Legal and ethical implications of opt-out HIV testing
Legal and ethical implications of opt-out HIV testing
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DOI：
10.1086/522543
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发表时间：
2007-12-15
影响因子：
11.8
通讯作者：
Hanssens, Catherine
中科院分区：
文献类型：
--
作者：
Hanssens, Catherine
美国疾病控制和预防中心的新指南建议，在没有患者书面同意的情况下选择退出人类免疫缺陷病毒（HIV）筛查是常规临床护理的一部分，并意味着与这种方法相冲突的州HIV相关法律应该修改。然而，艾滋病毒检测和治疗问题受一系列联邦和州法律、普通法原则、宪法规定和各种道德守则的管辖。患者检测方案应满足知情同意的法律的定义，以降低提供者的责任风险（即，卫生保健专业人员和设施）。严格应用新的指导方针可能会引发法律的索赔，特别是如果没有联系到照顾的人与积极的测试结果，没有证据的知情同意，或不充分的咨询。确保保密性、为提供者提供更好的测试培训以及提供者与艾滋病毒服务组织的合作可以降低患者索赔的风险，但州和联邦法律、道德准则以及对提供者责任的担忧应该缓和对建议选择退出筛查的指导方针的反射性大规模采用。
New guidelines from the Centers for Disease Control and Prevention recommend that opt-out screening for human immunodeficiency virus (HIV) without written patient consent be part of routine clinical care and imply that state HIV-associated laws in conflict with this approach should be amended. However, HIV testing and treatment issues are governed by a range of federal and state laws, common law principles, constitutional provisions, and various codes of ethics. Patient testing protocols should satisfy the legal definition of informed consent, to reduce risk of liability for providers (i.e., health care professionals and facilities). Rigid application of the new guidelines may trigger legal claims, especially if there is no link to care for persons with a positive test result, no proof of informed consent, or inadequate counseling. Ensuring confidentiality, better test training for providers, and provider collaboration with HIV service organizations can reduce the risk of patient claims, but state and federal laws, codes of ethics, and concerns about provider liability should temper reflexive wholesale adoption of guidelines that recommend opt-out screening.