OLR Bill Analysis
AN ACT CONCERNING REVISIONS TO THE HIV TESTING CONSENT LAW.
This bill revises the law on consent for HIV-related testing. Specifically, the bill:
1. eliminates the requirement for separate, written or oral consent for HIV testing and instead allows general consent for the performance of medical procedures or tests to suffice;
2. clarifies that HIV testing is voluntary and that the patient can choose not to be tested;
3. eliminates the current requirement for extensive pre-test counseling for all HIV tests;
4. adds a requirement that an HIV test subject, when he or she receives a test result, be informed about medical services and local or community-based HIV/AIDS support services agencies; and
5. provides that a medical practitioner cannot be held liable for ordering an HIV test under general consent provisions.
EFFECTIVE DATE: July 1, 2009
GENERAL CONSENT FOR HIV TESTING
The bill specifies that a person who gives general consent for medical procedures and tests is not required to also sign or be presented with a specific informed consent form relating to procedures or tests to determine HIV infection or antibodies to HIV. “General consent,” under the bill, includes instruction to the patient that (1) as part of the medical procedures or tests, the patient may be tested for HIV and (2) such testing is voluntary and the patient can choose not to be tested for HIV or antibodies to HIV.
Under the bill, general consent that includes HIV-related testing must be given without undue inducement or any form of compulsion, fraud, deceit, duress, or other constraint or coercion. The medical record must document a patient's refusal of an HIV-related test.
PRE-TEST INFORMATION AND COUNSELING
Under current law, informed consent to an HIV-related test must include a statement to the individual that includes (1) an explanation of the test, including the meaning of results and the benefits of early diagnosis and medical intervention; (2) acknowledgement that consent is not a precondition to receiving care but refusal to consent may affect the provider's ability to diagnose and treat; (3) an explanation of the procedures to be followed, including that the test is voluntary, and a statement advising of the availability of anonymous testing; and (4) an explanation of the confidentiality protections given confidential HIV-related information.
Also under current law, prior to receiving informed consent, the person ordering the test must explain AIDS and HIV-related illness and provide information about behaviors posing a risk for transmitting HIV infection.
The bill eliminates the provisions of current law governing HIV-specific informed consent.
POST-TEST RESULT COUNSELING
Current law requires the person ordering an HIV-related test to provide the test subject or his or her authorized representative with counseling information when giving the test results. The bill specifies that such counseling initiatives are required as needed and also adds counseling about available medical services and local or community-based HIV/AIDS support services agencies.
The law requires counseling or referrals (1) for coping with the emotional consequences learning of the test result; (2) concerning discrimination the test result disclosure could cause; (3) on behavior changes to prevent transmitting or contracting HIV infection; (4) for informing the person of available treatments; (5) to work towards involving a minor's parents or guardian in decisions about medical treatment; and (6) concerning the need of the test subject to notify his or her partners and, as appropriate, provide assistance or referrals for assistance in notifying partners.
CDC HIV Testing Guidelines and Recommendations
In 2006, the federal Centers for Disease Control and Prevention (CDC) revised its HIV testing guidelines by recommending that separate written consent for HIV testing not be required for patients in all health care settings. Instead, general consent for medical care should be considered sufficient to encompass consent for HIV testing, according the CDC.
Public Health Committee