Detention of Tuberculosis Patient Raises Serious Ethical Issues

27 year-old tuberculosis patient Robert Daniels, who has a drug resistant form of the contagious disease, is currently being held in Phoenix, Arizona in a hospital designed for prisoners. "Robert Daniels has been locked up indefinitely, perhaps for the rest of his life, since last July. But he has not been charged with a crime. Instead, he suffers from an extensively drug-resistant strain of tuberculosis, or XDR-TB. It is considered virtually untreatable." (MSNBC) His case is unusual, but it has caught national attention (even being discussed at length on Court TV) due to the moral, ethical, medical, and societal questions his situations raises.

Daniels's detainment resulted from a failure to wear a mask in public. "County health authorities obtained a court order to lock him up as a danger to the public because he failed to take precautions to avoid infecting others." (MSNBC) Daniel's situation is currently, rare; however, US health officials caution that such detainment may become more common in the future. As the US faces possible outbreaks of drug resistant tuberculosis, the avian flu, and a host of other potential catastrophic outbreaks, serious questions will have to be answered as to the rights of sick individuals, the public, and the role that the government will be able to play in prevention of an outbreak. While Daniel's case raises serious questions, public health officials are quick to point out that, at this point, his case is rare. They state that it takes a unique combination of an incurable, contagious disease, along with an uncooperative patient, in order to resort to legal means to take away an individual's civil liberties.

So what makes tuberculosis, in particular drug-resistant tuberculosis, a severe public health threat? According to Web MD, normal tuberculosis, which was epidemic in the 18th and 19th centuries, is treated with multiple antibiotics during a six to nine month period. If a patient doesn't complete the entire course of antibiotics, some TB bacteria may still be left in the lungs. The disease will then return in a drug resistant form. It is this form of the disease that is spreading across the world. It is contagious and represents a serious health threat. As for Robert Daniels, he is seeking his freedom. "Daniels plans to ask for his release at a court hearing late this month." (MSNBC) His predicament is a wakeup call for local public health authorities. It calls attention to the need for a comprehensive plan to deal with non-cooperative patients in the event of a pandemic.

Sources: MSNBC, Web MD