Mary J O'Grady | University of the Witwatersrand (original) (raw)

Papers by Mary J O'Grady

Research paper thumbnail of The Right to Know and the Right not to Tell: The Ethics of Disclosure of HIV Status (English version)

Postmodern Openings, 2011

Disclosure of HIV status has been considered an important public health issue for some 20 years. ... more Disclosure of HIV status has been considered an important public health issue for some 20 years. Yet the ethical issues surrounding the disclosure of positive HIV status have not been examined comprehensively. This report examines the ethics behind the disclosure of HIV-positive status primarily or individuals to their sex partners, and for health care practitioners to a patient’s sex partner when the patient is unwilling to disclose. Relevant rights and ethical principles are analysed, including the rights to: self-preservation; privacy and confidentiality; and the bioethical principles of respect for autonomy, beneficence, non-maleficence, and justice. Historic and contemporary individual rights that people living with HIV (PLHIV) have regarding disclosure are emphasised, especially in adverse circumstances, where ethics can support non-disclosure based on the right to self-preservation. Rights declarations and current disclosure guidelines for health care practitioners from several international and South African medical organisations also are reviewed. Of key importance to disclosure decisions are the specific situations of individuals in climates rife with stigma toward, and discrimination against, PLHIV, existing more or less worldwide. The potential negative impacts of disclosure are the basis for disclosure decisions of PLHIV. Research study results show that the negative impacts of disclosure can be severe for individuals, ranging from divorce or abandonment to community ostracism and even to murder. Relevant current theories of social justice related to HIV disclosure also are discussed. A conclusion is reached that, by decreasing stigma and discrimination against PLHIV and protecting individual rights related to HIV disclosure, prevention behaviours will be practised more widely, including ‘positive prevention’ by PLHIV and higher rates of disclosure. The eventual result will be the long-term public health goal of decreased spread of HIV.HIV, AIDS, Testing, Disclosure, Human Rights

Research paper thumbnail of The Right to Know and the Right Not to Tell: The Ethics of Disclosure of HIV Status

Social Science Research Network, 2009

Research paper thumbnail of Current status and trends of the AIDS epidemic in Africa

Research paper thumbnail of Can fear arousal in public health campaigns contribute to the decline of HIV prevalence? Commentary

Journal of Health Communication, 2006

Most American health professionals who work in HIV/AIDS do not support the use of fear arousal in... more Most American health professionals who work in HIV/AIDS do not support the use of fear arousal in AIDS preventive education, believing it to be counterproductive. Meanwhile, many Africans, whether laypersons, health professionals, or politicians, seem to believe there is a legitimate role for fear arousal in changing sexual behavior. This African view is the one more supported by the empirical evidence, which suggests that the use of fear arousal in public health campaigns often works in promoting behavior change, when combined with self-efficacy. The authors provide overviews of the prevailing American expert view, African national views, and the most recent findings on the use of fear arousal in behavior change campaigns. Their analysis suggests that American, post-sexual-revolution values and beliefs may underlie rejection of fear arousal strategies, whereas a pragmatic realism based on personal experience underlies Africans' acceptance of and use of the same strategies in AIDS prevention campaigns.

Research paper thumbnail of A principle‐based approach to justify the use of HIV self‐testing in South Africa

Developing World Bioethics, Jun 2, 2021

The South African government introduced the use of an HIV self‐testing (HIVST) kit in 2016 to exp... more The South African government introduced the use of an HIV self‐testing (HIVST) kit in 2016 to expand access to HIV testing services and to increase HIV testing uptake among men and key populations who may otherwise not test. By reviewing existing empirical data, including existing guidelines regarding the implementation and use of HIV self‐testing, this research explores the ethical implications of using the HIV self‐testing kit and draws arguments from the ethical principles: respect for autonomy, beneficence, non‐maleficence, and social justice. The implementation of HIV self‐testing in South Africa does not violate any ethical principles; however, the potential occurrences of coercion and intimate partner violence surrounding HIV self‐testing remain issues of concern challenging the principle of non‐maleficence. Furthermore, the available empirical data on potential harm does not provide compelling ethical grounds for restricting the sale of HIVST kits in South Africa. Hence, HIVST in South Africa remains an ethically justified intervention.

Research paper thumbnail of Just Inducing Fear of HIV/AIDS Is Not Just

Journal of Health Communication, Apr 1, 2006

Edward Green and Kim Witte have identified an important and controversial issue in HIV/AIDS commu... more Edward Green and Kim Witte have identified an important and controversial issue in HIV/AIDS communication programming over the past 20 years: the role of fear in educational messages and campaigns. The article poses intriguing questions about why “many ...

Research paper thumbnail of The bioethical and human rights challenges surrounding the HIV testing of women in South Africa and other sub-Saharan African countries

A thesis submitted to the Faculty of Health Sciences, University of the Witwatersrand, in fulfilm... more A thesis submitted to the Faculty of Health Sciences, University of the Witwatersrand, in fulfilment for the requirements for the degree of Doctor of Philosophy Johannesburg, 2015

Research paper thumbnail of The Right to Know and the Right Not to Tell: The Ethics of Disclosure of HIV Status

SSRN Electronic Journal, 2009

Research paper thumbnail of Postmodern quests in applied philosophy

Lumen Publishing House is recognized as an academic and scientific publishing house by CNCS (The ... more Lumen Publishing House is recognized as an academic and scientific publishing house by CNCS (The National Research Council) in Humanities, History and Cultural Studies, in B Category. After the CNCS assessment a number of only 30 publishing houses were accepted in A and B Category for at least one area of humanities. edituralumen@ gmail. com grafica. redactia. lumen@ gmail. com prlumen@ gmail. com www. edituralumen. ro www. librariavirtuala. com

Research paper thumbnail of Postmodern Quests in Applied Philosophy

Chapter: The Right to Know and the Right Not to Tell: The Ethics of Disclosure of HIV Status, 2012

Disclosure of HIV status has been considered an important public health issue for some 20 years.... more Disclosure of HIV status has been considered an important public health issue for
some 20 years. Yet the ethical issues surrounding the disclosure of positive HIV status have not been examined comprehensively. This report examines the ethics behind the disclosure of HIV-positive status primarily of individuals to their sex partners, and for health care practitioners to a patient’s sex partner when the patient is unwilling to disclose. Relevant rights and ethical principles are analysed, including the rights to: self-preservation; privacy and confidentiality; and the bioethical principles of respect for autonomy, beneficence, nonmaleficence, and justice. Historic and contemporary individual rights that people living with HIV (PLHIV) have regarding disclosure are emphasised, especially in adverse circumstances, where ethics can support non-disclosure based on the right to self-preservation. Rights declarations and current disclosure guidelines for health care practitioners from several international and South African medical organisations also are reviewed. Of key importance to disclosure decisions are the specific situations of individuals in climates rife with stigma toward,
and discrimination against PLHIV, existing more or less worldwide. The potential negative impacts of disclosure are the basis for disclosure decisions of PLHIV. Research study results show that the negative impacts of disclosure can be severe for individuals, ranging from divorce or abandonment to community ostracism and even to murder. Relevant current theories of social justice related to HIV disclosure also are discussed. A conclusion is reached that by decreasing stigma and discrimination against PLHIV and protecting individual rights related to HIV disclosure, prevention behaviours will be practised more widely, including ‘positive prevention’ by PLHIV and higher rates of disclosure. The eventual result will be the long-term public health goal of decreased spread of HIV.
Mary O’GRADY

Research paper thumbnail of The Right to Know and The Right Not to Tell: The Ethics of Disclosure of HIV Status

Research paper thumbnail of Managing HIV/AIDS in the Workplace: Examples of Nine Non-governmental Organisations in South Africa, Zambia and Zimbabwe

Research paper thumbnail of El control de las enfermedades de transmisión sexual: un manual para el diseño y la administración de programas

Research paper thumbnail of The impoverishing pandemic: The impact of the HIV/AIDS crisis in Southern Africa on development

From Disaster to Development: HIV and AIDS in …, 2004

Research paper thumbnail of Just Inducing Fear of HIV/AIDS Is Not Just

Journal of Health Communication, 2006

Research paper thumbnail of The Right to Know and the Right not to Tell: The Ethics of Disclosure of HIV Status (English version)

Postmodern Openings, 2011

Disclosure of HIV status has been considered an important public health issue for some 20 years. ... more Disclosure of HIV status has been considered an important public health issue for some 20 years. Yet the ethical issues surrounding the disclosure of positive HIV status have not been examined comprehensively. This report examines the ethics behind the disclosure of HIV-positive status primarily or individuals to their sex partners, and for health care practitioners to a patient’s sex partner when the patient is unwilling to disclose. Relevant rights and ethical principles are analysed, including the rights to: self-preservation; privacy and confidentiality; and the bioethical principles of respect for autonomy, beneficence, non-maleficence, and justice. Historic and contemporary individual rights that people living with HIV (PLHIV) have regarding disclosure are emphasised, especially in adverse circumstances, where ethics can support non-disclosure based on the right to self-preservation. Rights declarations and current disclosure guidelines for health care practitioners from several international and South African medical organisations also are reviewed. Of key importance to disclosure decisions are the specific situations of individuals in climates rife with stigma toward, and discrimination against, PLHIV, existing more or less worldwide. The potential negative impacts of disclosure are the basis for disclosure decisions of PLHIV. Research study results show that the negative impacts of disclosure can be severe for individuals, ranging from divorce or abandonment to community ostracism and even to murder. Relevant current theories of social justice related to HIV disclosure also are discussed. A conclusion is reached that, by decreasing stigma and discrimination against PLHIV and protecting individual rights related to HIV disclosure, prevention behaviours will be practised more widely, including ‘positive prevention’ by PLHIV and higher rates of disclosure. The eventual result will be the long-term public health goal of decreased spread of HIV.HIV, AIDS, Testing, Disclosure, Human Rights

Research paper thumbnail of The Right to Know and the Right Not to Tell: The Ethics of Disclosure of HIV Status

Social Science Research Network, 2009

Research paper thumbnail of Current status and trends of the AIDS epidemic in Africa

Research paper thumbnail of Can fear arousal in public health campaigns contribute to the decline of HIV prevalence? Commentary

Journal of Health Communication, 2006

Most American health professionals who work in HIV/AIDS do not support the use of fear arousal in... more Most American health professionals who work in HIV/AIDS do not support the use of fear arousal in AIDS preventive education, believing it to be counterproductive. Meanwhile, many Africans, whether laypersons, health professionals, or politicians, seem to believe there is a legitimate role for fear arousal in changing sexual behavior. This African view is the one more supported by the empirical evidence, which suggests that the use of fear arousal in public health campaigns often works in promoting behavior change, when combined with self-efficacy. The authors provide overviews of the prevailing American expert view, African national views, and the most recent findings on the use of fear arousal in behavior change campaigns. Their analysis suggests that American, post-sexual-revolution values and beliefs may underlie rejection of fear arousal strategies, whereas a pragmatic realism based on personal experience underlies Africans' acceptance of and use of the same strategies in AIDS prevention campaigns.

Research paper thumbnail of A principle‐based approach to justify the use of HIV self‐testing in South Africa

Developing World Bioethics, Jun 2, 2021

The South African government introduced the use of an HIV self‐testing (HIVST) kit in 2016 to exp... more The South African government introduced the use of an HIV self‐testing (HIVST) kit in 2016 to expand access to HIV testing services and to increase HIV testing uptake among men and key populations who may otherwise not test. By reviewing existing empirical data, including existing guidelines regarding the implementation and use of HIV self‐testing, this research explores the ethical implications of using the HIV self‐testing kit and draws arguments from the ethical principles: respect for autonomy, beneficence, non‐maleficence, and social justice. The implementation of HIV self‐testing in South Africa does not violate any ethical principles; however, the potential occurrences of coercion and intimate partner violence surrounding HIV self‐testing remain issues of concern challenging the principle of non‐maleficence. Furthermore, the available empirical data on potential harm does not provide compelling ethical grounds for restricting the sale of HIVST kits in South Africa. Hence, HIVST in South Africa remains an ethically justified intervention.

Research paper thumbnail of Just Inducing Fear of HIV/AIDS Is Not Just

Journal of Health Communication, Apr 1, 2006

Edward Green and Kim Witte have identified an important and controversial issue in HIV/AIDS commu... more Edward Green and Kim Witte have identified an important and controversial issue in HIV/AIDS communication programming over the past 20 years: the role of fear in educational messages and campaigns. The article poses intriguing questions about why “many ...

Research paper thumbnail of The bioethical and human rights challenges surrounding the HIV testing of women in South Africa and other sub-Saharan African countries

A thesis submitted to the Faculty of Health Sciences, University of the Witwatersrand, in fulfilm... more A thesis submitted to the Faculty of Health Sciences, University of the Witwatersrand, in fulfilment for the requirements for the degree of Doctor of Philosophy Johannesburg, 2015

Research paper thumbnail of The Right to Know and the Right Not to Tell: The Ethics of Disclosure of HIV Status

SSRN Electronic Journal, 2009

Research paper thumbnail of Postmodern quests in applied philosophy

Lumen Publishing House is recognized as an academic and scientific publishing house by CNCS (The ... more Lumen Publishing House is recognized as an academic and scientific publishing house by CNCS (The National Research Council) in Humanities, History and Cultural Studies, in B Category. After the CNCS assessment a number of only 30 publishing houses were accepted in A and B Category for at least one area of humanities. edituralumen@ gmail. com grafica. redactia. lumen@ gmail. com prlumen@ gmail. com www. edituralumen. ro www. librariavirtuala. com

Research paper thumbnail of Postmodern Quests in Applied Philosophy

Chapter: The Right to Know and the Right Not to Tell: The Ethics of Disclosure of HIV Status, 2012

Disclosure of HIV status has been considered an important public health issue for some 20 years.... more Disclosure of HIV status has been considered an important public health issue for
some 20 years. Yet the ethical issues surrounding the disclosure of positive HIV status have not been examined comprehensively. This report examines the ethics behind the disclosure of HIV-positive status primarily of individuals to their sex partners, and for health care practitioners to a patient’s sex partner when the patient is unwilling to disclose. Relevant rights and ethical principles are analysed, including the rights to: self-preservation; privacy and confidentiality; and the bioethical principles of respect for autonomy, beneficence, nonmaleficence, and justice. Historic and contemporary individual rights that people living with HIV (PLHIV) have regarding disclosure are emphasised, especially in adverse circumstances, where ethics can support non-disclosure based on the right to self-preservation. Rights declarations and current disclosure guidelines for health care practitioners from several international and South African medical organisations also are reviewed. Of key importance to disclosure decisions are the specific situations of individuals in climates rife with stigma toward,
and discrimination against PLHIV, existing more or less worldwide. The potential negative impacts of disclosure are the basis for disclosure decisions of PLHIV. Research study results show that the negative impacts of disclosure can be severe for individuals, ranging from divorce or abandonment to community ostracism and even to murder. Relevant current theories of social justice related to HIV disclosure also are discussed. A conclusion is reached that by decreasing stigma and discrimination against PLHIV and protecting individual rights related to HIV disclosure, prevention behaviours will be practised more widely, including ‘positive prevention’ by PLHIV and higher rates of disclosure. The eventual result will be the long-term public health goal of decreased spread of HIV.
Mary O’GRADY

Research paper thumbnail of The Right to Know and The Right Not to Tell: The Ethics of Disclosure of HIV Status

Research paper thumbnail of Managing HIV/AIDS in the Workplace: Examples of Nine Non-governmental Organisations in South Africa, Zambia and Zimbabwe

Research paper thumbnail of El control de las enfermedades de transmisión sexual: un manual para el diseño y la administración de programas

Research paper thumbnail of The impoverishing pandemic: The impact of the HIV/AIDS crisis in Southern Africa on development

From Disaster to Development: HIV and AIDS in …, 2004

Research paper thumbnail of Just Inducing Fear of HIV/AIDS Is Not Just

Journal of Health Communication, 2006