title: Ethics in human resource management: potential for burnout among healthcare workers in ART and community care centres.
abstract: This paper examines ethical dilemmas in providing care for people with HIV/AIDS. Healthcare providers in this sector are overworked, particularly in the high prevalence states. They are faced with the dual burden of the physical and the emotional risks of providing this care. The emotional risks result from their inability to control their work environment, while having to deal with the social and cultural dimensions of patients' experiences. The physical risk is addressed to some extent by post exposure prophylaxis. But the emotional risk is largely left to the individual and there is little by way of institutional responsibility for minimising this. The guidelines for training workers in care and support programmes do not include any detailed institutional mechanisms for reducing workplace stress. This aspect of the programme needs to be examined for its ethical justification. The omission of institutional mechanisms to reduce the emotional risks experienced by healthcare providers in the HIV/AIDS sector could be a function of lack of coordination across different stakeholders in programme development. This can be addressed in further formulations of the programme. Whatever the reasons may be for overlooking these needs, the ethics of this choice need to be carefully reviewed.
authors.affiliation: Achutha Menon Centre for Health Science Studies, Sree Chitra Tirunal Institute for Medical Science and Technology, Medical College PO, Thiruvananthapuram, 695 011 India. mala@sctimst.ac.in
authors.forename: Ramanathan
authors.initials: R
authors.lastname: Mala
authors.forename: Kumar M
authors.initials: KM
authors.lastname: Santhosh
authors.forename: Avijit
authors.initials: A
authors.lastname: Anshul
authors.forename: R
authors.initials: R
authors.lastname: Aarthy
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D002055:Burnout, Professional / Q000517:prevention & control*; D003151:Community Health Centers / Q000941:ethics / Q000458:organization & administration; D005260:Female; D019983:Guideline Adherence; D015658:HIV Infections / Q000188:drug therapy / Q000517:prevention & control; D006291:Health Policy; D006801:Humans; D007194:India; D007318:Inservice Training; D008297:Male; D010561:Personnel Staffing and Scheduling / Q000941:ethics* / Q000592:standards; D011369:Professional-Patient Relations; D000078329:Workforce; D016526:Workload