"It's 100% for me": hospital practitioners' perspectives on mandatory HIV testing.
This article explores the thinking of medical practitioners working in nine hospitals spread across five cities in India, on a contested subject--mandatory HIV testing of patients prior to surgery. We used in-depth interviews with practitioners and an interpretive analytical approach to understand their decisions to conduct mandatory tests. While many in the public health community see mandatory testing as an unacceptable violation of patient autonomy, the practitioners widely regarded it as a valuable cost-saving innovation for obviating transmission of infection during surgery. These conceptions are rooted in the day-to-day logic of practice which defines practitioners' actions--imperative of personal security, investment in core occupational roles and the importance of harmonious relations with co-workers. The experiences of hospitals with contrasting policies on mandatory HIV testing shows how an approach that balances patients' needs with an appreciation of practitioners' perspectives may result in more workable solutions for field-level ethical dilemmas.
Sheikh
Kabir
K
Health Policy Unit, London School of Hygiene and Tropical Medicine, 121 Sundar Nagar, New Delhi 110 003 India. kabir.sheikh@gmail.com
Porter
John D H
JD
D001291:Attitude of Health Personnel; D015658:HIV Infections / Q000517:prevention & control*; D006761:Hospitals; D006801:Humans; D007194:India; D017758:Infectious Disease Transmission, Patient-to-Professional / Q000517:prevention & control*; D018580:Mandatory Testing / Q000941:ethics; D016134:Organizational Policy; D010818:Practice Patterns, Physicians' / Q000941:ethics; D013514:Surgical Procedures, Operative