[An investigation into the obtainment of informed consent for HIV-tests in psychiatric patients]

AIDS confronts the psychiatrist with the dilemma of stress resulting from a positive test result on the one hand and the responsibility of preventing the spread of the disease on the other hand. Psychiatric disturbances sometimes limit a patient's ability to give informed consent, which is an ethical precondition to testing. The legal standards of informed consent are discussed. During the 6-month period after the first HIV-positive test at Weskoppies Hospital, a further 48 patients were tested; 42 were examined to test the obtaining of informed consent. Diagnoses, reasons for testing and results were noted. Comprehension of the nature of the illness and the implications of the test were examined in a structured clinical interview. The nature of consent and the feedback of the result to the patient were examined. Results indicate that the psychiatric disturbance is a poor indication of the ability to give informed consent. The latter should be evaluated separately. If informed consent cannot be obtained, the patient should be treated as positive until accountability has been restored. Written consent offers the patient the opportunity to assimilate written information and contributes to informed consent. AIDS remains a problem of education and the feedback of seronegativity will help to curb future high-risk behaviour.