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Question of the day

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First, the setup…

Doctors in Illinois may no longer have to get written consent from patients to give them HIV tests under a controversial state bill that’s part of a national effort to make HIV testing more routine.

Supporters of the bill, which could come to a vote in the Illinois House this week, say it would give crucial knowledge to the estimated 10,000 Illinois residents who are infected with the virus that causes AIDS but don’t know it. The initiative would enact new testing guidelines that the federal Centers for Disease Control and Prevention published last year in hopes of screening all patients between ages 13 and 64.

But the change in law also would require rescinding parts of Illinois’ 20-year-old AIDS Confidentiality Act, which ensures that patients cannot get tested for HIV without their knowledge. […]

All opponents of the proposed law said they share the center’s goal of expanding testing and helping more people find out if they are HIV-positive. But they want to make sure counseling is offered before and after the tests to help patients deal with the results and get appropriate care.

“Written consent is a way of proving you’ve had that discussion,” Fisher said.

Now, the question: Should doctors be allowed to test patients for HIV without their consent?

posted by Rich Miller
Tuesday, May 1, 07 @ 8:50 am

Comments

I don’t think doctors should be allowed to do anything to a patient without their consent. Period.

Comment by grand old partisan Tuesday, May 1, 07 @ 8:55 am
I agree GOP.

Comment by Bill Baar Tuesday, May 1, 07 @ 9:00 am
I’m with GOP. I don’t want a doctor doing any kind of test on me without my permission. The government should find another way to encourage HIV testing without this legal mandatory treatment.

Comment by Levois Tuesday, May 1, 07 @ 9:26 am
“The government should find another way to encourage HIV testing without this legal mandatory treatment.”

I don’t understand why government should be encouraging HIV testing anyways. No doctor of mine will be authorizing tests without my consent. I don’t care if Blago says it’s alright or not. Who pays for the unauthorized test anyways?

Comment by Anonymous Tuesday, May 1, 07 @ 9:29 am
I assume physicians perform most routine tests without getting explicit consent.

If a patient comes in complaining of a symptom the doctor begins getting information without explicitly explaining, “When you give urine I test for six different things with this test strip….”

However, this lack of consent is justified b/c there’s no expectation that the patient has a reason to say, no.

Unless the government is going to pay for treating the HIV for the patient the government doesn’t have a right to mandate a test.

Comment by Carl Nyberg Tuesday, May 1, 07 @ 9:48 am
When my doctor says he is running tests I am usually aware of what he is looking for. Under no circumstances should we (are we still free American citizens?) be subjected to any tests without our permission…I don’t care if Big Brother or my Doctor is paying for it - no way without my consent.

Comment by Mrs. America Tuesday, May 1, 07 @ 10:24 am
None of you understand the issue, although Carl Nyberg comes close. The question isn’t about testing without consent to testing, it’s about testing without explicit consent for HIV to be among the tests consented to. For example, you go for a physical, the doctor gets consent to draw blood for a blood test and urine for urine tests. He/she doesn’t tell you - here are the 42 tests we’re doing on your blood and urine. But under current law, he/she must get a separate consent for one of those tests to be an HIV test. So the question is - should the HIV test continue to require a separate consent, or should it just be subsumed under the general consent to test. Makes sense to me. Why should HIV be treated differently than say, a PSA test, or a test that might detect leukemia or other life-threatening conditions?

Comment by Anonymous Tuesday, May 1, 07 @ 10:27 am
The only way the government should be able to mandate an AIDS/HIV test is they are paying for it.

Comment by Wumpus Tuesday, May 1, 07 @ 10:31 am
Sorry, paying for the coverage/medical service

Comment by Wumpus Tuesday, May 1, 07 @ 10:32 am
Bad idea. I’d echo every comment made here so far. Also, current HIV testing methods aren’t all that accurate and have a high error rate. And who’s going to pay for the expense?!

Comment by Left Leaner Tuesday, May 1, 07 @ 10:33 am
If the government is responsible for paying your health care bill, you dance to the bureaucrat’s tune.

Otherwise, you are wasting *my* tax money, and causing other people not to receive treatment they desperately need.

Comment by Johnny USA Tuesday, May 1, 07 @ 10:54 am
You all continue to not get it. It’s not about mandating testing for anyone - it’s whether or not a separate consent is required when you have otherwise consented to tests. Doesn’t anybody read the articles before commenting?

Comment by Anonymous Tuesday, May 1, 07 @ 10:56 am
Those of you who are saving compulsory testing is bad…are you also against government required immunizations, too? That’s just sad.

Comment by Leroy Tuesday, May 1, 07 @ 10:56 am
Nothing, absolutely nothing without consent. Next they will do DNA testing without our consent. All people with a certain high level of intelligence will be barred from running for political office! Wait….thet might already happening in some places.

Comment by Justice Tuesday, May 1, 07 @ 11:15 am
It’s not the testing…it’s the reporting. Does the CDC mandate the results be reported to them for “tracking purposes”?

Comment by cashflowpro Tuesday, May 1, 07 @ 11:16 am
The sponsors of this bill have disregarded the right to privacy and avoidance of discrimintation issues in this controversial issue.

Many doctors, as they engage in pre-test counselling with a patient will encourage patients to be tested anonymously without name identification to protect the patient from several forms of discrimination that are very common.

Eliminating the pre-test counselling deprives the patient of this option. Their are ways of addressing the need for expanded testing without eliminating this patient protection.

Lets not “Throw the baby out with the bath water.”

Comment by Larry McKeon Tuesday, May 1, 07 @ 11:18 am
Where are the “fundies” on this issue. They opposed routine testing of young girls for the HPV virus that is closely linked to cervical cancer because it would encourage sexual behavior. Why are they not opposed to HIV testing without written informed consent? What does this silence say about the “fundies’?

Comment by Anon Tuesday, May 1, 07 @ 11:35 am
forgive me but who are the “fundies”…

Comment by Bill Baar Tuesday, May 1, 07 @ 12:17 pm
This bill does not allow a doctor to test a person without consent. All medical procedures require some form of consent. Reading the bill it appears that their must be informed consent. It just sounds bad that anyone would think that it is ever possible to do anything such as test a person without them knowing. I think you should read the bill again and inform the public of the truth of the matter.

Comment by get the facts correct Tuesday, May 1, 07 @ 12:27 pm
Routine and mandatory inoculations have a proven record to stop infectious diseases that are harmful to society as a whole. Diseases such as small pox, which has been stamped out due to mandatory inoculation, are airborne contagions. In other words, you can catch it without person to person contact.

HIV is passed by direct contact with an infected person.

Required HIV testing for those people who are not a risk is a waste of medical resources.

Comment by Huh? Tuesday, May 1, 07 @ 1:00 pm
It’s not “required” HIV testing, it’s not mandatory. It’s allowing the test to be part of routine blood work without a separate consent.

Comment by Anonymous Tuesday, May 1, 07 @ 1:19 pm
Sure, why not toss away another one of your Constitutional rights? We as Americans haven’t put up much of a fuss considering how the “Homeland Security Act” tramples all over our Civil Liberties.

Hell NO! Do not let anybody test you for anything without your consent. Why give away another chunk of your right to privacy? Doesn’t anybody here have a relative that has fought in WWII? If so, you are disrespecting them and minimizing the sacrifice they made so you could be free from governmental oppression.

Comment by Papa Legba Tuesday, May 1, 07 @ 3:05 pm
Leroy,

The immunizations you allude to are preventative in nature. They are a “cure” for those diseases. If there were to be an immunization for the prevention of HIV, then yes, administer it. But for now, keep your stinkin’ little fingers out of my body unless I say it’s OK.

Comment by Papa Legba Tuesday, May 1, 07 @ 3:12 pm
Why doesn’t the doc simply give a checklist of all the things he wants to test you for and you can check any/all/some of them and sign it and that would be your consent for any tests.

The reason we had the AIDS/HIV confidentiality law is because of the discrimination that people could face as a result of being HIV pos. Plus, individuals may not want to have the HIV pos result in their health file under their own name, when there are anonymous results you can get.

Comment by cermak_rd Tuesday, May 1, 07 @ 3:15 pm
I tried to say no against having this test done because I know that I couldn’t have been (I’d been bitten and my skin wasn’t broken) infected, but since I was sent from work, they test routinely. The test was done. Period, end of story. And I knew I was safe. Both of us were tested. I thought it was a stupid waste of tax payers money - and that includes me.

I think that written consent should be obtained and that it should be explained to the person getting the testing done.

Comment by Tessa Tuesday, May 1, 07 @ 7:07 pm
Besides testing without your consent, what database are the results being entered into? The other big problem is that the HIPAA laws protect your information from everyone but the insurance companies. People have go under an assumed name and get anonymously tested for things while paying cash to protect their privacy. If they test you for something while you’re uninsured and the answer comes back “bad” — be it a genetic test or whatever screening you’re talking about — now you’ve got a pre-existing condition. If it were only a question of health care, we would probably all consent. The insurance companies complicate the entire issue because they want to get access to this information so they can turn down applicants and deny claims.

Comment by NoGiftsPlease Tuesday, May 1, 07 @ 9:04 pm
I think the moderator and most of the commenters have completely missed the point. The CDC has said that testing for HIV should be one of the routine tests that go with all blood tests.

Although I agree it is problematic for someone to not realize that an HIV test was “thrown in” with all the other tests, and then they are unprepared for a positive result, that is far better than for them to go through life not knowing they are positive and (a) infecting others, and (b) not getting the medical treatment that they should be getting when it is much easier to stop the disease from progressing.

Comment by Having a "positive" view of life Tuesday, May 1, 07 @ 9:11 pm
By dropping ANY reference to CONSENT (informed or otherwise) this bill sets up a dangerous precedent for patients’ rights … The bill only requires NOTIFICATION of HIV testing and disallows coercion so if your doctor TELLS YOU he is testing for HIV and doesn’t tie you to examination table he is allowed to test you for HIV–no conversation, explanation, opportunity to decline, nothing!

Is this really how we want healthcare to operate in a free society? Most people explained the benefits of testing accept it. This over-steps the bounds of logic

Comment by Anonymous Wednesday, May 2, 07 @ 2:14 pm