Journal of Urban Health

, Volume 77, Issue 2, pp 222–231 | Cite as

The difficult, demanding, and demented AIDS patient in long-term care

  • Nancy Neveloff Dubler
Original Articles: HIV and Long-Term Care


Demented AIDS patients in long-term care present interconnected medical, ethical, and management problems. The patient's right to care must be considered in the context of the obligations owed to other residents and to staff members. A principled analysis should focus on substantive and procedural issues: the concept of autonomy must be modified by notions of accommodation to the needs of others; procedural fairness should guide discussions. A dynamic analysis should identify the various parties, their conflicting interests, and possible routes for resolving differences.

Key words

Ethics Long-term Care Autonomy Accommodation 


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  2. 2.
    Collopy B, Dubler N, Zuckerman C. The ethics of home care: autonomy and accommodation.Hastings Cent Rep. March/April 1990;(special Suppl).Google Scholar
  3. 3.
    Arras JD, Dubler NN. Introduction: ethical and social implications of high-tech home care. In: Arras J, ed.Bringing the hospital Home: Ethical and Social Implications of High-Tech Home Care. Baltimore, MD: The John Hopkins University Press; 1995:1–31.Google Scholar
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    Arras JD, Dubler NN. Bringing the hospital home: ethical and social implications of high-tech care.Hastings Cent Rep. September/October 1994;(special suppl).Google Scholar

Copyright information

© The New York Academy of Medicine 2000

Authors and Affiliations

  • Nancy Neveloff Dubler
    • 1
  1. 1.Division of Bioethics, Department of Epidemiology and Social MedicineMontefiore Medical CenterBronx

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