Mandatory HIV testing - Page 6

[rayo de sol]

This movie looks really interesting.

House of Numbers

[soso-lynn]

Originally Posted by rayo de sol

This movie looks really interesting.

House of Numbers

Ok, so science is biased and cannot be trusted yet a documentary with a bunch of out-of-context quotes and interviews with lunatics that ends up doing nothing more than showing that those lunatics exist should be proof that HIV is not real? I have seen this and can assure you that in no way does it advances your argument.

[Sorin]

I almost hesitate to dip my toe into this discussion, but it was on my mind because I just had a conversation with my midwife yesterday on this exact issue. I have been tested for HIV, HepB, and will be tested for HepC at my next visit. I have absolutely no problem with it, and I understand the reasons behind it. I want to have a waterbirth, and my status is necessary for my care providers to know to even make a waterbirth possible at the hospital where I am delivering. As we know, birth is a messy business, perhaps a bit more so in a tub (at least in terms of bodily fluids floating around instead of being wiped/whisked away!) Knowing that I am negative makes a waterbirth for me possible, as they will not allow (whoops! There's that dreaded word!) a woman who is positive for any of the above diseases to have a waterbirth. This is a policy in place for the protection of the care providers, and I understand it. Why should they take my word for it that I am negative when it comes to the protection of their own health? Poke me, draw some blood, test it, prove that I'm negative, and let's get rolling on this waterbirth.

I also understand the need for state mandated testing. We live in a society, and we (the people, the government, ect.--fit whatever "we" you want to in here) have an obligation to take care of the citizens in that society. You know that saying, "Your right to swing your fist ends when it hits my nose?" To me, state mandated HIV testing is the same thing. I absolutely have the right to refuse to be tested in 99.9% of all situations. BUT, when I became pregnant, it is just not about me anymore. There is a baby to think about. There are care providers to think about. I can argue to high heaven about my 0% risk, but the fact is that people lie. People are unaware of what really constitutes risk. People are deceived. If I have to "succumb" to mandated testing so that a doc or midwife can catch an unsuspecting woman who turns out to be HIV+ despite the fact that she truly believed that her partner was faithful and then move to help her give birth to a healthy baby and get treatment for herself so that she can go on to live a long and fulfilling life, then go ahead and stick me. I'm part of this society and care about all members in it. I have to get a license to drive a car. I have to register to vote. I have to obtain a degree to do my particular job, and I have to get an HIV test to give birth within the US medical system. I do not have a problem with any of these scenarios.

[MiaMama]

Originally Posted by MegBoz

OK, then education is the key here - educating people on the fact that you can get HIV other ways besides sex, blood transfusions & needle-drug use. There you go. That's the solution! Education & allowing people to make their own healthcare decisions.

Incidentally, I've also had "blood-borne pathogen" training. If I was exposed to the blood of a stranger, I'd get the HIV test. & I do think it's wise for a healthcare professional, such as nurse of EMT to get tested, as well as perhaps to get the Heb B vax. But DH & I work behind computers all day. Neither of us has ever encountered any strange blood! It's not part of our lives.

I totally agree that education is key.
For example, the CDC has documented cases of people aquiring HIV from their dentist and acupuncturist. It is very very rare, but I would be hard pressed to say I am 100% sure that there is no way I have been exposed. Maybe 99.999%?

I also agree that people should be able to make thier own healthcare decisions.

[nudnik]

What I think is the main issue here is not the testing, it's the treatment. If you are tested positive (or "maybe" positive), you can be forced into treatment you don't want. If you refuse to be tested, your baby can be forced into treatment you don't want.

Personally, I have no problem getting another test if they're drawing blood anyhow. Same with the PKU. It's information that could only help, right? It's the way they react to the test that worries me. If PKUs led to lots of babies being taken away from their mothers or drugs being forced on them, I might rethink that too.

[soso-lynn]

Originally Posted by nudnik

What I think is the main issue here is not the testing, it's the treatment. If you are tested positive (or "maybe" positive), you can be forced into treatment you don't want. If you refuse to be tested, your baby can be forced into treatment you don't want.

Personally, I have no problem getting another test if they're drawing blood anyhow. Same with the PKU. It's information that could only help, right? It's the way they react to the test that worries me. If PKUs led to lots of babies being taken away from their mothers or drugs being forced on them, I might rethink that too.

If you were HIV positive, would you really refuse treatment to prevent transmission? I think the number of people who actually refuse treatment after reviewing the available data and actually being diagnosed with HIV is way too low to even be significant. Within the community of people with HIV, it is widely agreed that the medical care that can prevent transmission to the baby has completely changed the lives of many HIV-positive women who now have the choice to become mothers despite their condition.

There are so many other situations where treatment would potentially be "forced" if parents refused it. Overall, if there is a significant risk to the baby that can easily be avoided, very few people would think it is acceptable to not do anything. I am pretty sure that if the PKU test showed an abnormality that was later confirmed, refusing treatment would not go over too well with doctors and potentially with judges. Or, if your baby needs oxygen at birth, your refusal would likely be ignored as well. If you're positive for gonorrhea while pregnant, refusing treatment would probably not be an option. If your child is choking on something at school, the certainly would disregard any orders you would give to let the child die. To me, those things do not even lead to a debate over freedom and such as it is so obvious that treatment is important and people just don't refuse unless they are severely miseducated on the facts.

[MegBoz]

Originally Posted by Sorin

I also understand the need for state mandated testing. We live in a society, and we (the people, the government, ect.--fit whatever "we" you want to in here) have an obligation to take care of the citizens in that society. You know that saying, "Your right to swing your fist ends when it hits my nose?" To me, state mandated HIV testing is the same thing. I absolutely have the right to refuse to be tested in 99.9% of all situations. BUT, when I became pregnant, it is just not about me anymore. There is a baby to think about.
<snip>
I'm part of this society and care about all members in it. I have to get a license to drive a car. I have to register to vote. I have to obtain a degree to do my particular job, and I have to get an HIV test to give birth within the US medical system. I do not have a problem with any of these scenarios.

Bolding mine.
These sentiments make me
If your HCP says, "I won't attend your waterbirth unless you are tested," well, that is the HCPs right & I fully support it! If that is how they feel, & how they choose to practice, that is their right.

But your points about a baby... uh... you make it sound as if protecting my baby is the responsibility of the government! & that's what makes me . No, it's up to me - the mama! Yeah, if I'm proven to be criminally endangering my child, then the state should save him (i.e. take him from me), but health care decisions, within reason, are mine to make. & not testing for everything under the sun is, to me, within reason* - therefore I don't want the government butting in & mandating that I test.
*Note I do think it's good to be tested, but I also think it is "within reason" to refuse.

Again, the sentiment that "The government/society has an obligation to care for the citizens" as justification for legally mandated testing can SO EASILY be extended to legally mandating ALL KINDS of healthcare! Remember, there have been rare cases were the law was used to FORCE women into unwanted repeat c-sections! (The OBs genuinely thought VBAC was way too dangerous of a risk to put a baby through!) And as we all know, many, many HCPs think it's a "needless risk" to forgo or even delay vaccines.

Why do you all think it's OK to legally mandate this one particular piece of healthcare practice & not others? Why also do you not think that this opens the door to more & more legal requirements of healthcare practices?

As for the statement that, "I don't mind, go ahead & stick me." I've posted it before & I'll post it again - whenever I get PG with #2, I plan to have an HB & if my MW says, "Yeah, I know, it's a 1 in a million shot that you have HIV, but I really just prefer you test for it." I'll say "OK, no problem!" It's not the testing itself I'm fighting against on this thread, it's using THE LAW to force ANY healthcare decision that I'm opposed to.

(OK, imminent death exempted here, such as choking, that's a "life & death issue" rather than a 'health care practice' issue.)