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Ethical Issues in Hepatitis B Screening

Am J Dis Child. 1988;142(1):13. doi:10.1001/archpedi.1988.02150010019007.
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Sir.—Jenista and Chapman's1 recommendation to screen all Asian-born adopted children for hepatitis B fails to address important ethical issues. The identification of hepatitis B carrier state carries significant risk and no direct benefit to the adopted child. At present, there is no treatment for hepatitis B carrier state, nor is it possible to prevent or treat complications of hepatitis B.2 On the other hand, the hepatitis screening may cause significant psychosocial harm by stigmatizing individuals and ethnic groups.3 Foreign-born adopted children must deal with numerous psychological issues, but their identification as hepatitis carriers may be the most serious. Already, these children have been refused admission to day-care centers. Both of the children in Jenista and Chapman's study who were in nursery school were excluded after the results of the tests were known. The hysterical response to children with acquired immunodeficiency syndrome and their unjustified exclusion from


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