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Some states permit HIV testing without informed consent under specified circumstances.

For example, many states permit testing of patients without permission after a significant exposure to emergency response workers or health care workers occurs, although permission generally must be sought.

For example, in many states, HIV information may not be disclosed based on a general release of medical information-specific authorization for release of HIV-related information must be obtained. have a duty to report HIV infections and AIDS cases to public health authorities.

Third, caregivers and patients may forget that HIV testing entails much greater psychosocial risks than other blood tests and that prenatal HIV testing differs from HIV testing in other settings.

Additional procedures or protections may be necessary to safeguard pregnant women's autonomous choices.

Although many examples are drawn from the United States, these issues are also explored from a global perspective. There are three widely recognized principles in American bioethics that apply to both clinical and research ethics: respect for persons, beneficence, and justice.(1-3) Respect for persons entails respecting the decisions of autonomous persons and protecting persons who lack decisionmaking capacity and therefore are not autonomous.

It also imposes an obligation to treat persons with respect by maintaining confidences and keeping promises.(1-3) Beneficence imposes a positive obligation to act in the best interests of patients or research participants.

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Our members come from different countries, have different skin colors, but most of them are HIV singles. For HIV positive singles, this is a safe, anonymous and comfortable place to find relationships, marriage, friendship, and support. Join today to meet other HIV positive singles on HIV Mingle, you are not alone here!The ethical concerns surrounding prenatal HIV testing are different in developing countries.To date, the cost of antiretroviral prophylaxis has been prohibitive and therefore, for the most part, pregnant women do not receive it.(33,34) Although knowing their HIV status may be helpful in guiding decisions concerning breastfeeding, in many circumstances, bottle-feeding is not a feasible option because of cost and lack of access to clean water(35).It recommended that all pregnant women be tested for HIV as a routine part of prenatal care. Public Health Service (USPHS) issued draft revised guidelines for prenatal HIV testing that stop short of the IOM recommendations.(31) The USPHS recommended that health care providers recommend HIV testing to all of their pregnant patients, but embraced the requirements for specific written informed consent required by many states.Under its recommendations, women would be informed that an HIV test would be conducted, along with other prenatal blood tests, but would not be required to consent specifically to the HIV test.(29) The American College of Obstetrics and Gynecology and the American Academy of Pediatrics have supported routine universal prenatal HIV testing.(30)Whether the IOM recommendations are adopted remains to be seen. It did note that verbal consent may be used, where permitted by state law, if written consent is deemed a barrier to testing.(31)The proposals to make HIV testing a routine part of prenatal care raise several concerns.(32) First, it is unknown whether such testing would be acceptable to pregnant women.They also argue that the health care workers' obligations to act in patients' best interests also mandate disclosure of HIV infection and, in some cases, restrictions on clinical activities.(15) Those who are against the federal policy argue that such disclosure or restrictions are inappropriate because they violate health care workers' privacy and because the risks to health care workers, for example from discrimination, far outweigh the benefits to patients, given that the risk of infection from a seropositive health care worker is very small.(15) Some have suggested that the federal policy should be revised in light of the data demonstrating that the risks of transmission in the health care setting are exceedingly low.(14)Because the physical risks are minimal, blood tests in the U. typically do not require extensive informed consent discussions, and consent often is implied rather than explicit.

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