Department of Human Science and Medical Ethics, St. Bartholomew's and The Royal London School of Medicine and Dentistry, Queen Mary, University of London, London E1 2AD, UK
Address for correspondence: Professor Len Doyal, Department of Human Science and Medical Ethics, St. Bartholomew's and The Royal London School of Medicine and Dentistry, Queen Mary, University of London, Turner Street, London E1 2AD, U.K.
l.doyal{at}mds.qmw.ac.uk
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.
