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  • Confidentiality, Consent and HIV Testing:Students’ View from Mainland China
  • Zhu Wei (bio)

Based on classroom discussion and brief interviews, we conclude that most of the people who are asked to share their opinion in this case insist that the best interest of the patient and his family should be considered first when it is in conflict with the patient’s autonomous right. Only a few of them believe the opposite should be done. They all agree that disclosure of information should happen as soon as possible. But they disagree on how to disclose the information and to whom it should be disclosed first.

I. Doctor’s Opinion

Doctor L: “The patient’s best interest must be prioritised.”

  1. 1. To answer the question whether or not the patient’s blood sample may be sent for testing without first notifying him, all I can say is that in mainland China it is not uncommon for doctors to do various kinds of testing for their patients as long as doctors find it necessary. In this Hong Kong case, since the decision to do HIV testing is a good one, and since it is in the interest of the patient, from my point of view as a doctor in mainland [End Page 417] China, they don’t have to obtain consent from the patient or his family before doing the test.

  2. 2. As for the optimal timing to disclose the patient’s condition, I would say the sooner the better. Such disclosure of information to the patien’s family can be done without consent from the patient, because the purpose is to protect the patient’s immediate family members. In our medical practice, we have had many cases where the patient’s syphillis testing is positive, and what we do is immediately notify the patient’s family without consent from anybody. In our understanding, since the law doesn’t prohibit this, it means we are allowed to notify the patient’s family.

II. Students’ Opinion

Student A: “Doctors should immediately disclose the patient’s condition.”

  1. 1. The patient is in a critical situation, and the top priority here is to save his life.

  2. 2. The patient has lost consciousness, and it is impossible to have his consent.

  3. 3. The patient’s wife may have been infected with HIV, and early disclosure of information could mean early treatment for patient’s wife.

Student B: “It is more important to protect the patient’s interest and benefit.”

  1. 1. Under normal circumstances, it is necessary and important to get the patient and his family’s consent before testing or disclosure of information.

  2. 2. In this case, it may be a violation of the patient’s autonomy to do blood sample testing without first acquiring his consent. But given the situation that the patient has lost consciousness and does not have the capacity to make an autonomous decision, the best thing the doctors can do is to protect the patient’s interest and benefit, and to notify the patient’s family.

Student C: “Informed consent is always a must.”

  1. 1. Whatever the nature of the test, disclosure of information to the patient and his family is always a must. In some cases, even when family members are not notified, the patient should have the right to know his own condition, the proposed treatment plan, and he should also have the right to [End Page 418] decide whether or not to accept the treatment plan. In this Hong Kong case, although the medical team is well-intentioned in what they do, they failed to get the patient’s consent.

  2. 2. As for the timing of disclosure, I think they should do it as soon as possible once they have got the patient’s consent. Though AIDS is still incurable, early diagnosis could help with the control of the condition and reduce the patient’s pain. It is true that in some cases, those with AIDS wouldn’t like their spouses or children to learn about the truth. When this happens, the medical staff should communicate with the patient and try to seek his consent before disclosing the information. The medical staff must not, out of fear of not...

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