Conflicts often exist when considering the rights of one person versus
those of another. This is especially so regarding HIV, where the right
of an infected person to keep his or her status confidential may interfere
with the right of a susceptible person to be informed of the infection
so as to avoid transmission. Invariably, public health officials are caught
in the middle trying to decide which of these rights has greater merit.
The conflict over rights is very apparent when it comes to mothers and
their offsprings, and issues of testing, disclosure and breastfeeding.
In a joint statement issued by six United Nations agencies (see "HIV and
infant feeding an interim statement" Weekly Epidemiological Record 71(39),
289-291, 1996), one sentence reads, "...it is mothers who are in the best
position to decide whether to breast-feed, particularly when they alone
may know their HIV status and wish to exercise their right to keep this
information confidential." That is, mothers who know they are HIV positive
may keep this information to themselves, and continue to breastfeed. The
sentence does not imply that the child has the right to avoid virus-laden
breast milk, or that the father has the right to participate in a decision
that may affect the welfare of his child. Instead it is the right of the
mother to keep her HIV status confidential that is given the higher consideration.
This apparent conflict seems even more evident when reading the UNICEF
Child Rights statement which all but a handful of nations have now signed
and ratified. Specifically, it states, "In all actions concerning children,
whether undertaken by public or private social welfare institutions, courts
of law, administrative authorities or legislative bodies, the best interests
of the child shall be a primary consideration" (Article 3, No. 1). The
statement goes on to say that the signing parties "recognize that every
child has the inherent right to life," (Article 6, No. 1) and that the
signing parties "shall ensure to the maximum extent possible the survival
and development of the child" (Article 6, No. 2).
By accepting the mother's
right to keep her HIV status confidential from her husband or from others
who might offer further guidance, the "best interests of the child" seems
not to be foremost. Perhaps others have opinions or insights on how this
apparent conflict between the rights of mother and child should be resolved
or are being addressed in their countries.