What Is the Difference between an HIV and a CBC?

G.L. was a sixty‐seven‐year‐old woman transferred to a university medical center for evaluation of pancytopenia of two years' duration and the recent onset of jaundice. Her clinical presentation was characterized by generalized weakness, a strong history of tuberculosis exposure, transfusion of two units of blood five years ago, splenomegaly, hemolytic anemia, and an abnormal chest X‐ray. After several days of intense investigation, her underlying disease remained confusing to both her primary care physician and to several consulting physicians. While reviewing her hospital course, the attending physician noted that an HIV antibody test had been requested; results pending. The test had been ordered in light of G.L.'s blood transfusion five years earlier, when blood supplies were not being screened routinely for the presence of antibodies to the AIDS virus. Further discussion with the house staff participating in the patient's care revealed that no one had discussed ordering the HIV antibody test with her or told her that such a test was being performed, despite the fact that her mental status was completely normal. When queried about their behavior, the house staff responded that the HIV serology was medically indicated, and that blood samples are routinely drawn from hospitalized patients without obtaining specific consent for each test. Should hospitalized patients know, and give consent, before their HIV antibody status is determined?