HIV Testing, Human Rights, and Global AIDS Policy: Exceptionalism and Its Discontents
HIV Testing, Human Rights, and Global AIDS Policy: Exceptionalism and Its Discontents
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DOI：
10.1215/03616878-2009-002
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发表时间：
2009-06-01
影响因子：
4.2
通讯作者：
Edington, Claire
中科院分区：
文献类型：
--
作者：
Bayer, Ronald;Edington, Claire
两年前，即2007年5月，艾滋病规划署和世卫组织发布了关于艾滋病毒检测的新准则。为了满足艾滋病大流行的需求，以及将抗逆转录病毒疗法的好处扩大到这种治疗几乎无法达到的地区的前景，新的指导方针是两个联合国机构内部和全球长期存在有时激烈争议的产物。那些迫切要求改变的人认为，在对艾滋病毒感染者无能为力的时候出现的检测模式不适合目前的情况。有人声称，目前的做法和严格的道德标准已成为有效应对艾滋病挑战的障碍，有些人对此持怀疑态度，如果不是敌意的话，他们认为拟议的改革是对知情同意这一基本道德原则的威胁。当然，最后，关于艾滋病毒检测的决定将由民族国家作出，国际组织的建议只是一个因素，无论多么重要，都将影响政策。然而，对最近争议的历史和动态及其结果的研究将为面临政策选择的人提供一个独特的资源;它还将提供一个独特的机会，揭示公共卫生与人权之间不断演变的复杂和充满政治色彩的关系。
Two years ago, in May 2007, UNAIDS and WHO issued new guidelines on HIV testing. Prepared to meet the demands of the AIDS pandemic and the prospects of extending the benefits of antiretroviral therapy to regions where such treatment had been all but out of reach, the new guidance was the product of an extended period of sometimes acrimonious controversy both within the two UN agencies and globally. Those pressing for change had argued that a paradigm of testing that had emerged at a time when little could be done for those infected with HIV was inappropriate to the current moment. Those who viewed with skepticism, if not hostility, the claims that current practice and stringent ethical standards had become an impediment to effectively confronting the challenge of AIDS saw in the proposed changes a threat to the bedrock ethical principles of informed consent. In the end, of course, decisions about HIV testing will be taken by nation - states, with the recommendations of international organizations constituting but one element, however important, that will shape policy. Nevertheless, an examination of the history and the dynamics of the recent controversy and its outcome will provide a unique resource to those faced with policy choices; it will also provide a unique opportunity to lay bare the complex and politically charged relationships evolving between public health and human rights.