From "HIV testing without consent could come to Illinois" by Jeremy Manier, posted 4/30/07 at the chicagotribune.com
Doctors in Illinois may no longer have to get written consent from patients to give them HIV tests under a controversial state bill that's part of a national effort to make HIV testing more routine.
Supporters of the bill, which could come to a vote in the Illinois House this week, say it would give crucial knowledge to the estimated 10,000 Illinois residents who are infected with the virus that causes AIDS but don't know it. The initiative would enact new testing guidelines that the federal Centers for Disease Control and Prevention published last year in hopes of screening all patients between ages 13 and 64.
But the change in law also would require rescinding parts of Illinois' 20-year-old AIDS Confidentiality Act, which ensures that patients cannot get tested for HIV without their knowledge.
Tensions between patients' rights and public health priorities have made the bill a politically dicey subject.
After advocates from the AIDS Foundation of Chicago and the AIDS Legal Council of Chicago announced their opposition to the bill on Monday, officials with the Illinois Department of Public Health said they would try to modify the legislation. The officials said they would work with Rep. LaShawn Ford (D-Chicago), the bill's sponsor, to add language clarifying the need for counseling and verbal consent before patients get tested for HIV.
All medical procedures require some form of consent, but doctors do not have to get specific, written permission to do routine tests. Officials with the Centers for Disease Control said the new guidelines would make HIV testing a normal part of medical care, requiring no patient action beyond the general consent forms that patients sign at the start of most visits.
"You don't have to obtain written informed consent for any other blood test," said Dr. Bernard Branson, who helped write the center's HIV testing guidelines.
"When a procedure requires more risk, that's usually when you have to get something separate in writing," Branson said.
Removing that bureaucratic hurdle could expand the number of people getting tested. A study published last month in the Journal of the American Medical Association found that when San Francisco's public health system ended its requirement for written consent in 2006, more patients were tested and more of them tested positive for HIV.
Center officials said a change to Illinois' consent rules may be necessary if the state is to receive its share of $30 million in new federal money to support early HIV diagnosis programs.
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