Published July, 2013

Perspectives on the ethical concerns and justifications of the 2006 Centers for Disease Control and Prevention HIV testing recommendations, Michael J. Waxman, Roland C. Merchant, M. Teresa Celada, and Melissa A. Clark, BMC Medical Ethics (2011)

This article summarizes perceived ethical merits and demerits of the Centers for Disease Control and Prevention (CDC)'s 2006 guidelines for HIV testing methods in U.S. clinical settings. While stating a continued commitment to "informed consent," the revised guidelines recommended an "opt-out" approach that eliminates explanations of the test and HIV, elimination of patient signatures to document consent, and optional as opposed to mandatory HIV prevention counseling. The recommendations were designed to encourage providers to increase HIV testing by eliminating the need to counsel and elicit consent that some doctors found burdensome. The article claimed that commentators "singled out harms or benefits" without weighing their relative costs and gains against each other, and attempted to objectively present these costs and benefits. Based on interviews with academics, members of advocacy groups, clinicians, policymakers, and researchers, the authors set forth common concerns and possible benefits regarding the changes, including possible loss of patient autonomy as well as increased rates of testing and early detection of HIV.