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AJPH First Look, published online ahead of print Jul 16, 2008
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September 2008, Vol 98, No. 9 | American Journal of Public Health 1545
© 2008 American Public Health Association
DOI: 10.2105/AJPH.2008.142703

LETTER

GOLDMAN ET AL. RESPOND

Janlori Goldman, JD, Sydney Kinnear, BA, Jeannie Chung, BA and David J. Rothman, PhD

Janlori Goldman is with the Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, NY, and the Health Privacy Project, Center for Democracy and Technology, Washington, DC. Sydney Kinnear is with the Center on Medicine as a Profession (CMAP), College of Physicians and Surgeons, Co-lumbia University, New York, NY. Jeannie Chung is a first year law student at Brooklyn Law School, Brooklyn, NY. David J. Rothman is with the College of Physicians and Surgeons and the Institute on Medicine as a Profession, Columbia University, New York.

Correspondence: Requests for reprints should be sent to David J. Rothman, Institute on Medicine as a Profession, College of Physicians and Surgeons, Columbia University, 630 West 168th Street, P&S Box 11, New York, NY 10032 (e-mail: djr5{at}colubmia.edu).

We address the larger points about diabetes surveillance and written informed consent for HIV testing in our response to New York City Health Department Commissioner Thomas R. Frieden. More specifically, in response to Das-Douglas et al., we believe that written consent for HIV testing is not a barrier to routine testing. Rather, it is an essential safeguard ensuring that physicians will fully discuss the procedure, its consequences (in particular, possible discrimination), and alternatives (in particular, anonymous testing) with patients. Without this safeguard, there is no way to guarantee, in overwhelmed health care settings, that oral consent is obtained or that patients are given or read through relevant materials. In fact, the New York City Health and Hospitals Corporation increased the number of patients tested by 63% in 2006 while maintaining written informed consent and made significant increases in subsequent years.1,2

Further, we believe it is unwise to base conclusions on the statement that no adverse consequences of eliminating written consent have been reported. It is unlikely that patients who were unknowingly tested, whose results were accidentally communicated to family members without permission, or who were not prepared to deal with the results of such a life-changing test would come forward and share their outrage, discrimination, family strain, or emotional turmoil with their medical care provider. The lack of reporting does not prove that no adverse consequences exist.

Footnotes

Contributors
All authors conceptualized ideas and wrote and revised drafts of the letter.

Accepted for publication May 6, 2008.

References

1. NYC Health and Hospitals Corporation. New York City Public Hospitals Expand HIV Testing [press release]; 2006. Available at: http://www.nyc.gov/html/hhc/html/pressroom/press-release-20061003.shtml. Accessed May 9, 2008.

2. NYC Health and Hospitals Corporation. Speaker Quinn Announces Rapid HIV Testing Expansion [press release]; 2008. Available at: www.nyc.gov/html/hhc/html/pressroom/press-release-20080329.shtml. Accessed May 9, 2008.





This Article
Right arrow Extract Freely available
Right arrow Full Text (PDF)
Right arrow All Versions of this Article:
AJPH.2008.142703v1
98/9/1545    most recent
Right arrow Submit a response
Right arrow purchase articles
Right arrow View Shopping Cart
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Similar articles in this journal
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Right arrow Get other permissions
Citing Articles
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Goldman, J.
Right arrow Articles by Rothman, D. J.
Right arrow Search for Related Content
PubMed
Right arrow Articles by Goldman, J.
Right arrow Articles by Rothman, D. J.
Related Collections
Right arrow Diabetes
Right arrow Health Policy
Right arrow HIV/AIDS
Right arrow Public Health Practice

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