Moral problems in the use of coercion in dealing with nonadherence in the diagnosis and treatment of tuberculosis.
Coercion and detainment can be a morally acceptable strategy to fight the spread of tuberculosis, but these measures need to be placed into a much broader context than that of their short-term potential effectiveness. TB should be de-stigmatized by full acknowledgment that we all share the blame for its perpetuation. When coercion and detention are necessary, they should incorporate a strategy of optimum protection for minimum violation of autonomy. National and international health care programs should provide effective and nonthreatening treatments for TB and other related illnesses such as HIV and should develop policies to tackle the environmental causes of TB and provide support for vulnerable victims. Corporate pressures to continue world poverty must be undermined.
Doyal
L
L
Department of Human Science and Medical Ethics, St. Bartholomew's and The Royal London School of Medicine and Dentistry, Queen Mary, University of London, UK. l.doyal@mds.qmw.ac.uk
D002961:Civil Rights; D003068:Coercion; D006801:Humans; D016312:Treatment Refusal; D018088:Tuberculosis, Multidrug-Resistant / Q000523:psychology* / Q000628:therapy*