Ethics: Would you work in an AIDS Clinic?

[Edge]

I was reading a list of questions that were asked in previous interviews available online and I fell on a tricky, yet simple question that I was hoping you can give me some input on.

 

It simply ask if you would ever work in an AIDS Clinic.

 

As simple and straightforward as it might seem, giving a simple yes is not a valid answer without being able to justify it, and, I care for the world and want to save it is not a valid justification.

 

If I say no, it surely going to wreck the show.

 

My answer would be that I'd have to think about it and consult with those close to me, eg family, friends and close peers because of the situation. And thats a genuine answer. However, it might seem selfish as an answer because it gives the impression and exposes a sort of double standard.

 

Youll risk your life in a hospital but not in an AIDS clinic?

 

How would you guys answer it, would you be straightforward about it?

[rmorelan]

Just a question - to anyone's knowledge in Canada has anyone ever actually contracted AIDS by working at one of these clinics? Seems rather unlikely to me to be honest

 

I was reading a list of questions that were asked in previous interviews available online and I fell on a tricky, yet simple question that I was hoping you can give me some input on.

 

It simply ask if you would ever work in an AIDS Clinic.

 

As simple and straightforward as it might seem, giving a simple yes is not a valid answer without being able to justify it, and, I care for the world and want to save it is not a valid justification.

 

If I say no, it surely going to wreck the show.

 

My answer would be that I'd have to think about it and consult with those close to me, eg family, friends and close peers because of the situation. And thats a genuine answer. However, it might seem selfish as an answer because it gives the impression and exposes a sort of double standard.

 

Youll risk your life in a hospital but not in an AIDS clinic?

 

How would you guys answer it, would you be straightforward about it?

[Edge]

Thanks for the replies, I didnt think of answering that way. Personally, I find this to be a trick question because to simply say, I have no problem, they are patients too would be too easy. Surely, they expect an intelligent and genuine response, in this case, how many cases of health care workers contracting HIV/AIDS in the line of work, and safety precautions.

[mwoldey]

I think its smart to mention safety precautions, but won't talking about health stats just make your answer sound rehearsed?

I think it helps to answer this question to yourself first, as opposed to thinking what they want to hear....would you work in an AIDS clinic?

[rmorelan]

Thanks for the replies, I didnt think of answering that way. Personally, I find this to be a trick question because to simply say, I have no problem, they are patients too would be too easy. Surely, they expect an intelligent and genuine response, in this case, how many cases of health care workers contracting HIV/AIDS in the line of work, and safety precautions.

 

In real practise I would be "scared" of far more things than AIDS. Compared to a lot of things it just doesn't have the same impact in a health care setting - it can be managed chronically, has long latancy, and poor transmission both in terms of getting it and in terms of passing it along to someone else. To be honest something like TB actually would worry me more.

 

Part of that take though might be just because I have worked with AIDS positive clients for a while now.

[rmorelan]

what do you think they're trying to find out about an applicant with this question? how well the person is informed? or just his/her thought process?

 

Thought process mostly I would say.

[estairella]

Yes. You're interested in medicine which means hopefully you'll eventually go to medical school which means you'll eventually go to clerkship which means you'll eventually be on a surgical rotation. And beyond that, you'll be doing a residency where you'll still have to do some surgical rounds.

 

So... there will be a 6% (medical student) to 20% (resident) chance you will get a needlestick injury.

http://www.ccohs.ca/oshanswers/diseases/needlestick_injuries.html

 

Even if you didn't use specific stats, it's pretty clear that working in an AIDS clinic is WAY safer than doing anything surgical, if that's what you're worried about... so why would you say no?

 

Unless you hate people with AIDS. In which case, uhh, maybe you should lie on your answer.

[Starling]

In real practise I would be "scared" of far more things than AIDS. Compared to a lot of things it just doesn't have the same impact in a health care setting - it can be managed chronically, has long latancy, and poor transmission both in terms of getting it and in terms of passing it along to someone else. To be honest something like TB actually would worry me more.

 

Same here. HIV is relatively hard to catch and doesn't remain infectious for long outside of the body.

 

I'd probably discuss importance of universal precautions and basically say that I'd have no problem with it.

[shannn]

I wouldn't personally call this an ethics question, it would just be a question to see your thought process on pros vs cons of working in an AIDS clinic

[rollester]

I think it'd be a good idea to mention that AIDS can't be contracted just by interacting with the patients, so you would be willing to work in the clinic.

 

However, as a drawback, you could mention the dilemma of societal pressure. Society (parents, relatives, neighbours and even friends) can be a bit of a problem here, so you would want to explain the point above (that AIDS can't be transmitted just by working with the patients) and convince them. Personally, THAT is the hard part, I think, and not YOU being worried about catching the disease.

 

Hope it helps.

[Starling]

Also, from a non-disease-catching perspective, you could also discuss how you would feel working with people who will eventually die from their disease.

[Edge]

I think its smart to mention safety precautions, but won't talking about health stats just make your answer sound rehearsed?

I think it helps to answer this question to yourself first, as opposed to thinking what they want to hear....would you work in an AIDS clinic?

 

Talking about stats briefly shouldn't hurt me, and answering your last question, would I work in an AIDS clinics? My roadmap in medicine isn't clinic oriented.

 

Unless you hate people with AIDS. In which case, uhh, maybe you should lie on your answer.

I don't hate AIDS patients, it just that my roadmap in medicine doesnt involving alot of one on one clinic work, thats why I wanted to know what others would say. If I "be myself," they might not approve of my roadmap.

 

However, as a drawback, you could mention the dilemma of societal pressure. Society (parents, relatives, neighbours and even friends) can be a bit of a problem here, so you would want to explain the point above (that AIDS can't be transmitted just by working with the patients) and convince them. Personally, THAT is the hard part, I think, and not YOU being worried about catching the disease.

That was one of my original answers, but I felt I would open myself to harder questions. AIDS is the buzz word these days, and I feel that they are using that ailment because its being singled out by society unfairly compared to a vitamin deficientcy.

[bloh]

Also, from a non-disease-catching perspective, you could also discuss how you would feel working with people who will eventually die from their disease.

 

The illness has made huge strides; it has become a manageable chronic condition.

 

To me, this question is gauging whether you are willing to put yourself at risk (albeit incredibly low and perceived risk) in order to help people. I think if you say no, you better have a solid reason with excellent and logical thought process.

As someone already mentioned, the risk of contracting HIV is very low. I have lived in the same household with HIV+ individuals and never really worried about it. However, what makes the question particularly effective is the additional perceived risk because of societal implications. It looks as if the question would like for you to identify them and show how they affect the situation.

[DWB]

I would never, never ever

[shannn]

I would never, never ever

.

 

Why not?

[celia19O5]

i think it is a difficult question to answer

[estairella]

Edge I'm curious why you think simply saying 'yes' is not a valid answer.

 

If you really want to elaborate you can say, "I'm not sure what my current interests are in the field of medicine, but I don't foresee there being any obstacles to me working in an AIDS clinic if that should become an interest to me."

 

I mean if someone asked you "Would you work in a TB clinic?" what would you say? That's the exact same question as the AIDS one (with higher infectivity as others have said), it's only because you bring your own prejudices that you view it as an ethics question.

 

And to be honest, if I was an interviewer, anything other than "yes" is going to be somewhat of a flag for me.

 

If I said "Would you work in a clinic if it only served Jewish people" and you said "well umm, working with Jews is not really on my ROADMAP" I'd think you're trying to sidestep the question, which is, do you have any prejudices against Jews. Same thing here.

[rmorelan]

Edge I'm curious why you think simply saying 'yes' is not a valid answer.

 

If you really want to elaborate you can say, "I'm not sure what my current interests are in the field of medicine, but I don't foresee there being any obstacles to me working in an AIDS clinic if that should become an interest to me."

 

I mean if someone asked you "Would you work in a TB clinic?" what would you say? That's the exact same question as the AIDS one (with higher infectivity as others have said), it's only because you bring your own prejudices that you view it as an ethics question.

 

And to be honest, if I was an interviewer, anything other than "yes" is going to be somewhat of a flag for me.

 

I think you are right in practical terms - the truth is you do not have absolute control over what doctor you will become (welcome to CARMS )and even what you want to do may change. Medical schools will be less likely to accept some one who appears inflexible for those two practical reasons alone.

[Delusionofreality]

i think that it isn't a matter of ethics... people don't choose to get aids. it's not the same thing as an abortion clinic.

 

however, i think that you could conceivably say no and discuss the right of a doctor to self-determination and what kind of work you are comfortable with. talking about how if you were to work at an aids clinic all day you incur huge risks upon yourself. and you could also talk about the fact that if you were to get it (and possibly not know about it till symptoms set in) you could infect your partner, etc. then perhaps draw it out to a discussion on the fact that it's a basic human right for self-determination and that this wouldn't be something you would want to do... i would definitely still include a discussion at least of the Yes viewpoint and talk about hte benefits though... even if you were to say no. I think you might be able to make yourself stand out if you were to make a good case for no... but if you said no and you didn't give a fantastic answer it could mean an auto red flag.

[Starling]

talking about how if you were to work at an aids clinic all day you incur huge risks upon yourself.

The risk that does exist may be too high for you, but I wouldn't call it "huge", especially considering the other more-infectious/transmittable diseases you will likely encounter as a doctor.

 

and you could also talk about the fact that if you were to get it (and possibly not know about it till symptoms set in) you could infect your partner, etc.

But if anything happened that would be remotely likely to infect you (e.g. needlestick injury, blood splash in the eye), I think you'd notice! And you would probably get some antiretrovirals plus a few tests in the months to follow.

[Wachaa]

Is the clinic for people who already have AIDS? Or just living with HIV.

 

And besides, an HIV/AIDs clinic in Canada and one in the poorest city of Africa are completely different and one should at least *recognize* that distinction if you're going to talk about the risk of infection, etc.

 

I'm working in a clinic that sees men, women, and children living with HIV in BC. I touch tubes of blood and I'm more afraid of dropping them and losing my sample than the actual blood squirting out of the tube and into my open wounds.

 

During the interview, I would NOT mention at all that "HIV is manageable... so that's why I would work there" or anything along those lines. Unless you say it very carefully and in context. Or else that is bound to screw you over because you're basically implying that the people living with HIV right now are just cruising along??

[Renin]

In real practise I would be "scared" of far more things than AIDS. Compared to a lot of things it just doesn't have the same impact in a health care setting - it can be managed chronically, has long latancy, and poor transmission both in terms of getting it and in terms of passing it along to someone else. To be honest something like TB actually would worry me more.

 

Part of that take though might be just because I have worked with AIDS positive clients for a while now.

 

Yeah... there's a lot more scary things you can get in a hospital. I'm not that scared of AIDS. Besides, just be good and take your post-exposure prophylaxis kit.

 

You're more likely to get TB, or Hep B or Hep C or something that will drive your life to misery.

[A-Stark]

Talking about stats briefly shouldn't hurt me, and answering your last question, would I work in an AIDS clinics? My roadmap in medicine isn't clinic oriented.

 

So how will you be doing followup appointments or seeing new patients in an ambulatory setting? (just askin'...)

 

I don't hate AIDS patients, it just that my roadmap in medicine doesnt involving alot of one on one clinic work, thats why I wanted to know what others would say. If I "be myself," they might not approve of my roadmap.

 

I don't really know what this means, but I don't understand why this question is the least bit complicated - and I have worked (well, shadowed) in an HIV/AIDS clinic. The question is not asking whether you would choose specifically to work in such a clinic, but whether you'd be willing to under certain circumstances. I can't think of any reasonable answer apart from "of course, why not?"