Legal considerations in screening pregnant women for human immunodeficiency virus, , ,

This article examines the legal implications of studies showing that the probability of maternal-to-infant human immunodeficiency virus transmission can be reduced by physician interventions. These interventions require knowledge of a pregnant woman’s human immunodeficiency status. Hence the offering of human immunodeficiency virus testing has become a standard of care in pregnancy. This standard of care is examined with respect to the following: (1) the physician’s legal duty to the infant, (2) negligence for failing to test, (3) liability when testing only reduces the probability of transmission, (4) damages, (5) informing women about the results of their testing, (6) protecting against liability, and (7) dealing with human immunodeficiency virus–infected pregnant women. It is concluded that the physicians are likely to have legal difficulties if a human immunodeficiency virus–infected baby is born to a woman who was not offered testing or if testing is done without documenting consent. Suggestions are made for reducing liability when testing is done, when patients refuse testing, and when one is caring for human immunodeficiency virus–infected women. (Am J Obstet Gynecol 1999;180:259-64.)