Machiavelli, I am very interested in the comments you have made about the HIV tests that were administered to Amanda in Capanne. I am going to take your word for it that you have information about these, and even may know who administered them.
I would suggest that if Andrea Vogt ever comes to her senses and decides to walk the straight and narrow, she could have the story of her career by doing an investigative piece just on the HIV testing of Amanda, as it represents possibly the most serious violation of Amanda Knox’s human rights as an inmate of a European prison. Maybe you could even share your records with her (wink wink nudge nudge).
At issue are these principles of medical ethics and standards of care: consent, confidentiality, counseling, equivalence of care, vulnerable patients, and the doctor in dual roles. Just for starters, here is a
list of potential violations:
- All HIV testing must be voluntary, confidential, and undertaken with the patient's consent.
- Patients have the right to decline the test. They should not be tested for HIV against their will, without their knowledge, without adequate information or without receiving their test results.
- Pre-test information and post-test counselling remain integral components of the HIV testing process.
- Patients should receive support to avoid potential negative consequences of knowing and disclosing their HIV status, such as discrimination or violence.
- Testing must be linked to appropriate HIV prevention, treatment, care, and support services.
- Decisions about HIV testing in health facilities should always be guided by what is in the best interests of the individual patient.
- Provider-initiated HIV testing and counselling is not, and should not be construed as, an endorsement of coercive or mandatory HIV testing.
- Implementation of provider-initiated HIV testing and counselling should be undertaken in consultation with key stakeholders, including civil society groups, acknowledging that what works and is ethical will inevitably differ across countries.
- When implementing provider-initiated HIV testing and counselling, equal efforts must be made to ensure that a supportive social, policy and legal framework is in place to maximize positive outcomes and minimize potential harms to patients.
- A system that monitors and evaluates the implementation and scale-up of provider-initiated testing and counselling should be developed and implemented concurrently.
Basically, the UNODC, UNAIDS and WHO
Policy Brief on HIV testing and counselling in prisons and other closed settings, recommends that medical professionals in prisons:
- "Unequivocally oppose mandatory testing or counselling:
- "Emphasize that regardless of whether HIV testing is client- or provider-initiated, it should always be voluntary." [page 1]
- ".….these mandatory or compulsory forms of HIV testing violate ethical principles and the basic rights of consent, privacy and bodily integrity. They are not necessary for the protection of prisoners, staff or visitors and cannot be justified from a public health perspective." [page 3]
There is a lot more where that came from. Here are some links to get her started on her research:
- Policy Brief: HIV Testing and Counselling in Prisons and Other Closed Settings (from the United Nations Office on Drugs and Crime (UNDOC); Joint United Nations Program on HIV/AIDS (UNAIDS; World Health Organization (WHO)
- European Standards on Confidentiality and Privacy in Health Care (from the EuroSOCAP Project, funded by the European Commission (2003-2006)
- Health in Prisons: A WHO Guide to the Essentials of Prison Health: 2. Standards in prison health: the prisoner as a patient -Andrew Coyle (from the WHO Regional Office for Europe)
- Health in Prisons: A WHO Guide to the Essentials of Prison Health: 7. HIV infection and human rights in prisons - Rick Lines (from the WHO Regional Office for Europe)
If Andrea doesn’t take the story, maybe someone else will. A lot of media consumers don't know their rights when it comes to health care, but people in the medical profession sure do. This would be of interest to a medical journal, no doubt. Quite a plum for a writer's resume.
Given the other violations of Amanda’s privacy in prison (men accompanying her to every doctor appointment and watching her physical exams), this is a women’s rights issue as well as a public health and prisoner’s rights issue.