Truth-telling to the patient, family, and the sexual partner: a rights approach to the role of healthcare providers in adult HIV disclosure in China

Abstract

Patients’ rights are central in today’s legislation and social policies related to health care, including HIV care, in not only Western countries but around the world. However, given obvious socio-cultural differences it is often asked how or to what extent patients’ rights should be respected in non-Western societies such as China. In this paper, it is argued that the patients’ rights framework is compatible with Chinese culture, and that from the perspective of contemporary patient rights healthcare providers have a duty to disclose truthfully the diagnosis and prognosis to their patients, that the Chinese cultural practice of involving families in care should – with consent from the patient – be promoted out of respect for patients’ rights and well-being, and that healthcare providers should be prepared to address the issue of disclosing a patient’s HIV status to sexual partner(s). Legally, the provider should be permitted to disclose without consent from the patient but not obliged to in all cases. The decision to do this should be taken with trained sensitivity to a range of ethically relevant considerations. Post-disclosure counseling or psychological support should be in place to address the concerns of potentially adverse consequences of provider-initiated disclosure and to maximize the psychosocial and medical benefits of the disclosure. There is an urgent need for healthcare providers to receive training in ethics and disclosure skills. This paper concludes also with some suggestions for improving the centerpiece Chinese legislation, State Council’s “Regulations on AIDS Prevention and Control” (2006), to further safeguard the rights and well-being of HIV patients.

Crowdsourced partner services among men who have sex with men living with HIV: A pilot randomized controlled trial in China

“…[4] China's AIDS Prevention and Control legislation states that PLWH have a duty to inform sexual partner(s) of the diagnosis in an honest and timely manner. [5] Yet, conventional HIV PS using referral cards have made it difficult for healthcare professionals to encourage newly diagnosed patients to disclose to their sexual partners and have their partners present at HIV testing clinics [6], and the uptake of HIV PS remains low in China [7]. Stigma, privacy concerns, and worries about possible negative consequences discourage MSM PS service uptake.…”

Disclosure of maternal HIV infection to children among Chinese women with HIV: The application of the Theory of Planned Behaviour and the role of various norms

“…In addition, healthcare professionals play an important role in assisting patients in planning and conducting HIV status disclosure. In China, there is a lack of proper policy and training for healthcare professionals in supporting individuals with HIV in performing the disclosure, which was evidenced by studies showing that some healthcare professionals disclosed the patients’ HIV status to their family members or close friends before the patient in China (Chen et al, ; Nie, Walker, Qiao, Li, & Tucker, ).…”