Nie Jing-Bao, Walker Simon Thomas, Qiao Shan, Li Xiaoming, Tucker Joseph D
a Bioethics Centre, University of Otago , Dunedin 9016 , New Zealand.
b Department of Pediatrics , School of Medicine, Prevention Research Center, Wayne State University , Hutzel Building, Detroit MI 48201 , USA.
AIDS Care. 2015;27 Suppl 1(sup1):83-9. doi: 10.1080/09540121.2015.1071772.
Patients' rights are central in today's legislation and social policies related to health care, including HIV care, in not only Western countries but around the world. However, given obvious socio-cultural differences it is often asked how or to what extent patients' rights should be respected in non-Western societies such as China. In this paper, it is argued that the patients' rights framework is compatible with Chinese culture, and that from the perspective of contemporary patient rights healthcare providers have a duty to disclose truthfully the diagnosis and prognosis to their patients, that the Chinese cultural practice of involving families in care should - with consent from the patient - be promoted out of respect for patients' rights and well-being, and that healthcare providers should be prepared to address the issue of disclosing a patient's HIV status to sexual partner(s). Legally, the provider should be permitted to disclose without consent from the patient but not obliged to in all cases. The decision to do this should be taken with trained sensitivity to a range of ethically relevant considerations. Post-disclosure counseling or psychological support should be in place to address the concerns of potentially adverse consequences of provider-initiated disclosure and to maximize the psychosocial and medical benefits of the disclosure. There is an urgent need for healthcare providers to receive training in ethics and disclosure skills. This paper concludes also with some suggestions for improving the centerpiece Chinese legislation, State Council's "Regulations on AIDS Prevention and Control" (2006), to further safeguard the rights and well-being of HIV patients.
患者权利在当今与医疗保健（包括艾滋病护理）相关的立法和社会政策中处于核心地位，这不仅在西方国家如此，在全世界范围内亦是如此。然而，鉴于明显的社会文化差异，人们常常会问，在中国这样的非西方社会，患者权利应如何或在多大程度上得到尊重。本文认为，患者权利框架与中国文化是相容的，从当代患者权利的角度来看，医疗保健提供者有责任向患者如实披露诊断结果和预后情况；出于对患者权利和福祉的尊重，在征得患者同意的情况下，应推广中国让家属参与护理的文化习俗；医疗保健提供者应准备好解决向患者性伴侣披露其艾滋病病毒感染状况的问题。从法律上讲，提供者应被允许在未经患者同意的情况下进行披露，但并非在所有情况下都有义务这样做。做出这一决定时，应在对一系列伦理相关考量具备经过培训的敏感性的情况下进行。披露后应提供咨询或心理支持，以解决由提供者发起披露可能产生的不良后果方面的担忧，并最大限度地提高披露在心理社会和医疗方面的益处。医疗保健提供者迫切需要接受伦理和披露技巧方面的培训。本文最后还就完善中国的核心立法——国务院的《艾滋病防治条例》（2006年）提出了一些建议，以进一步保障艾滋病病毒感染者的权利和福祉。
