The resurgence of tuberculosis (TB) in the early 1990s, including multidrug-resistant strains, led health officials to recommend the use of involuntary detention for persistently nonadherent patients.
Using a series of recently published articles on the subject, this paper offers some opinions on how detention programs have balanced protection of the public's health with patients'civil liberties.
Detained persons are more likely than other TB patients to come from socially disadvantaged groups.
Health departments have generally used coercion appropriately, detaining patients as a last resort and providing them with due process.
Yet health officials still retain great authority to bypass « least restrictive alternatives » in certain cases and to detain noninfectious patients for months or years.
Misbehavior within institutions may inappropriately be used as a marker of future nonadherence with medications.
As rates of TB and attention to the disease again decline, forcible confinement of sick patients should be reserved for those persons who truly threaten the public's health.
Mots-clés Pascal : Tuberculose, Mycobactériose, Bactériose, Infection, Observance médicamenteuse, Homme, Traitement, Chimiothérapie, Antituberculeux, Efficacité traitement, Détention préventive, Ethique, Programme sanitaire, Exploration, Etats Unis, Amérique du Nord, Amérique, Antibiotique
Mots-clés Pascal anglais : Tuberculosis, Mycobacterial infection, Bacteriosis, Infection, Drug compliance, Human, Treatment, Chemotherapy, Antituberculous agent, Treatment efficiency, Imprisonment before trial, Ethics, Sanitary program, Exploration, United States, North America, America, Antibiotic
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 99-0108116
Code Inist : 002B05B02O. Création : 16/11/1999.