Ethical aspects of directly observed treatment for tuberculosis: a cross-cultural comparison.
Ethical aspects of directly observed treatment for tuberculosis: a cross-cultural comparison.
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DOI：
10.1186/1472-6939-14-25
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发表时间：
2013-07-02
影响因子：
2.7
通讯作者：
Porter JD
中科院分区：
文献类型：
--
作者：
Sagbakken M;Frich JC;Bjune GA;Porter JD
结核病是一项重大的全球公共卫生挑战，大多数国家已采取了一种形式的短期直接观察治疗结核病全球战略。根据埃塞俄比亚和挪威的研究结果，本文的目的是从跨文化的角度来强调和讨论直接观察治疗（DOT）实践的伦理方面。埃塞俄比亚和挪威的研究表明，严格执行直接观察治疗与患者的自主、尊严和正直相冲突。这些治疗方法，特别是以最严格的形式实施的治疗方法，使结核病患者面临额外的负担和费用。社会上处于不利地位的群体，如无家可归者、打零工和缺乏雇员权利的人，面临的负担最重。从伦理的角度来看，我们认为直接观察治疗的严格做法很难证明是合理的，对结核病的社会决定因素的反应应该成为结核病管理的一个组成部分。
Tuberculosis is a major global public health challenge, and a majority of countries have adopted a version of the global strategy to fight Tuberculosis, Directly Observed Treatment, Short Course (DOTS). Drawing on results from research in Ethiopia and Norway, the aim of this paper is to highlight and discuss ethical aspects of the practice of Directly Observed Treatment (DOT) in a cross-cultural perspective. Research from Ethiopia and Norway demonstrates that the rigid enforcement of directly observed treatment conflicts with patient autonomy, dignity and integrity. The treatment practices, especially when imposed in its strictest forms, expose those who have Tuberculosis to extra burdens and costs. Socially disadvantaged groups, such as the homeless, those employed as day labourers and those lacking rights as employees, face the highest burdens. From an ethical standpoint, we argue that a rigid practice of directly observed treatment is difficult to justify, and that responsiveness to social determinants of Tuberculosis should become an integral part of the management of Tuberculosis.
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影响因子：
4.5
作者：
Barter DM;Agboola SO;Murray MB;Bärnighausen T
通讯作者：
Bärnighausen T
DOI：
10.1111/j.1749-6632.2001.tb11379.x
发表时间：
2001-01-01
期刊：
NEW VISTAS IN THERAPEUTICS, FROM DRUG DESIGN TO GENE THERAPY: DRUG-RESISTANT TUBERCULOSIS, FROM MOLECULES TO MACRO-ECONOMICS
影响因子：
--
作者：
Doyal, L
通讯作者：
Doyal, L
影响因子：
168.9
作者：
HART, JT
通讯作者：
HART, JT
影响因子：
3.4
作者：
Bond, P;Dor, G
通讯作者：
Dor, G
影响因子：
3.3
作者：
Lienhardt, C;Ogden, JA
通讯作者：
Ogden, JA