tag:blogger.com,1999:blog-34437165.post3244714465434542854..comments2023-06-10T09:46:41.089-04:00Comments on Grade-One Gadfly: Gadfly takes requests, part I - HIV testing changesGadflyhttp://www.blogger.com/profile/16188819165408548771noreply@blogger.comBlogger3125tag:blogger.com,1999:blog-34437165.post-70613294909082998262006-09-27T19:33:00.000-04:002006-09-27T19:33:00.000-04:00Are you proposing mandatory AIDS testing as part o...Are you proposing mandatory AIDS testing as part of ordinary bloodwork, suggesting that it's a good idea for doctors to do it by default without the knowledge or consent of patients, or something else? Please keep in mind that most people in the United States are at extremely low probability of having HIV infection--it is transmitted primarily through specific identifiable risky activities. It doesn't make sense to do blanket testing of populations outside of those that engage in those activities, because even a highly accurate test will have more false positives than true positives for a population with a low baseline rate of infection. And the costs (especially opportunity costs) will outweigh the benefits. This is why states that required mandatory HIV testing for a marriage license discontinued the practice--it wasn't remotely cost effective to spend $1 million in testing to find one person with HIV.<br /><br />This is the same reason that it's a bad idea to do random drug testing of fifth graders--you'll end up making false accusations more frequently than you find drug users.Lippardhttps://www.blogger.com/profile/16826768452963498005noreply@blogger.comtag:blogger.com,1999:blog-34437165.post-498374474117186962006-09-25T10:49:00.000-04:002006-09-25T10:49:00.000-04:00Personally, I think anytime a person is potentiall...Personally, I think anytime a person is potentially infected in cases like that through their official capacity (e.g. police officers, ER doctors, paramedics), testing the potential source should be mandatory. I know that this is a privacy intrusion, but in this case other interests should control. Even things like freedom of speech have limits, such as the classic example of shouting "fire" in a crowded theater. In this limited case the health interest of the public servant should outweigh the privacy concerns of the other person.<br /><br />By the way, I'm putting aside how horrible a person one has to be to have potentially infected a doctor, etc. and then refuse to agree to be tested. Legalities aside, that is just something horrible and indefensible to do.Gadflyhttps://www.blogger.com/profile/16188819165408548771noreply@blogger.comtag:blogger.com,1999:blog-34437165.post-12498790742941366522006-09-23T20:05:00.000-04:002006-09-23T20:05:00.000-04:00Thanks!
One more scenario to put into the mix. D...Thanks!<br /><br />One more scenario to put into the mix. During the course of taking care of a person found passed out on a street corner, a ER physician is stuck with a contaminated needle. The patient cannot be tested for HIV without the patient's written consent. If consent was not obtained, the ER doc would be treated with HIV prophylaxis and then have to wait the several months to determing whether or not they were infected with HIV from the needlestick.<br /><br />Scary.Anonymousnoreply@blogger.com