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The ethics of anonymised HIV testing of pregnant women: a reappraisal
  1. Paquita de Zulueta
  1. Imperial College School of Medicine, London

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    “Anonymised screening is a research tool to inform policy and practice and individual decision making, but is not a tool to identify those at risk that could directly benefit from intervention.”1

    The assumption that the information acquired will be used to prioritise health care resources may prove false. A government, after weighing up the costs and benefits, may choose not to adopt appropriate interventions. Or, even if a policy is proposed, (such as universal screening in areas of high prevalence), it may not be adhered to. Even as I write, antenatal clinics that serve populations with the highest concentration of refugees from sub-Saharan Africa, and therefore of those at risk, still do not have a policy of universal screening.

    Anonymised screening is a form of non-therapeutic research, and should comply with the Helsinki Declaration on Non-therapeutic Research involving Human Subjects. I have already argued that physicians who undertake anonymised screening have abrogated their duty, as outlined in article one, “ ... to remain the protector of the life and health of that person on whom biomedical research is being carried out”.2

    In addition, article four states: “In research on man, the interest of science and society should never take precedence over considerations related to the wellbeing of the subject.”2

    The desire for an outcome—perfect epidemiological figures—should not override the ethics of the process whereby this is achieved. The …

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    • Paquita de Zulueta, MBBChir, MA(Cantab), MRCP, MRCGP, MA(London) is a Part-time General Practitioner, and Lecturer at the St Mary's Campus, Imperial College School of Medicine, London.

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