) where a risk of injury to the worker may result in exposure of the patient’s open tissues to the blood of the worker (McGoldrick, 2012). In 2009 The British Dental Association (BDA) endorsed the Beijing Declaration and announced that the ruling is “unfair and unlawful” giving the reason that dentistry in general, does not involve situations where the blood from clinician and patient mixes (Erridge, 2007). While in U.S and according to Centers for Disease Control and Prevention (CDC) the guidelines regarding the HIV-infected health care workers (HCW) including the dentists are state-based where every state has its own regulation (CDC, 2008) The states seemed to recognize that the risk of transmission from HCWs to patients was extremely low, especially when the universal precautions already in place are followed (Henderson et al., 2010).