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China Discusses Medical Secrecy After Woman Infects Unaware Husband with HIV

The story of a young man being infected with HIV because he was unaware that his wife was HIV positive has made the headlines in China. Netizens discuss an ethical dilemma: should patient confidentiality override the safety of the partner?

Manya Koetse

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The story of a young man being infected with HIV because he was unaware that his wife was HIV positive has made the headlines in China. Netizens discuss an ethical dilemma: should patient confidentiality override the safety of the partner?

The news that Xiaoxin has HIV came as a bolt out of the blue. The young man from Henan Province is in the prime of his life and just got married. He was completely oblivious to the fact that his wife had been diagnosed with HIV. Now it is too late to take extra measures.

Xiaoxin’s case has become trending on Sina Weibo, where netizens are discussing an ethical dilemma: should the doctors have told Xiaoxin of his wife’s condition, or was it right for them to maintain professional secrecy?

 

“I lost all hope. I felt like my world was crumbling. I am still so young, what am I going to do?”

 

As reported by Legal Evening News (法制晚报), the young man Xiaoxin from Yongcheng, Henan Province, told his story on City TV this week.

In March of 2015, Xiaoxin was preparing to get married with his fiancee Xiaoxie. In order to get their marriage registration, they needed to do pre-marital health check-ups at the local hospital. The results of the check-ups came out quickly, Xiaoxin says, and although Xiaoxie was called into the doctor’s office for some time, the doctor later told him that everything was normal.

Three months later, when the couple was already married and living together, Xiaoxin, who was on a business trip, got the news from Xiaoxie that she had received a phone call from the Center for Disease Control (CDC) telling her that a confirmatory test came out positive for HIV and that he might have contracted it too – which later out turned out to be the case. Xiaoxin told City TV: “At that time I lost all hope. I felt like my world was crumbling. I am still so young, what am I going to do?”

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Xiaoxin tells City TV: “At that time I lost all hope. I felt like my world was crumbling. I am still so young, what am I going to do?”
According to the CDC, Mrs. Xiaoxie had since long known she had HIV; they have her records on file to prove it. The rapid pre-marital tests in March had also indicated that she was “likely to be HIV positive”. Xiaoxin’s name was written on top of the results cart, but he claims he never even saw those papers. His wife also claims that she did not know, and that she does not know why the hospital was not more clear to her when the results had come through in March. The question remains: who was hiding the truth, Xiaoxie or the CDC?

Xiaoxin is now suing the hospital for not disclosing the results of the pre-marital tests with him.

 

“What is more important, Xiaoxie’s right to medical secrecy, or Xiaoxin’s right to decide over his own life and health?”

 

Chinese media and netizens debate what is more important, Xiaoxie’s right to medical secrecy, or Xiaoxin’s right to decide over his own life and health?

According to experts, if Xiaoxie knew she had contracted HIV, she should have told her (future) husband herself. Medical staff and the CDC have professional confidentiality and are not allowed to inform others about her condition. Some experts and lawyers believe that this confidentiality, however, should not apply to those who live together with the patient and who can easily be infected, especially when it concerns their legal spouse.

Yunnan, Guangxi, and other provinces have already proposed a new law that gives local disease control departments the right to inform spouses or partners of AIDS or HIV patients of their condition, if the patient does not take the initiative to inform people themselves, Legal Evening News writes.

 

“Why don’t you attack the woman who concealed this?”

 

HIV/AIDS is a major problem in China. The most common form of HIV infection is through heterosexual transmission (46.5% in 2011), followed by injection drug use (28.4%) (Saag 2014, 329). According to HIV specialist Nitin Saksena, the number of young, predominantly gay men getting infected has also been growing at an alarming rate in 2015. Faltering sex education and unawareness about HIV are contributing factors to China’s HIV epidemic. Those living with HIV face serious social stigmas (also read our story on the 8-year-old with HIV who was banned from his village).

“This story neglects one thing,” a Weibo netizen comments on the case of Xiaoxin: “Which is that doctors are required to maintain the patient’s medical confidentiality. So shouldn’t the woman who concealed her condition be the one you attack? The law states that doctors need to protect their patient’s privacy, and it’s not like you cannot get married when you have AIDS. So before you start blaming doctors, you should first look at the whole picture.”

Sharing one’s HIV status is a personal choice, but in some countries it may also be a legal requirement. Some states in the US have laws that stipulate that HIV patients have to tell specific people about their diagnosis. In Australia, a man who was accused of inflicting HIV on another man appeared in court this month. He was charged with “recklessly inflicting grievous bodily harm”. In The Netherlands, three men were sentenced to prison (one of them for 12 years) in 2005 for deliberately infecting other men with HIV during private sex parties.

For doctors, keeping patients’ HIV status a secret from their (bed) partners is a medical duty, but sometimes also becomes a moral dilemma (also read: Should Doctors Keep Patients’ HIV Status a Secret?)

 

“If you don’t let him know, then what is the whole purpose of the pre-marital check-up?”

 

Weibo user Qiu Haihai says: “This belongs to the realm of personal privacy. The hospital has no obligation to tell others. If the man would break up with the woman because of it, and she commits suicide afterwards, her family would hold the hospital responsible.”

Another netizen remarks that the pre-marital health check-up is not an ordinary health check-up, but that it is a confirmation that both sides are healthy before they get married: “If you don’t let him know [about her HIV status], then what is the whole purpose of the pre-marital checkup?”

“The doctor did not just conceal information,” one person says: “He deceived him by saying everything was normal.”

“What a poor guy,” another commenter writes: “You might as well stay together and live in peace now. Take it easy, get medical treatment. Medical science is improving all the time. Maybe a miracle will happen. May Buddha bless you and lead you out of the shadows towards a healthy future.”

By Manya Koetse

References (if not stated here then they are linked through in-text)

Saag, Michael S. 2014. Updates in HIV and AIDS: Part I, An Issue of Infectious Disease Clinics. Birmingham: Elsevier.

©2016 Whatsonweibo. All rights reserved. Do not reproduce our content without permission – you can contact us at info@whatsonweibo.com.

Manya Koetse is the founder and editor-in-chief of whatsonweibo.com. She is a writer, public speaker, and researcher (Sinologist, MPhil) on social trends, digital developments, and new media in an ever-changing China, with a focus on Chinese society, pop culture, and gender issues. She shares her love for hotpot on hotpotambassador.com. Contact at manya@whatsonweibo.com, or follow on Twitter.

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  1. Avatar

    Nadia

    February 15, 2016 at 8:27 am

    May Jesus Christ have mercy on Xiaoxin for not knowing about his wifes HIV status.

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China and Covid19

Video Shows Real-Time “Departure” Information Board at Chinese Crematorium

From “cremation in process” to “cooling down,” the digital display shows the progress of the cremation to provide information to those waiting in the lobby. The crematorium ‘departure’ board strikes a chord with many.

Manya Koetse

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A video showing a live display screen announcing the names and status of the deceased at a Yunnan crematorium has been making its rounds on Chinese social media, from WeChat to Weibo, where one version of the video received over 1,7 million views.

Somewhat similar to a real-time platform departure display on train stations, the screen shows the waiting number of the deceased person, their name, gender, the name of the lounge/room (if any) for families, the name of the crematorium chamber, and the status of the cremation process. Below in the screen, it says “the final journey of a warm life” (温暖人生的最后旅程).

For example, the screen displays the names of a Mr. Chen and a Mr. Li; their bodies were in the process of being cremated (火化中), while other cremations were marked as “completed” (完成) or “cooling down” (降温中).

Through such a screen, located in the crematorium lobby, family members and loved ones can learn about the progress of the cremation of the deceased.

The video, recorded by a local on Jan. 7, received many comments. Among them, some people commented on the information board itself, while others simply expressed grief over those who died and the fragility of life. Many felt the display was confronting and it made them emotional.

“It makes me really sad that this how people’s lives end,” one commenter said, with another person replying that the display also shows you still need to wait in line even when you’re dead.

“I didn’t expect the screens [in the crematorium] to be like those in hospitals, where patients are waiting for their turn,” another Weibo user wrote. “It would be better if the names were hidden, like in the hospitals, to protect the privacy of the deceased,” another person replied.

Others shared their own experiences at funeral parlors also using such information screens.

Another ‘departure display’ at a Chinese crematorium, image shared by Weibo user.

“My grandfather passed away last September, and when we were at the undertaker’s, the display was also jumping from one name to the other and we could only comfort ourselves knowing that he was among those who lived a relatively long life.”

“Such a screen, it really makes me sad,” another commenter from Guangxi wrote, with others writing: “It’s distressing technology.”

Although the information screen at the crematorium is a novelty for many commenters, the phenomenon itself is not necessarily related to the Covid outbreak and the number of Covid-related deaths; some people share how they have seen them in crematoriums before, and funeral parlor businesses have used them to provide information to families since at least 2018.

According to an article published by Sohu News, more people – especially younger ones – have visited a funeral home for the first time in their lives recently due to the current Covid wave, also making it the first time for them to come across such a digital display.

The online video of such an information board has made an impact at a time when crematoriums are crowded and families report waiting for days to bury or cremate their loved ones, with especially a large number of elderly people dying due to Covid.

On Jan. 4, one social media user from Liaoning wrote:

I really suggest that the experts go to the crematoriums to take a look. There is no place to put the deceased, they’re parked outside in temporary containers, there’s no time left to hold a farewell ceremony and you can only directly cremate, and for those who were able to have a ceremony, they need to finish within ten minutes (..) At the funeral parlor’s big screen, there were eight names on every page, and there were ten pages for all the people in line that day, I stood there for half an hour and didn’t see the name of the person I was waiting for pop up anymore.”

As the video of the display in the crematorium travels around the internet, many commenters suggest that it is not necessarily the real-time ‘departure’ board itself that bothers them, but how it shows the harsh reality of death by listing the names of the deceased and their cremation status behind it. Perhaps it is the contrast between the technology of the digital display boards and the reality of the human vulnerability that it represents that strikes a chord with people.

One blogger who reposted the video on Jan. 13 wrote: “Life is short, cherish the present, let’s cherish what we have and love yourself, love your family, and love this world.” Among dozens of replies, some indicate that the video makes them feel uncomfortable.

Another commenter also wrote:

I just saw a video that showed an electronic display at a crematorium, rolling out the names of the deceased and the stage of the cremation. One name represents the ending of a life. And it just hit me, and my tears started flowing. I’m afraid of parting, I’m afraid of loss, I just want the people I love and who love me to stay by my side forever. I don’t want to leave. I’m afraid I’ll be alone one day, and that nobody will ever make me feel warm again.”

One person captured why the information board perhaps causes such unease: “The final moments that people still spent on this earth take place on the electronic screen in the memorial hall of the funeral home. Then, they are gone without a sound.”

 

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By Manya Koetse 
with contributions by Zilan Qian

Spotted a mistake or want to add something? Please let us know in comments below or email us. First-time commenters, please be patient – we will have to manually approve your comment before it appears.

©2023 Whatsonweibo. All rights reserved. Do not reproduce our content without permission – you can contact us at info@whatsonweibo.com.

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China and Covid19

Chinese Social Media Users Respond to Covid-Related Death Toll

While many commenters support Chinese authorities for providing data on Covid-related deaths, some questioning the accuracy were censored.

Manya Koetse

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On January 14, 2023, Chinese health authorities officially disclosed the number of Covid-related deaths between 8 December and 12 January. According to Jiao Yahui (焦雅辉), director of the National Health Commission’s Bureau of Medical Administration, a total of 59,938 Covid deaths were recorded. This number only covers Covid-related deaths in Chinese hospitals.

This is the first time China has given an exact number on the number of Covid-related deaths since the ending of its ‘zero Covid’ policy in December.

Earlier this month, Chinese official media stated that it is difficult to accurately assess the death rate during the early stages of an epidemic, and that an accurate assessment would later be made. The last report only recorded 37 deaths between December 7 and January 8.

According to Jiao Yahui, the death toll includes 5503 cases of death due to Covid-related respiratory failure, and 54,435 cases already had underlying medical conditions before getting Covid. The reported average age at the time of death was 80.3 years old, with the overall majority of patients (90.1%) being 65 and older. 56.5% were 80 years or older.

These statements were made during a press conference, where the peak of the current Covid outbreak was also discussed. On January 2, 2023, emergency departments across China saw a peak in visits – over 1,5 million emergency department visits in one day, – after which the number started to decline again. That downward trend was also visible in the number of hospitalizations of Covid patients, which peaked on January 5 of this year with more than 1,6 million patients hospitalized with Covid.

The top comments on Weibo, underneath a post about the death toll by state media outlet Xinhua, all spoke out in support of authorities releasing these numbers.

“It’s good to seek truth from facts, I hope the deceased can rest in peace and condolences to those left behind,” the most popular comment said, with another saying: “The country really did all they could and paid a high price to protect the largest number of people possible.”

“Open and transparent,” was another recurring reply within the comment section, which was controlled and only displayed the comments that were selected by Xinhua (“以下为博主精选评论”).

On TikTok (Douyin), the topic also attracted online discussions, with some threads less controlled than the Xinhua one, such as one underneath a post by the China Business Newspaper (华商报): “This number only counts hospital [deaths], there’s still those who died at home. I hope there’s no illness in heaven,” one Douyin user wrote, another one adding: “This data is not clear. Going back home to the countryside, the whole journey to the county town, there were really too many funerals.”

There were also many commenters sharing their own stories about loved ones they have lost. “This morning, my maternal grandfather passed away because of Covid, I no longer have a grandfather now, it’s so hard to bear.” “My grandfather died, he passed away at home,” others shared.

“Among these deaths is my husband, he was only 32 years old,” one woman wrote.

The fact that China’s recent data on Covid-related deaths only counts those patients who were hospitalized is something that is mentioned a lot by Chinese netizens, who suggest the actual number of deaths must be much higher if it would include those who died at home. Other comments also suggested that the number of deaths in the hospitals might also be underreported, asking for more clarifications on how these deaths had been counted.

This was something that was also reiterated by the well-known political commentator Hu Xijin (@胡锡进), who published a commentary on the issue on Saturday. He wrote that the recent numbers should be regarded as “incomplete statistics” (“不完全统计”) at a time when accurately counting the deaths in the midst of this Covid outbreak is very difficult. Authorities therefore only released the number of Covid-related hospital deaths in a “great effort to be objective.”

But the well-known blogger ‘Burn Superman Abao’ (@烧伤超人阿宝), a burn specialist at a Beijing hospital, suggested that the numbers do not make a lot of sense:

In 2021, we had a total of 36,570 hospitals in the entire country, including 3275 tertiary hospitals; 10,848 secondary hospitals; 12,649 primary hospitals; 9798 non-classified hospitals. During the epidemic, most hospitals fully opened and all departments treated patients with respiratory problems in order to take on this epidemic wave. What’s the concept of 60,000 Covid-related deaths in hospitals in over a month? If we assume all deaths occurred in secondary and tertiary hospitals and other hospitals had no deaths, then in five weeks’ time, every secondary or lower-level hospital in China only had an average number of 4 patients dying of Covid. In other words, on average, less than one patient per week per hospital dying of Covid.”

Later, the post was no longer online and his account was temporarily locked. On Sunday, the doctor wrote: “I won’t say anything else. I feel drained.”

Some also refuted Abao’s critique, saying that many tertiary hospitals in places such as Suzhou, Hangzhou or Hefei were not nearly as crowded as those in Beijing, Shanghai, or Guangzhou, and that his claims could not be backed up by data.

One Weibo user wondered: “Is it possible, 60,000? Actually, it is not difficult to count the number [of deaths] – the crematoriums have all the data.”

Besides the discussions on the accuracy of China’s Covid death toll, there are also many commenters who just want to express sympathies and grief over all the lives that are lost: “I just hope they can rest in peace.”

Read more about the end of China’s ‘zero Covid’ policy here.

By Manya Koetse, with contributions by Miranda Barnes

 

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