Ethics, Tuberculosis, and Compassion: Lessons From Praxis
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While there are many challenging aspects to this case that will generate important engagement with ethical theory, as the medical director of an Australian tuberculosis program, I would offer some reflections arising from praxis.
Financial burden arising from TB disease is a substantial issue globally, and eliminating catastrophic costs from TB is recognized as a priority issue. In Victoria, treatment for tuberculosis is provided without cost to the individual, including medications, diagnostic tests, and hospitalization. This remains true for those who are not eligible for Medicare, such as in the case described. In practice, then, no action to recover the cost of Xiang’s treatment should be taken, and some material supports (such as paying for mobile phone credit to allow contact with his family) would be provided. In part, this is a policy taken on pragmatic public health grounds, as financial barriers to treatment would likely lead to increased risk of community transmission of TB...