Question

M. tuberculosis causes tuberculosis.

Would you expect it to be harder to treat a TB infection when the bacterium is in latent form? Why?

And an ethics question:   A patient is infected with the extremely drug resistant form of TB refuses to follow doctor's orders - he still plans to go out to dinner, fly on airplane, etc. Is it ok to put that patient in jail until the treatment is effective?

Answer 1

In this case the person should remain alert to symptoms of active tuberculosis for the rest of his/her life.

And even after completing the full course of medication, there is no guarantee that the tuberculosis bacteria have all been killed.

In second case:

If the patient is infected with the extremely drug resistant form of TB, and he refuses the advice of doctor, then it’s a serious issue as:

• Drug-resistant forms of TB can develop if treatment is incorrect or incomplete, and it is very fatal.
• In this stage bacteria that are resistant to treatment with at least two of the most powerful first-line anti-TB medications like Rifampin & Isoniazid
• Antibiotics are nonresponsive against resistant strains of TB.

In this case the patient should take extra precaution and if he still plans to go out to dinner, fly on airplane, etc. It is not ethical to put him jail.

But at the same time it is advisable to educate/counsel/motivate the patient regarding his moral responsibility towards the society.

As it may affect the society health, hence he should motivate for proper usage of mask

.

And if possible avoid journey.

As it may get spread.

Tell him that it is curable, and once he will be okay, he can go for such lifestyle, can plan for tour etc.