TY - JOUR
T1 - Human immunodeficiency virus and assisted reproduction
T2 - Reconsidering evidence, reframing ethics
AU - Drapkin Lyerly, Anne
AU - Anderson, Jean
N1 - Funding Information:
Dr. Anne Drapkin Lyerly is supported by a grant from the Greenwall Foundation.
PY - 2001
Y1 - 2001
N2 - Objective: To review the advances in the treatment of human immunodeficiency virus (HIV) infection and revisit the medical, ethical, and legal issues surrounding infertility management in HIV-infected couples. Design: Analytic review. Result(s): HIV infection continues to be a serious public health and reproductive issue. However, present policies which allow for the categorical exclusion of HIV-infected individuals from infertility services should be reconsidered in light of improvements in the prognosis of infected individuals and a dramatic decrease in the risk of vertical transmission. An analysis of the ethical cogency of the arguments against the provision of services does not substantiate the exclusion of HIV-infected individuals; rather, the principle of justice requires that HIV-infected women be treated the same way as a woman who might have an increased risk of conceiving a child with a disability or a may have a decreased life expectancy due to a chronic illness such as diabetes. Ethical disagreement notwithstanding, with the precedents recently established by the Americans with Disabilities Act (ADA), discrimination based on HIV status would also likely be unlawful under most circumstances. Conclusion(s): With advances in the treatment of HIV infection, contextualized counseling and a respect for patients' decisions regarding infertility treatment should be adopted as public policy. It is neither ethically nor legally justifiable to categorically exclude individuals from infertility services on the basis of HIV infection.
AB - Objective: To review the advances in the treatment of human immunodeficiency virus (HIV) infection and revisit the medical, ethical, and legal issues surrounding infertility management in HIV-infected couples. Design: Analytic review. Result(s): HIV infection continues to be a serious public health and reproductive issue. However, present policies which allow for the categorical exclusion of HIV-infected individuals from infertility services should be reconsidered in light of improvements in the prognosis of infected individuals and a dramatic decrease in the risk of vertical transmission. An analysis of the ethical cogency of the arguments against the provision of services does not substantiate the exclusion of HIV-infected individuals; rather, the principle of justice requires that HIV-infected women be treated the same way as a woman who might have an increased risk of conceiving a child with a disability or a may have a decreased life expectancy due to a chronic illness such as diabetes. Ethical disagreement notwithstanding, with the precedents recently established by the Americans with Disabilities Act (ADA), discrimination based on HIV status would also likely be unlawful under most circumstances. Conclusion(s): With advances in the treatment of HIV infection, contextualized counseling and a respect for patients' decisions regarding infertility treatment should be adopted as public policy. It is neither ethically nor legally justifiable to categorically exclude individuals from infertility services on the basis of HIV infection.
KW - AIDS
KW - Americans with Disabilities Act
KW - Ethics
KW - HIV
KW - Infertility
KW - Reproduction
KW - Women
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U2 - 10.1016/S0015-0282(01)01700-9
DO - 10.1016/S0015-0282(01)01700-9
M3 - Review article
C2 - 11334892
AN - SCOPUS:0035042209
SN - 0015-0282
VL - 75
SP - 843
EP - 858
JO - Fertility and sterility
JF - Fertility and sterility
IS - 5
ER -