4273.0: Tuesday, October 23, 2001 - 5:30 PM

Abstract #22103

Ethics of preventive therapy: The case of tuberculosis

Chau Trinh, MS, Joseph L. Mailman School of Public Health Division of Sociomedical Sciences, Columbia University, 600 West 168th Street, New York, NY 10032, , cbt8@columbia.edu

For communicable diseases, ethical discourses have focused primarily on issues of treatment for active disease. Less attention has been placed on the ethics of preventive therapy. However, current strategies to eliminate tuberculosis have supported expansion of targeted testing of latent tuberculosis infection (LTBI) and resource allocation to vaccine development. For LTBI testing, many questions arise. Who should be tested? How often should testing occur? Should testing be mandated for certain populations and in what settings? Should incentives be provided? What are the consequences of such testing? Should those who test positive be provided treatment and, if so, do they have the right to decline treatment of LTBI? Similarly, other questions arise in the case of the administration of vaccines. Should vaccines be made available to all who are at-risk and, if so, in what context should vaccines be provided? In what situations, does the government have the authority to mandate vaccination and to whom? Furthermore, how do these issues evolve for the United States with a strong preventive health tradition that places emphasis on individual autonomy and responsibility to a global environment where infectious diseases are no longer confined by spatial or temporal boundaries? The intersection of ethics, law and public health on TB control and case study interviews of leading public health practitioners and policymakers in TB will be discussed to examine the ethics of preventive therapy within a global context as it pertains to urban communities in the United States.

Learning Objectives: At the conclusion of the session: 1) participants will be able to identify ethical principles 2) differentiate between public health ethics and law 3) apply ethical frameworks to evaluating current programs.

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

The 129th Annual Meeting of APHA