Hiv Testing in Newborns

analytical Essay
2979 words
2979 words

This paper presents an ethical analysis of the mandatory newborn HIV testing law enacted in New York State. The law was passed as an effort to decrease maternal transmission of HIV, by treating infants born to HIV positive mothers immediately after birth with AZT. Newborn testing was promoted by the legislative and medical community following the overwhelmingly positive response from HIV infected pregnant women who were given AZT in the ACTG 076 clinical trials. Pregnant mothers who were given AZT had a markedly lower transmission rate than mothers who had not received it. This paper examines this newborn testing policy from a Utilitarian perspective to ascertain if the goals of the policy are feasible. The potential advantages, as well as the failures of using this policy are discussed. Implementations to improve the policy are also presented.

Ethical Dimensions of Mandatory HIV Testing of Newborns

in New York State: A Utilitarian Perspective

Description of Policy

In June of 1999 all hospitals in the state of New York were notified by the New York State Department of Health that beginning August first, 1999, a radical new approach to HIV screening was to be initiated. According to the policy, "for those women without prenatal HIV test results who decline HIV testing during delivery, hospitals are required to conduct expedited HIV testing of all newborns" (New York State Department of Health, June, 1999). This policy was the consequence of a heated debate in the legislature over the results of anonymous HIV screening performed on pregnant women in the state of New York (Cameron, 2002). New York State had been engaged in anonymous testing of newborns since the late 1980s, and this testing consistently reve...

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...d November 24, 2004, from

Turner, B. J., Newschaffer, C. J., Zhang, D., Fanning, T., & Hauck, W. W. (1999). Translating clinical trial results into practice. Annals of Internal Medicine, 130(12), 979-986.

West, H. R. (n.d.). Utilitarianism. Retrieved 11162004, from Encyclopedia Britannica Web Site:

Wolf, L. E., Lo, B., Beckerman, K. P., Dorenbaum, A., Kilpatrick, S. J., Weintrub, P. S., et al. (2001). When parents reject interventions to reduce postnatal human immunodeficiency virus transmission. Archives of Pediatric and Adolescent Medicine, 155(8), 927-933.

Zulueta, P de (2000). The ethics of anonymised HIV testing of pregnant women: a reappraisal . Journal of Medical Ethics, 26, 16-21.

In this essay, the author

  • Argues that the need of the community in public health may supercede the rights of individuals to maintain autonomy when granting that autonomy may contribute to the spread of hiv.
  • Explains that utilitarian theory can be perceived as permitting unethical acts in order to achieve goals. positive hiv testing leads to stigmatization, discrimination, and possible loss of housing or employment.
  • Presents an ethical analysis of the mandatory newborn hiv testing law enacted in new york state to decrease maternal transmission of hiv.
  • Explains the roots of utilitarian theory in ancient greece and frances hutchenson's theories. bentham drew from a plethora of theorists to formulate his theory of "philosophical radicalism."
  • Explains that utilitarianism determines the ethics of actions based on their overall good or bad consequences. the principle of utility dictates that the maximum benefit should be pursued in the realm of public policy and health care.
  • Explains that the new york state department of health initiated a radical new approach to hiv screening for women without prenatal hiv test results who decline hiv testing during delivery.
  • Explains that every mother who delivers a baby in the state of new york is affected by this policy.
  • Explains that the value of hiv testing for newborns is determined by the overall benefit of knowing the test results outweighs any harm that might come from that knowledge.
  • Argues that the utilitarian model of testing and treating all infants demonstrates a cost effective public health policy.
  • Explains that mandatory newborn testing may not serve the best interests of the infant who tests positive for hiv.
  • Opines that the medical community should build a community of trust that eliminates the need for mandatory testing.
  • Cites the american academy of pediatrics and american college of obstetricians and gynecologists' joint statement.
  • Cites the american nurses association's position statement on hiv testing.
  • Cites schultz, b. and newschaffer, c. j. turner, fanning, and hauck, w.
  • Cites wolf, l. e., lo, b, beckerman, k. p, dorenbaum, a, kilpatrick, s. j, weintrub, p.

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