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HIV检测书面知情同意书的终结:并非轰轰烈烈而是悄然落幕。

The End of Written Informed Consent for HIV Testing: Not With a Bang but a Whimper.

作者信息

Bayer Ronald, Philbin Morgan, Remien Robert H

机构信息

Ronald Bayer is with the Center for the History and Ethics of Public Health, Mailman School of Public Health, Columbia University, New York, NY. Morgan Philbin is with the Department of Sociomedical Sciences, Mailman School of Public Health. Robert H. Remien is with the HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute, Columba University Medical Center, New York.

出版信息

Am J Public Health. 2017 Aug;107(8):1259-1265. doi: 10.2105/AJPH.2017.303819. Epub 2017 Jun 22.

Abstract

In 2014, only two states in the United States still mandated specific written informed consent for HIV testing and, after years of controversy, New York ended this requirement, leaving only Nebraska. New York's shift to opt-out testing meant that a singular feature of what had characterized the exceptionalism surrounding HIV testing was eliminated. We trace the history of debates on written informed consent nationally and in New York State. Over the years of dispute from when HIV testing was initiated in 1985 to 2014, the evidence about the benefits and burdens of written informed consent changed. Just as important was the transformation of the political configuration of HIV advocacy and funding, both nationwide and in New York State. What had for years been the subject of furious debate over what a rational and ethical screening policy required came to an end without the slightest public protest. (Am J Public Health. 2017;107:1259-1265. doi:10.2105/AJPH.2017.303819).

摘要

2014年,美国仅有两个州仍强制要求进行艾滋病病毒检测时提供特定的书面知情同意书,经过数年的争议,纽约取消了这一要求,只剩下内布拉斯加州。纽约转向选择退出式检测意味着,围绕艾滋病病毒检测的特殊性的一个独特特征被消除了。我们追溯了全国范围内以及纽约州关于书面知情同意书的辩论历史。从1985年艾滋病病毒检测开始到2014年的多年争议中,关于书面知情同意书的益处和负担的证据发生了变化。同样重要的是,全国范围内以及纽约州艾滋病倡导和资金的政治格局发生了转变。多年来关于合理且符合伦理的筛查政策要求的激烈辩论,在没有丝毫公众抗议的情况下结束了。(《美国公共卫生杂志》。2017年;107:1259 - 1265。doi:10.2105/AJPH.2017.303819)

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