Etiska dilemman och avvägningar mellan smittskydd och sekretesskydd

Sammanfattning: Due to their contagiousness, communicable disease require healthcare staff to not only see to the needs of their patient, but also to the protection of themselves and other people from getting infected. Ethical issues and dilemmas tied to the patient’s anatomy and confidentiality arise as interventions to prevent further spread of the disease necessarily involve informing others about the risk of infection. Knowledge of and about communicable disease is necessary for acts of caution to be taken by both the person carrying it and those who are at risk of becoming infected. The Swedish communicable disease control system is regulated mainly with the Communicable Diseases Act (smittskyddslag, SFS 2004:168) and confidentiality within healthcare is regulated by the Public Access to Information and Secrecy Act (offentlighets- och sekretesslag, SFS 2009:400). In this thesis we identify dilemmas and concessions in the taking of measures to prevent the spread of communicable diseases, focusing especially on these two laws. This is done from the perspective of social work in healthcare settings with some focus on healthcare counsellors. For this purpose we have used content analysis with a deductive approach, produced a coding schedule, and analyzed relevant data in official documents. To discuss identified dilemmas and concessions further, we have used a theory of care ethics and utilitarianism. In our results we describe dilemmas consisting of situations where it is impossible to both maintain secrecy regarding the patient’s status as ill while informing others about their risk of infection, situations where differing interests arise, and situations where several principles which need to be followed differ from one another. These dilemmas are ethical in nature rather than legal, although professionals must make decisions regarding what information to share and what to keep secret. This makes for situations where practical answers to ethical dilemmas are necessary, and the contagious nature of the patient’s disease makes work more difficult.