2021 Volume 9 Pages 41-47
In the case of tuberculosis, the treatment goals of patient survival and greater public health occasionally conflict with patient autonomy, so the ethical validity of the said treatment becomes questionable. This paper reports the case of an aged tuberculosis patient who was discussed during an ethics consultation.
A 95-year-old man was admitted to the hospital for the treatment of active tuberculosis. He had dysphagia and was bedridden before admission ; it became impossible for him to take medicine orally. While the attending staff considered continuing his treatment with a nasogastric tube to let him return to a care facility familiar to him, he wished to not take curative treatment anymore but died naturally. Ethics consultation was provided for this case. After consultation, the staff, including the ethics consultants, felt it unwise to abandon curative treatment because of the issue of public health. The case was brought to the Committee for Examination of Infectious Diseases, which concluded that palliative care should be administered rather than curative treatment.
The main treatment for tuberculosis is oral medication, and its purpose is rehabilitation. However, this is not suitable as palliative care for patients at the end of life. Here, the ethical challenges need to be recognized and tackled so that transparent, consistent, and ethically acceptable decisions are made.
