Assignment Task:
Case: In a sub-Saharan African country, Dr. Charles directs a rural health clinic that an international organization funds. Funding requires the clinic to follow new WHO guidelines for the PMTCT. The guidelines specifically recommend using antiretroviral drugs throughout the breastfeeding period by HIV-positive women (WHO 2010). The district health office is also requiring Dr. Charles to develop guidance for his clinical staff on how to carry out the guidelines in a way that takes the values and beliefs of the community into account. Implementing the guidelines poses a major challenge for Dr. Charles because of the country's weak health infrastructure, the small number of paid staff in his clinic, and an inadequate facility with limited general supplies. However, his facility boasts a lab, and he has received some funding to support the PMTCT program. Recently, a woman in labor came to the clinic and told Dr. Charles she was HIV positive. She wanted to know how she could breastfeed without awakening suspicions of her HIV status. She was worried that if neighbors or family found out, her husband would abandon her, and she would have to support herself and the child in a hostile environment.
1. What is the scope and legitimacy of legal authority, and which laws and regulations apply?
2. What are the moral norms and claims of stakeholders; and how strong are they?
3. Are precedent legal or ethical cases relevant for identifying the presumptive moral norms?
4. Which features of the social-cultural-historical context apply?
5. Do professional codes of ethics provide guidance?