Testing for HIV without permission.

A proposal has been made by R. Doll ("A proposal for doing prevalence studies of AIDS," British Medical Journal 1987 Feb 14; 294(6569): 244) to carry out anonymous screening for AIDS on blood samples taken in hospitals for other purposes. Gillon analyzes ethical objections to the proposal: (1) the testing--which constitutes nontherapeutic research--would be done without the patient's consent; and (2) patients could not be told whether they have HIV antibodies even if they wished to know. He denies that a patient who lets blood be taken for testing is giving implied consent for the use of that blood for purposes other than the patient's benefit. Included with his article is an inset "outline proposal for obtaining implied consent to prevalence studies for HIV antibody." It calls for leaflets to be given to patients explaining the research goal, the implications for the patient, and the fact that permission for such testing will be assumed unless explicitly withheld.