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. 1993 May;83(5):649–654. doi: 10.2105/ajph.83.5.649

The dual epidemics of tuberculosis and AIDS: ethical and policy issues in screening and treatment.

R Bayer 1, N N Dubler 1, S Landesman 1
PMCID: PMC1694697  PMID: 8484443

Abstract

As the recent increase in cases of tuberculosis is addressed, there is a danger that the need for increased protection of the public health will create a climate in which the rights of individuals with tuberculosis and human immunodeficiency virus (HIV) infection may be disregarded. This paper considers ethical and policy issues in the control of tuberculosis. The authors conclude that mandatory HIV testing is not critical to effective tuberculosis control, and that although individuals infected with HIV are at increased risk for developing tuberculosis, exclusionary employment practices are not justified. Because failure to complete the course of tuberculosis treatment increases the prospect that drug-resistant strains will develop, it is crucial to require all those who commence treatment to complete their therapy. To ensure the completion of treatment, special attention must be paid to the needs of the homeless, drug users, and those with psychiatric impairments. In addition, all tuberculosis patients should begin their posthospital care under direct observation. Patients who fail to complete treatment despite efforts to encourage and facilitate their cooperation should be subject to confinement after a hearing with full due process protections.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

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