Important note: Information in this article was accurate in 2000. The state of the art may have changed since the publication date.
Bangkok Post - August 20, 2000
Aphaluck Bhatiasevi
The guidelines will be considered by the Medical Council's administrative committee, said Vichai Chokeviwat, a member of the drafting committee.
The main points of the guidelines spell out rights of patients with HIV/Aids, children born to them, and doctors dealing with them.
Issues heavily debated on include the level of necessity in making patients have their blood tested, the right to survival of children born to HIV-positive mothers and the responsibility of doctors to keep their patients' medical records secret.
The first point of the guidelines states that doctors should not deny treatment to patients due to their HIV status.
The second states that doctors can convince patients into having the test, but it should be done only on a voluntary basis and the results should not affect the treatments they are to receive.
Nimit Thienudom, director of Access, an Aids counselling centre, said doctors can advise patients to have their blood tested, but they should not be pushed into it unless it is necessary for their treatment.
Representing a network of people with HIV/Aids in Thailand, Paisal Tan-ud said learning about their HIV positive status was like a "death penalty" for most patients, for it completely changes their lives.
"To have one's blood tested for HIV is therefore not that easy," he said.
The third point of the guidelines states the importance of pre-test counselling.
The fourth emphasises written consent from the individual to have an HIV test. Dr Chaiyaporn Rojanasirivej of Bamrasnaradura hospital said the rate of suicide attempts at the hospital among patients with HIV/Aids has been successfully reduced as compared to the past 2-3 years, due to effective pre- and post-test counselling.
"With standardised counselling, our patients have begun to accept themselves more and are even willing to reveal their identity," he said.
The fifth point states that all pregnant women should willingly undergo an HIV test as soon as possible, in order to protect their babies from infection.
Chulalongkorn hospital paediatrician Usa Thisyakorn said pregnant women should be convinced into having the test and informed of all possible alternatives they can choose from to protect their babies from HIV infection.
Medical law expert Vitoon Ungpraphan said the mother's life should come before the infant's.
But in cases where a mother's life is not affected by the blood test, the pregnant woman should be made to undergo the test to give the foetus the right to be protected from HIV.
The sixth point states that in case a medical staff member is accidentally exposed to the blood of a patient, the patient should be made to undergo a blood test in order to provide necessary treatment for the staff.
Kanokwan Tharawan of the Population Council said patients should not be made to suffer by being forced into a blood test, just for the satisfaction of the medical staff.
She said the state should be prepared to spend on anti-retroviral drugs like AZT, which are given to hospital staff accidentally exposed to blood which may be HIV-contaminated.
Dr Vinai Rattanasuwan of Siriraj hospital said that every year 70-80 staff at the hospital accidentally come in contact with blood of patients which could be HIV-positive.
He said the hospital has to spend between 20,000-30,000 baht in providing their staff with anti-Aids drugs.
The seventh point states that it is advisable that all rape victims undergo a blood test because they risk HIV infection.
The eighth point states that doctors should keep their patient's HIV status a secret and though it is important for their partners to know their status, the decision on whether to inform their spouse or not should remain with the patient.
Regarding the rights of medical professionals, the guidelines state that doctors who know that they risk HIV infection should undergo blood tests and those identified as HIV-positive should not be allowed to treat patients as they could further spread the infection.
Regarding the practice towards infants with HIV/Aids, the guidelines urge doctors to inform parents of ways to care for the children, so that they know about ways to deal with waste contaminated with the virus.
Dr Vichai said though the guidelines cannot force people in other professions to abide by the requirements, doctors will be made responsible for making staff under their supervision follow the guidelines.
000820
BP000802
Copyright © 2000 - The Bangkok Post. Reproduction of this article (other than one copy for personal reference) must be cleared through the Bangkok Post.
AEGiS is a 501(c)3, not-for-profit, tax-exempt, educational corporation. AEGiS is made possible through unrestricted funding from Broadway Cares/Equity Fights AIDS, Elton John AIDS Foundation, the National Library of Medicine, Pacific Life Foundation and donations from users like you.
Always watch for outdated information. This article first appeared in 2000. This material is designed to support, not replace, the relationship that exists between you and your doctor.
AEGiS presents published material, reprinted with permission and neither endorses nor opposes any material. All information contained on this website, including information relating to health conditions, products, and treatments, is for informational purposes only. It is often presented in summary or aggregate form. It is not meant to be a substitute for the advice provided by your own physician or other medical professionals. Always discuss treatment options with a doctor who specializes in treating HIV.
Copyright ©1980, 2000. AEGiS. All materials appearing on AEGiS are protected by copyright as a collective work or compilation under U.S. copyright and other laws and are the property of AEGiS, or the party credited as the provider of the content. .