Whether, with whom, and when to have children are among the most precious of our private decisions. Increasingly, however, the interest of others in these decisions raise difficult questions about the role of government and health professionals in influencing reproductive choice. Nowhere is this tension felt more keenly than in the context of HIV and AIDS. This book takes on the tough issues related to HIV and childbearing: Is there a moral right to have children? What are the limits of persuasion? Are there constitutional constraints on interference with reproduction? What are the precedents with restricting the childbearing behavior of women who use drugs? The book includes original work by doctors, lawyers, ethicists, and public health professionals. Also included are the experiences of HIV-infected women and their health care providers. Interviews were conducted over a two-year period with HIV-infected women and with health care providers from four cities to examine what issues of childbearing in the context of HIV mean to them. The book is divided into four sections on medical and public health issues, legal issues, ethical and social issues, and comments from the community. It concludes with recommendations for clinical practice and public policy. Public policy makers, health care providers, practitioners in bioethics, pediatrics, health law, and obstetrics/gynecology will find this book invaluable when dealing with issues related to HIV and childbearing.

The proliferation of Acquired Immune Deficiency Syndrome (AIDS) among women and children represents one of the gravest health issues confronting contemporary society. Women, most of childbearing age, now constitute 11 percent of all cases, and the U.S. Public Health Service has projected over 3,000 cases of pediatric AIDS by the end of 1991. In the face of these sobering statistics, experts have been called upon to grapple with a difficult, compelling question: under what conditions, if any, should HIV testing of women and children be required? Also at issue are the surreptitious testing for HIV antibodies as part of routine prenatal and neonatal examinations, and whether such testing should be performed on all women and infants, or only those who belong to groups judged at "high risk." In this unique contribution to the debate about HIV screening and testing, Ruth Faden, Madison Powers, and Gail Geller have assembled perspectives from experts in public health, medicine, law, and ethics. Their wide-ranging treatment examines the history of prenatal and neonatal screening programs; informed consent; legal issues and confidentiality; reproductive decision-making; and numerous other aspects of HIV testing. Alternative policy options for both now and the future are discussed in detail. This volume provides a comprehensive analysis of these pressing medical, public health, legal, ethical, and social issues, and is essential reading for AIDS researchers and clinicians, public health specialists, ethicists, health policymakers and analysts, obstetricians, and pediatricians.

Clearly argued and written in nontechnical language, this book provides a definitive account of informed consent. It begins by presenting the analytic framework for reasoning about informed consent found in moral philosophy and law. The authors then review and interpret the history of informed consent in clinical medicine, research, and the courts. They argue that respect for autonomy has had a central role in the justification and function of informed consent requirements. Then they present a theory of the nature of informed consent that is based on an appreciation of its historical roots. An important contribution to a topic of current legal and ethical debate, this study is accessible to everyone with a serious interest in biomedical ethics, including physicians, philosophers, policy makers, religious ethicists, lawyers, and psychologists. This timely analysis makes a significant contribution to the debate about the rights of patients and subjects.