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Commentary: Why we did not seek informed consent before testing patients for HIV

We agree completely with the Nuremberg code and the Helsinki declaration that informed consent is an essential prerequisite for medical research. However, we believe that there may be extraordinary circumstances when this right may be waived. We identify four crucial requirements that must be fulfilled before research without informed consent may be permitted.

1. It is impossible to obtain informed consent 

Eighty five per cent of admissions to our unit are emergency cases. These patients cannot give informed consent because they are critically ill. A second option is to obtain consent from a relative. In our study this would have resulted in two possible scenarios. Firstly, if the patient survived he or she could choose to be informed about the result of HIV testing and maintain the right to limited disclosure. But if the patient died the relative would have the right to know the result. This would be a serious breach of …