To think consent is required to do a HIV or hepatitis blood test??

Do I think that is best pratice ? No
Can I see how that could happen in a busy A&E ? absolutely.
Just for interest what is about BBV that requires specific consent ?
I would say something like " I am taling blood to check your liver, kidney and thyriod function" but other people may just say " routine bloods" which isn't wrong.

Similarly I tend to say " I am checking for hepatitis, hiv, syphylis, gonorrhoea, TB and chalmydia because thse infections can be asymptomatic and are easy to treat but I could just say I doing an infection screen. Again that wouldn't be wrong.

It is 15 years since I had a baby but they tested pregnant mothers for HIV as routine at that point. It is as much about keeping a track on how many have it, as much as it is about ensuring it isn't passed on to babies. Presumably it helps inform public health spending as well as clinical needs of different groups within the population.

As others have said unless there is a LPOA decisions are taken in best interests- it has been this way dor at least 10 years.

Well I can only speak from experience, and my family most definately were asked for permission to remove the breathing tubes and create a tracheotomy. This was a few years go granted, but if that is something else that has changed in recent years, then I find that worrying in terms of how the NHS is treating the concept of consent.

That is medically incorrect we never remove breathing tubes to check for responses. It's having a tube in that causes someone to gag when sedation is lightened that causes the response. You can remove a tubebwithousomeone having adequate tidal volumes, low enough oxygen requirements, ventilator support, good cough, and obeying commands

No treatment on icu do we ask permission to do. We seek the relatives opinions on what the patient may want. Never permission

That's a miscommunication on their part. We never ask permission to withdraw treatment, that is a medical decision and on us only (we would never want a family to feel responsible for their loved ones passing). We don't ask permission to do traches, we are more trying to determine the patients wishes via your thoughts on the matter (occasionally people would have predetermined wishes "never to be on a breathing machine" for eg. But again it's a medical decision, we are seeking your opinions but it's not asking permission. Noone but a power of attorney can consent on behalf of another outside of paeds

Well it is true that, unless they have Lasting Power of Attorney for Health and Welfare a relative cannot actually consent on behalf of someone who lacks capacity, and "next of kin" doesn't really have any legal basis. But, apart from in emergency circumstances, staff should make an effort to determine what the likely wishes of a patient who lacks capacity would be and that often involves speaking to family. Relatives shouldn't be made to feel that they are responsible for making major medical decisions but we should have a voice.
I honestly don't think I have met any doctors or other healthcare staff who don't genuinely believe they are acting in their patient's best interests but I have met quite a few who are poor communicators and who don't seem to have read the GMC guidance on decision making and consent or the Mental Capacity Act recently! But we digress...

It was disorienting when my baby was in NICU how little input I had into her care. I was barely even informed about, let alone asked for consent, as to what was taking place. In fact I was pretty much entirely irrelevant to the situation. The only thing I recall being asked for my consent about was what brand of formula they should give her 😂,

But what is being discussed is when that HIV test is done without consent being sought, using a get out clause that 'oh we have posters saying you must object if you don't want one'. That is not and should never be acceptable.

@MrsAvocet Thank you for the reply. It is worrying to me that some posters believe that Dr's have this sort of complete right to carry out certain things without outside consent from relatives or if an impasse is reached, somebody who is impartial deciding on it, ie the courts.

To be clear I tell patients when I am ordering an HIV test, but I couche it in terms of it being routine screening as it can be asymptomatic but have devastating consequences if untreated.

hence the reply to the person who was talking about patients who lack capacity. (and with insight that that's not what the thread was originally about, but attempting to clarify some of the nonsense that's being posted with a misguided tone of expertise)

Again… because your patients lack capacity!

Also to look at the post about medical staff making decisions without consent from next of kin. That is patently not the case or we wouldn't have had the circus with that boy who was clinically dead, but his mother had on life support for months with court cases.
It's quite complex @ARealitycheck
Doctors can make decisions in the best interests of patients who lack capacity but it is best practice to involve next of kin/other people who have a legitimate interest. Ultimately though, doctors make medical decisions. We had this with a relative who lacked capacity, with lots of "best interests meetings" involving the family, carers and various health professionals but it was the doctors who signed a special consent form for treatment, not us as next of kin. We came to agreement, which I imagine is the usual outcome in most cases, but if there is impasse then I think medical staff would generally seek a court order. It's rare though, which is why such cases hit the headlines. Legally doctors cannot be forced to provide futile treatment but of course there are sometimes differences of opinions even between specialists so legal intervention is sometimes needed, to protect all involved. But most of the time families and HCPs can come to a resolution without needing to involve lawyers.
Medical staff should be well trained in matters relating to consent and have a good understanding of the Mental Capacity Act, Deprivation of Liberty Safeguards and so on, but in my experience it is very variable.

Your view may well depend on your personal experience and employment as well as location. A London based Dr have a completely different experience of life than a farmer from Wales.

I didn't say I was terrified, but in the inital being told a person has aids/hiv. There most definately is the shock factor for many.

Also to look at the post about medical staff making decisions without consent from next of kin. That is patently not the case or we wouldn't have had the circus with that boy who was clinically dead, but his mother had on life support for months with court cases.

Unless you're going to demand a detailed breakdown, requiring individual consent for every other test ever carried out, it isn't bodily autonomy you are concerned about. It is prejudice. This is not like covid, it is not "forced" nor is entry to anywhere dependant upon having the test.

Sorry meant to quote this poster.

I am 48 I was 10 in 1986 yes I remember being terrified by Chernobyl and AIDS. But times change as I said up thread effective treatment for HIV has been around for 30 yrs. Yes it was a tragedy that all those young men in the West and 100,000s of women and children in the developing world lost their lives in the late '80s/ early 90s but those men would be in their 60s and 70's now. Even if you are the same age it has been a treatable condition for most of your adult life. To be so terrified of HIV in 2025 is anachronistic.

In your mind it is not a good reason. But for many people it remains a concern, and as I and everybody else has autonomy over our bodies, then it is something that should not be forced on people, even by implied consent.

Again using covid, remember the outcry about forced testing or vaccination cards to enter certain places. It was decided it was not ethically acceptable.

'removing breathing tubes to see if a patient will respond' is not a thing we do on ICU. The next of kin also doesn't consent to procedures unless they have POA for health and welfare. Their opinion is sought and given very heavy weight, however if a patient is incapacitated and doesn't have a POA set up/ hasn't expressed their wishes then decision is based on medical best interests.

Yes but that’s because your patients don’t have capacity!

I've been in the position as the relative of somebody in ICU and unable to give consent due to induced coma. The team caring for her most definately asked our permission to remove breathing tubes. As well as carrying out a tracheotomy to insert a breathing tube directly into the windpipe.

If you work in ICU, you must be used to the team asking next of kin to turn off the life saving machines when there is no hope. Without that permission depending on the wants of the family, you may need a court order to remove care.

Misconception is not a good reason not to test.

It was tongue in cheek, I've worked in icu for 5y.

No next of kin (except for minors) can consent to anything unless they have power of attorney for health. 95% of our decisions are best interest ones as very few people have poa

I suspect you wouldn’t have the same objection if they routinely tested for eg, meningitis, diabetes, lupus or whatever. But the stigma of conditions like HIV is where your issue lies. But that’s all they are, conditions.