HIV screening is a procedure that many countries have adopted the world over in a bid to get the necessary statistics to ensure effective detection and treatment of the virus. However, Mandatory HIV screenings is a radical measure that raises various moral and legal questions with regard to the need to protect the society and the duty to respect individual rights. There are various moral arguments that are aimed at supporting mandatory HIV screenings including paternalism, prevention of vertical transmission, and facilitation of behavior change.
Prevention of Vertical Transmission of the Virus
Mandatory HIV screenings during prenatal care are essential because they help to prevent the vertical transmission of the virus to the unborn children and give an opportunity to healthcare professionals to provide specialized care for the pregnant women. It is important to note that government has the moral duty to protect the unborn children from harm because the unborn also have rights. As such, the protection of the rights of the unborn should not be beyond the scope of human rights protection. Accordingly, even if the status of unborn children under the law may be controversial depending on the legal system, their needs are unique and require exceptional care, which is not possible unless the overall health of the mother is determined. Even though the international guidelines about medical research and clinical care require all healthcare professionals to abide by the principles relating to the respect of individual rights to autonomy, there is need to weigh those duties against the duty that these professionals have towards the unborn children. Failure to screen pregnant women trumps the rights of the unborn as well as the obligations that the health professionals have towards every child, whether born or unborn. Accordingly, the fact that abortion is illegal in many jurisdictions shows that it is the duty of the state to protect the rights of the unborn children. In the same breath, one can rightly argue that introduction of mandatory HIV screenings is part of the government efforts to protect the rights of the unborn. Ultimately, preventing further infection through mandatory screening helps to maximize the wellbeing of the citizens and the reduction of the HIV burden.
Paternalism
This refers to the moral duty for the government to intervene in the health of the individuals in a bid to promote public health by measuring the extent of the infection and developing the necessary policies for the purposes of controlling the spread of the disease. Whereas clinical medicine promotes the fiduciary duty between the medical practitioners and individuals, the scope of public health entails the moral obligation based on societal obligations to promote and protect the health of the entire population (Buchanan & Miller 729). As such, large-scale HIV screenings are important in the identification of the carriers of the virus for the purposes of providing them with the necessary education and training in order to ensure that they do not continue to spread the virus unabated. It is important to note that one of the most vital duties for any government is the duty to protect its citizens. In this regard, the mandatory form of screening is on the basis of the moral duty of the government towards the protection of health rights of its citizens (Areen 1079-1080). Governments have the moral duty to weigh the rights of the individual against the rights of the society and whenever the latter outweighs the former then the government must take the necessary steps to ensure that individual rights do not extinguish the rights of the society as a whole (Buchanan 15). Notably, mandatory screening is meant to improve the health of the society given that the government cannot and should never give preference to individual autonomy when the well-being of the entire society is under threat.
Facilitation of Behavior Change
Mandatory screening enables people to know their status and this usually enables individuals to change their behaviors accordingly. For instance, through proper guidance and counseling, a person who, through mandatory screening, realizes that he/she is HIV positive is likely to change their sexual behaviors knowing that they have a moral obligation not to spread the virus. Such knowledge is also important in assisting the infected person take better care of their body through eating properly and undergoing treatment to maintain their health. On the other hand, individuals who find that they do not have the HIV virus will continue to take care of themselves to ensure that they do not contract the disease and in so doing, the government will be able to prevent further spread of the virus (Obermeyer 1762).
Counter Argument
Mandatory HIV screening is morally wrong because it compromises the integrity of the healthcare system and only discourages people needing health services from accessing the healthcare facilities. As more people refuse to access health care services, the health of the society as a whole is compromised. As such, rather than hp in promoting the health of the entire society, mandatory screening leads to increased risks of infection. Accordingly, the discrimination and stigmatization of the people living with the HIV virus ensure that those who have reason to believe that they might be infected become afraid of undergoing the mandatory screening and do everything possible to avoid being subjected to the tests. Further, the mandatory screening gives false hope to the people who are at high risk of becoming infected. For instance, health care workers may decide not to use effective measures to protect themselves when caring for patients, while the clients visiting sex workers may also decide not to use protection because they believe that every prostitute has been tested and there is no likelihood of the government allowing infected persons to prostitute themselves. Accordingly, the mandatory screening programs are expensive and lead to the diversion of the resources from concentrating on preventive measures (World Health Organization 21). It is also important to note that the mandatory screening is usually a one-time test and therefore it is virtually impossible to identify individuals who are spreading the infection and those who are not. With regard to mandatory screening for the pregnant women, there are no guarantees that those found to be HIV positive will heed the advice of the health professionals and protect the unborn child. Accordingly, the stress and depression associated with HIV positive people may not contribute to the wellbeing of the unborn child. Ultimately, mandatory screening may assist in understanding the statistics regarding the percentage of the infected person but does little, if anything, to control the spread given that screening does not necessarily facilitate behavior change.
Aristotle’s virtual ethics postulates a society whose fundamental principles are base on virtues, that is, what is important to that particular society. For instance, liberty and justice are the values that are highly appreciated within the American society. As such, anyone observing these justice and liberty in his or her actions is deemed to have acted ethically. It is important to note that different societies have different values and that not all individuals or groups observe values that are similar to the mainstream. As such, Aristotle concludes that authorities should develop codes of ethics that seek to unite, guide and protect every individual, whether the individual belongs to a group or an organization and to protect the organization (NetCE). With regard to the foregoing, Aristotle ethics advocate for the protection of individual right and by extension protects the rights of the society. As such, Aristotle would not support mandatory HIV screening because the process tends to erode the rights of an individual. On the other hand, DW Ross moral theory is deontological, which means that in a fiduciary relationship there arises a prima facie duty to uphold confidentiality unless the duty is in conflict with another more essential duty (Cowan 1181). As such, Ross introduces a hierarchy of prima facie duties hence for a doctor there is duty to uphold the autonomy of the patient and the duty to protect the society. From Ross’ perspective, the doctor’s duty to uphold patient autonomy is imperative in the practice of medicine, but this duty is not absolute. In this regard, Ross would support mandatory HIV testing if it is geared towards protecting the society as a whole.
Conclusion
With regard to the foregoing, it is apparent that the issue of mandatory HIV screenings has become an emotive subject that requires thorough analysis before introducing the practice. While there are legitimate views regarding the mandatory screenings such as enhancing the ability of the government to put in place the necessary programs to curb the spread of the virus, there are also legitimate concerns regarding the disadvantages that such practice would bring about. It seems that the opinion regarding mandatory testing is sharply divided among scholars, as is the case with Aristotle and DW Ross and with each faction providing compelling evidence to support their arguments, there is no likelihood of reaching a definite conclusion on the matter, at least not in the near future.
Work Cited
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