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The importance of the right to privacy, when properly understood, cannot be underestimated. Privacy concerns raised by student groups have prompted University Health Services (UHS) to consider a plan to make its confidential HIV testing entirely anonymous. We strongly support this change and urge UHS to adopt it as soon as possible.
Under the status quo, the names of patients who receive HIV testing are recorded but kept confidential in their private medical files. The costs of these tests, along with similar tests for other viruses, are included in the mandatory health fee paid by every Harvard student.
UHS Director Dr. David S. Rosenthal '59, who said he has no objections to the new system, explained how it would work. "An anonymous policy of testing would be for a patient to come in, be assigned a number, have a test done and ask for the result [by] the number when they come back," he said. No record of the test would be kept in the student's medical file or elsewhere.
The major advantage to this proposal is that it eliminates the intimidation factor that is tied to the HIV test. According to members of AIDS Education and Outreach (AEO), Peer Contraceptive Counselors (PCC) and Contact, the current system may deter students who want and need HIV tests seeking them. Such students would like to receive an HIV test but fear having their names taken down--even for a supposedly confidential file. This possible intimidation is a serious problem. In this day and age, the need for more HIV testing is simply too important to be put at risk for no clear benefit.
The students who suffer from intimidation have good reason to be fearful. According to PCC Co-Chair Kyoko Okamura '96, insurance companies can find out whether prospective clients have received HIV tests, even if the test results themselves are kept confidential.
The fact that insurance companies can learn whether a patient had an HIV test raises a dangerous potentiality: the insurance company can interpret the mere fact that someone had an HIV test as a danger sign, an indicator that a prospective client leads a risky life that puts them in danger of contracting HIV. Simply having had an HIV test could then be held against someone seeking medical insurance.
Insurance companies have demonstrated their interest in such knowledge. Patients applying for medical insurance must sign waiver forms to reveal their medical records. Insurance companies would like to know whether or not applicants for insurance have received HIV tests; they see it as relevant to their assessment of the risk they would take on in insuring a given individual.
In this case, however, the resulting benefit to insurance companies may be outweighed by the possible harm. Giving information about HIV tests to insurance companies allows and even encourages them to penalize those people who have simply asked for the tests. Companies may then charge these individuals higher premiums or deny them coverage altogether.
Such a violation of privacy makes it possible for insurance companies to penalize people simply for demonstrating concern for their own health--which is what having an HIV test really demonstrates. Clearly the current system is an unfair one.
Beyond these pragmatic concerns, there is an important philosophical reason that also supports an anonymous system: the patient's right to privacy, an essential guarantee of individual freedom. Each person is entitled to a certain private space in his or her life into which no one else can intrude without permission. We can think of few things that would be more deeply personal and more deserving of privacy protections than a person's own health.
Recognizing the importance of privacy concerns, hospitals test all other viruses on an anonymous basis. We fail to see why HIV should be an exception to this rule. Hospitals have already recognized that anonymous testing is a good idea. Most hospitals carry out HIV testing in a procedure that assigns numbers rather than patient names to each test. Cambridge Hospital, Massachusetts General Hospital and the Fenway Community Health Center all carry out HIV testing on an anonymous basis.
Regardless of any logistical difficulties, UHS should catch up with the times, fall in line with its neighbors and adopt anonymous testing for HIV.
"I tell you that Indian guy had it all going on. Of course, that could have been because he was naked."
Candice Wilson, a participant in the 13th annual Book Fair and Romance Festival, referring to one of the scantily costumed contestants in the competition for Mr. Romance Cover Model of 1995.
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