J Forensic Odontostomatol. 2013 Oct 1;31 Suppl 1:164-5.

Ethical and legal issues of HIV testing in the dental setting.

Naidoo S.

Author information

• Department of Community Dentistry, University of the Western Cape. South Africa.

Abstract

The emergence of the HIV/AIDS pandemic has challenged traditional ethical values of the health care profession. These include the infectious nature of HIV, the social stigma of the disease and its ethical and legal dilemmas. This poster presentation will address some of the pertinent questions related to HIV infection and AIDS. This presentation is structured around the following: autonomy and consent, confidentiality, disclosure, knowledge of patient and provider HIV status, the right to choose whom to treat, testing for HIV, and the importance of HIV policies in the workplace to guard against discrimination. The three broad principles of ethics, namely, autonomy, beneficence and justice, provide the basic framework on which this poster presentation is based. Biotechnology advances in the rapid oral fluid diagnostic testing particularly in the detection of HIV antibodies from patients in the dental setting have raised additional ethical and legal considerations for both research and clinical treatment and in the subsequent management of HIV infected patients to include disclosure of test results to the patient and proper referral to physicians or nurse practitioners. Dentists saw a major shift in their role as oral diagnosticians testing for HIV antibodies. That shift also necessitated an in-depth understanding of bioethical principles and their judicious application in clinical management. The oral health care worker must thus have a solid foundation in the application of bioethical principles. The principles of biomedical ethics from medical practice have now become even more important and need to be integrated into dental practice. Lack of understanding and the wrongful application of ethical principles may lead to patient harm and legal liability. 

Conclusion: The multifaceted challenge of the HIV/AIDS pandemic has had a profound effect in dental practice necessitating a re-examination and application of the concepts of ethics, responsibility, autonomy and justice. On a global scale it has raised moral concerns of social justice with regard to access to health care, basic human rights, the government's responsibility to care for its citizens, and the duty of beneficence of the developed towards the developing world. On a national level it has re-opened debates on issues of distributive justice and fairness. The understanding of bioethical principles and their judicious application should ensure that patients with HIV infection are justly treated commensurate with any patient who suffers from a chronic illness. Given the increasing numbers of people living with HIV worldwide, polices must be upheld and revised as needed to protect healthcare providers, patients, and society generally against stigma and discrimination.