Cooper EB; International Conference on AIDS.
Int Conf AIDS. 1996 Jul 7-12; 11: 52 (abstract no. We.D.491).
Fordham University School of Law, New York, NY. Fax: 212/636-6923. E-mail: ecooper@mail.lawnet.fordham.edu.
Issue: Results from clinical trial ACTG 076 have been used to support calls in the US for mandatory HIV testing of pregnant/delivering women & newborns. As mandatory testing would challenge established standards of informed consent (IC) analysis must be conducted using legal and ethical principles and data concerning access to care. Project: Using historical ethical and legal principles contributing to IC standards regarding individual and familial autonomy (decision-making; bodily integrity) an evaluation of consent-to-testing rates among women in pre/perinatal settings and an examination of the impact of mandatory testing programs assess the anticipated impact of mandatory pre/perinatal testing programs on both facilitating access to care and societal valuations of IC. Results: Data reveal that consent-to-testing rates vary but are highest when testing is linked to care and assurances of confidentiality (NY CA GA IL MD PR). Mandatory testing has not fared well re: access to care. History has valued IC to encourage testing treatment and improved prevention in the context of HIV-related stigma. Ethical principles of beneficence and autonomy and legal principles of privacy and due process favor strong IC practices - enhancing patient competence knowledge and voluntariness. Established exceptions to IC (significant risk; emergency) are not available because a less intrusive more successful and protective (societal/individual) approach is available through universal counseling/voluntary testing (UC/VT). Attempts to diminish IC for one population appears to encourage diminished IC for others. Lessons Learned: Access to care for families living w/HIV is best accomplished through UC/VT. This is favored by women living w/HIV their care providers & major medical/public health org's. Historical ethical and legal principles underlying IC which facilitate trust in health care providers continue to apply and ought to be supported. Despite increasing calls for mandatory testing in pre/perinatal settings and media pressure most legislatures and public health officials appropriately have opted for UC/VT to facilitate family-based HIV-related care.
Publication Types:
Keywords:
- Acquired Immunodeficiency Syndrome
- Confidentiality
- Counseling
- Female
- HIV Infections
- HIV Seropositivity
- Humans
- Immunologic Techniques
- Infant, Newborn
- Informed Consent
- Mandatory Testing
- Mass Screening
- Physical Examination
- methods
Other ID:
UI: 102219251
From Meeting Abstracts