A 32-year-old man is listed for elective inguinal hernia repair. The resident wants to send blood for HIV serology along with the routine pre-operative panel. As per NACO guidelines, the ethically and legally correct step is:

• A Test without informing the patient, since universal precautions make disclosure unnecessary
• B Obtain specific informed consent for HIV testing after pre-test counselling, separate from the general surgical consent ✓
• C Inform only the operating surgeon of a positive result and withhold it from the patient
• D Make HIV testing compulsory and record the result in the discharge summary without discussion

Explanation

HIV testing demands specific informed consent accompanied by pre-test and post-test counselling; the general consent for surgery does not cover it. Testing without consent is permitted only in two settings: anonymous unlinked sentinel surveillance and screening of donated blood. Withholding a positive result from the patient breaches his right to know, and compulsory undisclosed testing would itself constitute professional misconduct and a violation of his autonomy.

Reference: NACO Guidelines for HIV Testing, National AIDS Control Organisation ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.