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The Single Disease Hospital: Why Tuberculosis Justifies a Departure That AIDS Does Not

Published online by Cambridge University Press:  01 January 2021

David J. Rothman
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Extract

Although HIV disease has set a new model for resolving the tensions between civil liberties and public health interests, with an unprecedented commitment to individual privacy and autonomy, the resurgence of tuberculosis has sparked new and troublesome concerns. One particularly intense controversy has emerged around the value and appropriateness of single disease hospitals. In HIV disease, the single hospital turns out to be an altogether unsuitable and unnecessary innovation. In the instance of tuberculosis, however, it appears to have a critical and legitimate role, particularly for involuntary commitment of patients who have been non-compliant with treatment regimens. To be sure, that role must be carefully circumscribed and the facilities themselves closely monitored. But a hospital dedicated to tuberculosis now occupies a central place in public policy that is not to be found for HIV disease. What considerations promote this difference, and how a single disease hospital for tuberculosis may avoid the pitfalls that make it so inapposite for HIV, are the two questions this essay will be exploring.

Type
Article
Information
Journal of Law, Medicine & Ethics , Volume 21 , Issue 3-4 , Fall Winter 1993 , pp. 296 - 302
Copyright
Copyright © American Society of Law, Medicine and Ethics 1993

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References

For the full report see, the New York City Task Force on Single Disease Hospitals, “Advantage and Disadvantages of Special Hospitals for Patients with HIV Infection,” New England Journal of Medicine, 323 (1990): 764–68.CrossRefGoogle Scholar
Weinberg, D.S., Murray, H.W., “Coping with AIDS: The Special Problems of New York City,” New England Journal of Medicine, 317 (1987): 1469–73; Cotton, D.J., “Improving Survival in Acquired Immunodeficiency Syndrome: Is Experience Everything?” Journal of The American Medical Association, 261 (1989): 3016-17CrossRefGoogle Scholar
[New York] Mayor's Task Force on AIDS, “Assuring Care for New York City's AIDS Population,” issued March 1989.Google Scholar
See Fox, Daniel M., “Social Policy and City Politics: Tuberculosis Reporting in New York 1889–1900,” Bulletin History of Medicine, Summer (1975: 171-175.Google Scholar
New York Academy of Medicine Committee on Single Disease Institutions for Tuberculosis, “Recommendations on the Facilities Needed to care for Patients with Tuberculosis,” in The Tuberculosis Revival: Individual Rights and Societal Obligations in a Time of AIDS (New York: United Hospital Fund, 1992): 43–49.Google Scholar
Altman, Lawrence, “Drug-Resistant TB Makes U.S. Re-think Elimination Program,” New York Times, January 28, 1992, C.3; see also the editorial of Gordon, F., “Tuberculosis Control: Back to the Future?” Journal of the American Medical Association, 267 (1992): 2649.Google Scholar
This is the very argument put forward by public health officials in their description of the Lemuel Shattuck Hospital Tuberculosis Treatment Unit; see, Etkind, Sue et al., “Treating Hard-to-Treat Tuberculosis Patients in Massachusetts,” Seminars in Respiratory Infections, 6 (1991): 274.Google Scholar
Brudney, Karen, Dobkin, Jay, “A Tale of Two Cities: Tuberculosis Control in Managua and New York City,” Seminars in Respiratory Infections, 6 (1991): 266.Google Scholar
Gostin, Lawrence O., “Controlling the Resurgent Tuberculosis Epidemic,” Journal of the American Medical Association, 269 (1993): 255–261.CrossRefGoogle Scholar
Etkind, et al., “Treating Hard-to-Treat Tuberculosis Patients,” supra note 7, at 280–281.Google Scholar