Ethical and Psychosocial Considerations in Informing HIV-Exposed Uninfected Children That They Were Exposed to HIV and Antiretroviral Medications In Utero.
We build on what is known about the potential long-term health effects of perinatal antiretroviral medication exposure to examine ethical and psychosocial issues associated with disclosure by applying lessons from other health conditions, theories of child and adolescent development and rights, and the relevant literature and legal contexts. We present 2 cases to highlight potential issues; apply a bioethical framework that includes principles of autonomy, beneficence, nonmaleficence, and justice; and explore other factors, including the current uncertainty about these exposures' possible long-term health risks. This ethical framework can help clinicians and researchers consider and balance relevant concerns in deciding whether to inform offspring of HIV and related exposures.
Robert Klitzman is with the Masters of Bioethics Program, Columbia University, New York, NY. Claude A. Mellins, Morgan M. Philbin, and Robert H. Remien are with the HIV Center for Clinical and Behavioral Studies and Department of Psychiatry, Columbia University and the New York State Psychiatric Institute, New York, NY. Elaine J. Abrams is with the Mailman School of Public Health, International Center for AIDS Care and Treatment Programs, Columbia University.
Robert
R
Klitzman
Robert Klitzman is with the Masters of Bioethics Program, Columbia University, New York, NY. Claude A. Mellins, Morgan M. Philbin, and Robert H. Remien are with the HIV Center for Clinical and Behavioral Studies and Department of Psychiatry, Columbia University and the New York State Psychiatric Institute, New York, NY. Elaine J. Abrams is with the Mailman School of Public Health, International Center for AIDS Care and Treatment Programs, Columbia University.
Claude A
CA
Mellins
Robert Klitzman is with the Masters of Bioethics Program, Columbia University, New York, NY. Claude A. Mellins, Morgan M. Philbin, and Robert H. Remien are with the HIV Center for Clinical and Behavioral Studies and Department of Psychiatry, Columbia University and the New York State Psychiatric Institute, New York, NY. Elaine J. Abrams is with the Mailman School of Public Health, International Center for AIDS Care and Treatment Programs, Columbia University.
Morgan M
MM
Philbin
Robert Klitzman is with the Masters of Bioethics Program, Columbia University, New York, NY. Claude A. Mellins, Morgan M. Philbin, and Robert H. Remien are with the HIV Center for Clinical and Behavioral Studies and Department of Psychiatry, Columbia University and the New York State Psychiatric Institute, New York, NY. Elaine J. Abrams is with the Mailman School of Public Health, International Center for AIDS Care and Treatment Programs, Columbia University.
Elaine J
EJ
Abrams
Robert Klitzman is with the Masters of Bioethics Program, Columbia University, New York, NY. Claude A. Mellins, Morgan M. Philbin, and Robert H. Remien are with the HIV Center for Clinical and Behavioral Studies and Department of Psychiatry, Columbia University and the New York State Psychiatric Institute, New York, NY. Elaine J. Abrams is with the Mailman School of Public Health, International Center for AIDS Care and Treatment Programs, Columbia University.
Robert H
RH
Remien
D044966:Anti-Retroviral Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D003219:Confidentiality; D030881:Disclosure; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000523:psychology; D020408:Health Insurance Portability and Accountability Act; D006801:Humans; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control; D009014:Morals; D026684:Personal Autonomy; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000188:drug therapy* / Q000523:psychology; D011297:Prenatal Exposure Delayed Effects / Q000188:drug therapy* / Q000523:psychology; D012935:Social Justice / Q000941:ethics / Q000523:psychology; D057545:Social Stigma; D014481:United States
D044966:Anti-Retroviral Agents