Nurses with blood-borne pathogens and the moral responsibilities of nurse regulating authorities.

This paper examines, for consideration by nurses and nurse regulating authorities (NRA), certain ethical and practice issues concerning registered/enrolled nurses with blood-borne pathogens (BBPs), such as Human Immunodeficiency Virus and Hepatitis Viruses. Under existing legislation, the identity and infectious status of a nurse with a BBP may be notified to a NRA by either a medical practitioner or another person. In the event of a notification being made, NRAs need to consider the question of how best to achieve a workable balance between protecting the significant moral interests of both the public and the nurse concerned. This paper clarifies how such a balance may be achieved, and provides recommendations on how the issue can be addressed in practice.

Breaking (through) the law--coming out of the silence: nursing, HIV/AIDS and euthanasia.

This paper provides a nursing perspective on ethical, legal, professional and practical issues faced by nurses working in HIV/AIDS care in relation to euthanasia/assisted suicide. Nurses who care for PLWHA (People Living with HIV/AIDS) have been conspicuously silent in the recent debates about euthanasia in Australia. Many factors prevent nurses from openly acknowledging their participation in assisted suicide/euthanasia and contributing to important debates about this topic. Their commitment to client confidentiality and the illegality of the practices are clearly significant factors which inhibit nurses from speaking freely. In addition, however, nurses' well-documented precarious legal position (Johnstone, 1994-alpha) and their subordinate status within the health care system make their public silence almost inevitable. Naming and challenging the factors which contribute to nurses silence, this paper draws on the experiences of nurses who have cared for PLWHA who have requested assistance in dying. It identifies practical, ethical and legal issues and dilemmas which can arise for nurses who may be involved in these practices, highlighting their special skills, relationships with clients, responsibilities and the complexity of their role; it also elucidates, however, the serious professional and personal risks nurses face given the legal and legislative status quo. This paper suggests that nurses may play a central, though covert, role in assisted suicide/euthanasia in HIV/AIDS care, rendering it imperative that their perspectives be included in the debates about the legalization of assisted suicide/euthanasia. Moreover, the paper identifies and challenges some severe impediments nurses must confront and address if they are to be able to contribute fully to this debate and to those which may arise in the future.