{"id":2786,"date":"2014-06-07T09:31:50","date_gmt":"2014-06-07T08:31:50","guid":{"rendered":"https:\/\/blogs.bmj.com\/medical-ethics\/?p=2786"},"modified":"2014-06-07T12:37:59","modified_gmt":"2014-06-07T11:37:59","slug":"intentionally-exposing-patients-to-hiv-when-might-it-be-ethical","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/medical-ethics\/2014\/06\/07\/intentionally-exposing-patients-to-hiv-when-might-it-be-ethical\/","title":{"rendered":"Intentionally Exposing Patients to HIV: When Might it be Ethical?"},"content":{"rendered":"<p><strong>Guest Post by\u00a0Bram Wispelwey, Ari Zivotofsky, and Alan Jotkowitz<\/strong><\/p>\n<p>Much has been made of the fact that over the last two decades HIV has transformed from an inevitable, agonising killer into a controllable chronic disease. \u00a0But have we reached a point where infecting someone with HIV in order to avoid other, potentially worse health outcomes might be justified? \u00a0In the realm of organ transplantation we found that if we are not yet there, perhaps we should be.<\/p>\n<p><span style=\"text-decoration: underline;color: #0000ff\"><a href=\"http:\/\/jme.bmj.com\/content\/early\/2014\/06\/04\/medethics-2014-102027.short\"><span style=\"color: #0000ff;text-decoration: underline\">Our paper<\/span><\/a><\/span> was in part inspired by what many considered a shocking ruling by former Israeli Chief Rabbi Eliyahu Bakshi-Doron, <span style=\"text-decoration: underline;color: #0000ff\"><a href=\"http:\/\/www.ynetnews.com\/articles\/0,7340,L-4376611,00.html\"><span style=\"color: #0000ff;text-decoration: underline\">who decreed that it was consistent with Jewish religious law<\/span><\/a><\/span> for HIV-negative individuals to receive HIV-positive organ transplants, even if the evidence indicates a possibility for the recipient to contract the disease. \u00a0Many considered this opinion premature because only recently had HIV-positive individuals been found to be <span style=\"text-decoration: underline\"><span style=\"color: #0000ff\"><a href=\"http:\/\/www.aidsmeds.com\/articles\/hiv_liver_kidney_transplant_2636_20841.shtml\"><span style=\"color: #0000ff;text-decoration: underline\">good candidates for solid organ transplantation<\/span><\/a><\/span><\/span>, and doctors in South Africa were still in the early research stages of examining kidney transplantation <span style=\"text-decoration: underline;color: #0000ff\"><a href=\"http:\/\/www.samj.org.za\/index.php\/samj\/article\/view\/5754\/4236\"><span style=\"color: #0000ff;text-decoration: underline\">between HIV-positive individuals<\/span><\/a><\/span>.\u00a0 But in examining the ethical considerations of autonomy, beneficence, non-maleficence, and justice, we argue in our paper that Rabbi Bakshi-Doron\u2019s opinion is ethically sound.<\/p>\n<p>Focusing on the history of HIV in transplantation and using a comparison to current practice with regard to another infectious disease, cytomegalovirus, we demonstrate that disallowing HIV-negative candidates from receiving HIV-positive organs would be a significant limit on patient autonomy. \u00a0The elimination of the ban on this type of potentially life-saving (and improving) donation may also represent a more socially just option, as it would expand the donor pool and engender cost savings. <span style=\"text-decoration: underline\"><span style=\"color: #0000ff\"><a href=\"http:\/\/www.nature.com\/news\/united-states-to-allow-transplants-of-hiv-infected-organs-1.14170\"><span style=\"color: #0000ff;text-decoration: underline\">HIV-positive to HIV-positive donation will soon be a reality<\/span><\/a><\/span><\/span> in several countries; it\u2019s time to think about going one step further.<\/p>\n<p>&nbsp;<\/p>\n<p><em>Read the full paper <span style=\"text-decoration: underline\"><span style=\"color: #0000ff\"><a href=\"http:\/\/jme.bmj.com\/content\/early\/2014\/06\/04\/medethics-2014-102027.short\"><span style=\"color: #0000ff;text-decoration: underline\">here<\/span><\/a><\/span><\/span>.<\/em><!--TrendMD v2.4.8--><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Guest Post by\u00a0Bram Wispelwey, Ari Zivotofsky, and Alan Jotkowitz Much has been made of the fact that over the last two decades HIV has transformed from an inevitable, agonising killer into a controllable chronic disease. \u00a0But have we reached a point where infecting someone with HIV in order to avoid other, potentially worse health outcomes [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/blogs.bmj.com\/medical-ethics\/2014\/06\/07\/intentionally-exposing-patients-to-hiv-when-might-it-be-ethical\/\">Read More&#8230;<\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[968,2153,443,591,2144],"tags":[],"class_list":["post-2786","post","type-post","status-publish","format-standard","hentry","category-clinical-ethics","category-guest-post","category-jme","category-life-and-death","category-organ-donation"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.5 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Intentionally Exposing Patients to HIV: When Might it be Ethical?  - Journal of Medical Ethics blog<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/blogs.bmj.com\/medical-ethics\/2014\/06\/07\/intentionally-exposing-patients-to-hiv-when-might-it-be-ethical\/\" \/>\n<meta property=\"og:locale\" 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