title: 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.
authors.affiliation: a Bioethics Centre, University of Otago , Dunedin 9016 , New Zealand.
authors.forename: Jing-Bao
authors.initials: JB
authors.lastname: Nie
authors.affiliation: a Bioethics Centre, University of Otago , Dunedin 9016 , New Zealand.
authors.forename: Simon Thomas
authors.initials: ST
authors.lastname: Walker
authors.affiliation: b Department of Pediatrics , School of Medicine, Prevention Research Center, Wayne State University , Hutzel Building, Detroit MI 48201 , USA.
authors.forename: Shan
authors.initials: S
authors.lastname: Qiao
authors.affiliation: b Department of Pediatrics , School of Medicine, Prevention Research Center, Wayne State University , Hutzel Building, Detroit MI 48201 , USA.
authors.forename: Xiaoming
authors.initials: X
authors.lastname: Li
authors.affiliation: c London School of Hygiene and Tropical Medicine , Keppel St, London WC1E 7HT , UK.
authors.forename: Joseph D
authors.initials: JD
authors.lastname: Tucker
mesh_terms: D000328:Adult; D002648:Child; D002681:China; D003376:Counseling; D005190:Family; D005260:Female; D015658:HIV Infections / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D028701:Patient Rights; D010819:Physician's Role; D012747:Sexual Partners; D014342:Truth Disclosure
keywords: China; HIV disclosure; cultural differences; family; partner notification; patients’ rights; privacy