Ethical Conflicts in Mandatory HIV Testings among Mentally Ill Patients
Chakrabartty Arupkumar,I Srihari J.SII
Issues of mandatory HIV testings among mentally ill patients are potentially
debatable topic concerning the greater human rights of susceptible population
versus human rights of single suspected individual. It has hardly bothered policy
makers & service providers except few countries like US, Canada & Thailand.
There remains need of exhaustive discussion and social researches to come into
How did the issue emerge?
Two important events in early & late 1997 in New York City earned lot of
discussions on this issue.
New Jersey legislation recommending mandatory HIV testings as a routine
procedure for mentally ill patients, admitted into indoor of the hospital without
Another was the arrest of Nushawn Williams on cocaine case. He was HIV
positive and was diagnosed to be schizophrenic before being positive.1
These incidences attracted public concern about association between mental
illness and HIV status. They have not yet completely come with a uniform
established rule to solve the problem.
Priority Issues on HIV & Mental challenged patients
Prevalence of HIV among mentally ill patients
Studies done around 1987 in New York City in psychiatric settings suggest
that the prevalence rate ranges from 4.0% to 22.9%. Another study done for
patients who are both substance users and psychiatrically ill revealed the figure
to be around 23%. In 1996, in NY City nearly 1189 known HIV positive patients
were served in mental health systems who were seriously mentally ill. Risks of
infection among mentally ill patients are 8 times higher than the general
The service providers may underestimate risks of infection among these
mentally challenged patients. Even experienced clinicians may sometimes
mistakenly view people with serious mental illness, as asexual.1 While it is true