Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về ngành y học đề tài: HIV disclosure to surrogate decision makers: privacy versus presumption. | Available online http content 11 3 416 Letter HIV disclosure to surrogate decision makers privacy versus presumption Jason P Lott School of Medicine University of Pennsylvania Stemmier Hall 3450 Hamilton Walk Philadelphia Pennsylvania 19104 USA Corresponding author Jason P Lott lottj@ Published 5 June 2007 Critical Care 2007 11 416 doi cc5927 This article is online at http content 11 3 416 2007 BioMed Central Ltd See related commentary by Vernillo et al. http content 11 2 125 In their recent commentary Vernillo and coworkers 1 argue that disclosure of a critically ill patient s HIV status to a surrogate is appropriate when necessary for the surrogate to make decisions that reflect the patient s values and interests or when failure to disclose poses direct and foreseeable risks to the surrogate. Although few would disagree with the latter precept the ethical and legal permissibility of the former is less obvious 2 . Dispensing with patient confidentiality under the rubric of beneficence does not guarantee preferable end-of-life outcomes. Even if the emotional impact of this disclosure has minimal influence on surrogates decision making abilities they are ceteris paribus left no better informed of their loved one s wishes than before. HIV-infected patients may have various rational reasons for refusing to disclose their seropositivity or declining antiretroviral treatment which are unlikely to be easily divined by most critical care teams. What is known about many of these patients is that they have chosen to keep their HIV status confidential often at great sacrifice. Surmising that they favor the timely withdrawal of painful or futile interventions -precisely when these patients can no longer speak for themselves - both begs the question and stretches the bounds of human inference. The authors proposed framework for disclosing privileged information risks positing knowledge of patients attitudes and .
