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A child whose mother dies must deal with very real fears of
separation, loss of love, and loneliness. This child not only lost her
mother but was forced to separate from her father. Her short life has
been overshadowed by the efforts of medical systems in two countries to
enforce choices for her care which her parents did not want. Her case
came to public attention when her parents did not want her to have an HIV
test, fearing that they would be pressured to give her antiretroviral
drugs and abandon breastfeeding. We understand that her father fought
hard to return to the UK, where he hoped to find medical care in sympathy
with his views.
It seems that the courts accept the assertions of doctors that there
is no possible question that the testing and treatments they prefer will
provide the girl with the best chance of healthier outcomes. Yet
questions still remain about the accuracy of HIV tests, the relative
benefits of the drugs and the balance of risks between the known
detrimental effects of formula feeding and the estimated risk of HIV
transmission through breastfeeding.
When there are so many unknowns in the equation, and the father is co
-operating with the authorities in the UK, it is troubling to read reports
such as yours in which he is said to be ‘refusing to allow her treatment’.
Our reading of the media reports indicate that he is choosing one sort of
treatment rather than another. You report that the child has been made a
ward of court and that doctors will now have the ultimate choice over her
treatment.
Surely we require a public debate about the relative harms involved
here. Given that the AIDS drugs are not a cure and have debilitating and
sometimes fatal side effects, are we really sure that such force is
justified in a case where the health outcomes of different choices are not
well studied and far from clear?
Magda Sachs, UK
David Crowe, Canada
Valerie McClain, USA AnotherLook at breastfeeding and hiv/aids
HIV and the Rights of Parents
A child whose mother dies must deal with very real fears of
separation, loss of love, and loneliness. This child not only lost her
mother but was forced to separate from her father. Her short life has
been overshadowed by the efforts of medical systems in two countries to
enforce choices for her care which her parents did not want. Her case
came to public attention when her parents did not want her to have an HIV
test, fearing that they would be pressured to give her antiretroviral
drugs and abandon breastfeeding. We understand that her father fought
hard to return to the UK, where he hoped to find medical care in sympathy
with his views.
It seems that the courts accept the assertions of doctors that there
is no possible question that the testing and treatments they prefer will
provide the girl with the best chance of healthier outcomes. Yet
questions still remain about the accuracy of HIV tests, the relative
benefits of the drugs and the balance of risks between the known
detrimental effects of formula feeding and the estimated risk of HIV
transmission through breastfeeding.
When there are so many unknowns in the equation, and the father is co
-operating with the authorities in the UK, it is troubling to read reports
such as yours in which he is said to be ‘refusing to allow her treatment’.
Our reading of the media reports indicate that he is choosing one sort of
treatment rather than another. You report that the child has been made a
ward of court and that doctors will now have the ultimate choice over her
treatment.
Surely we require a public debate about the relative harms involved
here. Given that the AIDS drugs are not a cure and have debilitating and
sometimes fatal side effects, are we really sure that such force is
justified in a case where the health outcomes of different choices are not
well studied and far from clear?
Magda Sachs, UK
David Crowe, Canada
Valerie McClain, USA
www.Anotherlook.org
Competing interests: No competing interests