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To the Editor: In his Commentary on human immunodeficiency virus (HIV) testing without consent in critically ill patients, Dr Halpern¹ reported on the current policies in the United States and presented arguments for and against nonconsented testing. No less important are the issues surrounding confidentiality after testing, not only when the patient becomes competent (as discussed in the article) but also and more frequently when the results of a positive nonconsented HIV test cannot be communicated due to persisting cognitive impairment.

Recently, our ethics committee was consulted regarding a critically ill patient who was admitted to the intensive care unit following a serious traumatic event. HIV testing was nonconsented due to the nature of the injuries and was positive. After discharge from the unit, there was concern regarding the timing of communicating this result, given the patient's slowly resolving cognitive impairment and the potential effects of prompt disclosure to the . . . [Full Text of this Article]

Virginio Bonito, MD; Maria Simonetta Spada, PsyD; Francesco Locati, MD
flocati@ospedaliriuniti.bergamo.it

Gianmariano Marchesi, MD; Marco Salmoiraghi, MD; Sandro Spinsanti, PsyD
Ospedali Riuniti di Bergamo
Bergamo, Italy

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