Summary
Commentary by Diego Silva
Ethics is about who we should be, what we should do, and what good we want to do in the world.¹ As an academic discipline, we look at these questions in a more formal way, including asking these three questions in the context of what we owe each other and the relationship between States (in other words, questions of politics). Since laws tell us the bare minimum in terms of what we can or cannot do, ethics is vital in filling out important and vast lacuna on how best to act; ethics can also tell us when we should consider resisting laws that run afoul of ethical standards. Tuberculosis, like other infectious diseases, raise a host of ethical challenges in our efforts to curb transmission and treat persons with TB or TB infection.² Whether instituting infection control measures or prescribing medicine, we need to consider how the rights and wellbeing of persons with TB can best coexist with the needs of their wider community.³ For example, while upholding the privacy and confidentiality of persons with TB is of utmost importance, the need to conduct contract tracing precludes the ability of national TB programs (NTPs) to give persons with TB absolute assurances on questions of confidentiality; in turn NTPs need to make sure persons with TB are cared for while on treatment, including the need to address challenges associated to stigma to the greatest degree possible.
References
1. Crisp, R. Ethics and meta-ethics. Ethics, 1998, doi:10.4324/9780415249126-L132-1. Routledge Encyclopedia of
Philosophy, Taylor and Francis, https://www.rep.routledge.com/articles/overview/ethics/v-1/sections/ethics-and-
meta-ethics.
2. World Health Organization, Ethics Guidance for the Implementation of the End TB Strategy. 2017. Geneva, Switzerland.
https://iris.who.int/bitstream/handle/10665/254820/9789241512114-eng.pdf
3. Silva DS, Dawson A, Upshur RE. Reciprocity and Ethical Tuberculosis Treatment and Control. Journal of Bioethical
Inquiry. 2016 Mar;13(1):75-86.
