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August 10, 2005

HIV Testing Without Consent in Critically Ill Patients

Author Affiliations

Author Affiliations: Department of Medicine, Center for Clinical Epidemiology and Biostatistics, Center for Education and Research on Therapeutics, and Center for Bioethics, University of Pennsylvania School of Medicine, Philadelphia.

JAMA. 2005;294(6):734-737. doi:10.1001/jama.294.6.734

Consider the following 3 newly admitted patients. The first patient has marked hypoxemia requiring mechanical ventilation and is found to have nonspecific, bilateral, alveolar infiltrates on chest radiography. The second patient has had a severe change in mental status and on brain imaging has an enhancing lesion exerting a mass effect. The third patient has high fevers, ventilator-dependent respiratory failure, and diffuse nodular infiltrates on chest radiography, with negative blood, urine, and sputum cultures after 48 hours.