HIV Programmes and Advocacy, International AIDS Society, Avenue de France 23, 1202, Genève, Switzerland.
University of Hertfordshire, Hatfield, Hertfordshire, AL10 9AB, UK.
J Bioeth Inq. 2022 Jun;19(2):239-254. doi: 10.1007/s11673-022-10169-9. Epub 2022 Feb 24.
In recent times, informed consent has been adopted worldwide as a cornerstone to ensure autonomy during HIV testing. However, there are still ongoing debates on whether the edifice on which informed consent requirements are grounded, that is, personal autonomy, is philosophically, morally, and practically sound, especially in countries where HIV is an epidemic and/or may have a different ontological perspective or lived reality. This study explores the views of participants from Zambia. In-depth and focus group discussions were conducted at various locations in Lusaka and Chongwe, Zambia. Participants came from various demographics, including people living with HIV (PLHIV), healthcare professionals and workers, policymakers, pregnant women, churchgoers, teachers, rural-based persons, and police officers. Data were manually analysed by conducting inductive and deductive thematic analyses. Results show that participants were not in favour of HIV policies that promote personal autonomy at the expense of pursuit of the common good. Participants viewed interdependence, not autonomy, as an essential characteristic of being human. The participants' views have a realistic potential to provide a contextual and appropriate ethical, respectful, and realistic foundation for HIV testing policies.
最近,知情同意已在全球范围内被采用,作为确保 HIV 检测期间自主性的基石。然而,对于知情同意要求所依据的基础,即个人自主性,在哲学、道德和实践上是否合理,仍在进行持续的辩论,尤其是在 HIV 流行且/或可能具有不同本体论观点或现实生活的国家。本研究探讨了来自赞比亚的参与者的观点。在赞比亚的卢萨卡和 Chongwe 各地的不同地点进行了深入的和焦点小组讨论。参与者来自不同的人群,包括 HIV 感染者(PLHIV)、医疗保健专业人员和工作者、政策制定者、孕妇、信徒、教师、农村居民和警察。通过进行归纳和演绎主题分析对手动分析数据。结果表明,参与者不赞成以牺牲追求共同利益为代价来推行促进个人自主性的 HIV 政策。参与者认为相互依存,而不是自主性,是人类的一个基本特征。参与者的观点具有现实的潜力,可以为 HIV 检测政策提供一个切合实际、尊重和现实的伦理、尊重和现实的基础。