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In Reply: Dr Bonito and colleagues correctly point out that disclosure of HIV status to presently or previously incompetent patients can be difficult, that every effort should be made to ensure the confidentiality of this information, and that ethics consultations can assist clinicians in responding to challenging cases. However, in the case they describe, it is not clear why there was a rush to test a young trauma patient for HIV. Did the physicians caring for this patient think that an HIV test result could inform the diagnosis or usefully guide the acute management? Although it may be advisable to perform HIV testing for all patients in health care settings,¹ such testing should wait until the patient's competency is ensured unless it could influence the patient's immediate treatment.

If there was a clinical reason to perform the test immediately in this case, then physicians faced the difficult decision regarding whether . . . [Full Text of this Article]

Scott D. Halpern, MD, PhD, MBioethics
shalpern@cceb.med.upenn.edu
University of Pennsylvania School of Medicine
Philadelphia

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