The Legal Void of Liberty Restriction: Involuntary Treatment of Bacilliferous Patients with Mycobacterium Tuberculosis

Abstract

INTRODUCTION AND OBJECTIVES Tuberculosis (TB) was declared a global emergency by WHO and, despite significant progress in reducing TB's incidence, there has been an increase in resistant forms and a decay in the decrease of new cases. This epidemiological threat is even more relevant if individuals refuse treatment, as they put in conflict several constitutionally protected rights. This study aims to evaluate the importance of addressing this legal void and whether the involuntary treatment is appropriate and proportionate to the current TB's epidemiological situation, justifying the regularization of this measure for public health protection. MATERIAL AND METHODS A review on TB literature was conducted across different official entities to characterize TB's mechanisms of infection, transmissibility, diagnosis, therapy and resistance. Concerning the study of the legal void and framework, a review on diverse Portuguese and European databases was carried out. Lastly, a search on Pubmed was performed. RESULTS TB's literature review showed its easy transmissibility, making it highly contagious in social environments. Like susceptible TB, resistant TB rates vary significantly between countries, making it a global concern and a public health threat. Two Portuguese Court Rulings, several articles, European and National laws ruled in favor of involuntary treatment, considering it can be justifiable in certain situations. CONCLUSIONS Deprivation of liberty is the most severe measure a State can impose in the name of public health. Due to TB's highly contagious nature, refusal of treatment may require restrictive measures, such as the involuntary treatment. In Portugal there is no Constitutional basis for its application within Public Health scope. Therefore, resolving this legal void is of special importance as this legislation will facilitate the conflict resolution between individuals' and community's rights, minimizing the negative impact of TB transmission on people's lives, health and society and would guarantee a standardized, equal and non-discriminatory intervention.