Ethical issues of routine universal screening

Abstract

Few diseases have raised as many ethical questions as AIDS and HIV infection. One of these questions concerns the use of blood tests to identify individuals infected with HIV. Because there is no known cure for AIDS, most efforts today aim at reducing the number of cases through prevention of transmission. This fact sparked the debate over identifying HIV carriers. Fear of transmission throughout much of the population has led many to call for a universal routine screening to identify people who are seropositive for HIV and who therefore could transmit the virus to others. In this short presentation, the ethical issue concerning systematic screening of an entire population is purposely ignored because such a screening programme is hardly feasible and the costs of the operation are very high. I think that it is more appropriate to focus on the following two main issues: (a) an explanation of the set of general ethical guidelines that serve as a basis for all screening programmes, whether voluntary or mandatory; and (b) the application of these ethical principles to the issue of routine universal screening to specific groups in a hospital setting.