LETTER TO THE EDITOR
Sergio Pripas
Lung Specialist PhD, Centro de Especialidades, São Carlos
Sir,
Notwithstanding progresses made in the comprehension of tuberculosis and of the technology available for control, the disease still surpasses the goals set forth by the government. From the involvement of the basic network, follow-up of patients, action in cases of non-adherence, difficulty in referrals, epidemiological surveillance and even for treatment we face discouraging barriers.
An important factor has been patients non-adherence and consequent abandonment even when we provide the conditions needed to avoid such a situation. The patient that in the vast majority of cases does not adhere to treatment in a completely irresponsible manner, entails consequences for himself with worsening of the disease, as well as for the community, thereby contributing to an even greater dissemination of the disease.
There is a controversy about the ethics and correctness concerning the use coercive measures that would force the individual to undergo treatment since every patient has the prerogative to accept or not treatment. Nevertheless, when we think in collective terms the right of the community to be protected must prevail over the individuals denial to be treated.
In this sense we appealed to the Prosecuting Attorney and Citizen, Minors and Adolescents Protection Office that a suit be filed against patients who did not adhere to treatment. The judge found the plea plausible and ruled, that under coercing escort (if necessary with police support), these patients appear daily at our service to receive supervised medication
In the four cases referred successful treatment was achieved. None of the cases required police coercion and the daily attendance of patients to the service fostered a better relationship understanding with the staff.
This communication is still another statement that aims to reduce the non-adherence rates and might be used in other municipalities facing the same quandary.
Publication Dates
-
Publication in this collection
17 June 2004 -
Date of issue
Apr 2004
