Objective: Most HIPC policies are supported by evidence and/or common sense, but significant knowledge gaps remain and policy implementation often falters. Rather than “everybody’s business”, infection control may seem “no-one’s responsibility”. This paper will explore ethics-based approaches to HIPC.
Methods: The limited literature on HIPC ethics was reviewed and several approaches, based on various ethical theories (e.g. rules-, outcomes or virtue-based) compared. A framework for an ethical approach to HIPC is proposed.
Results: A practical approach to HIPC ethics requires consideration of the rights, responsibilities and needs of a) individuals - patients and healthcare workers (HCW); b) organizations – professional bodies, healthcare administrations and funding authorities; and c) communities – within and beyond the healthcare system. Patients’ infection status, risks and medical needs vary. HCW include individual practitioners and salaried staff in different specialties, each with its own hierarchical and industrial systems; all are potentially exposed, unwittingly, to occupational infection risks (viz SARS). Funding bodies - government (aka “the public”) or private companies (aka “shareholders”) – may have different priorities. There are major variations, within and between stakeholder groups, in roles, knowledge, attitudes; authority, power; culture and beliefs. Development and implementation of HIPC policies must account for these differences, by respectful consultation and joint decision-making in the context of shared values and goals.
Conclusion: HIPC is the responsibility of organizations; individual HCW and funding bodies. It should be supported by local performance auditing, data feed-back and improvement strategies as well as mutual respect, empathy, transparency, accountability and communication.