Legal medicine and drug-resistant TB in South Africa

Abstract

Tuberculosis poses a threat to public health in South Africa. The situation is aggravated by an inadequate health infrastructure, the AIDS epidemic, and a growing incidence of drug-resistant TB which is mainly caused by treatment failure. This scenario raises many legal issues, such as whether mandatory treatment may be imposed when all reasonable efforts to obtain patients’ consent and voluntary participation in treatment have failed. Since patients have to be treated in isolation, the question also arises whether mandatory isolation may be imposed and, if so, for which periods of time and under which conditions. Mandatory measures will seriously invade individual rights that are guaranteed by the South African Constitution. These rights are not absolute and may be restricted, and the law requires that a balance be struck between the rights of the individual patient and those of the community. While the South African law on the requirement of informed consent is clear enough, the legal position is far from settled with regard to involuntary measures, as no definitive measures have been adopted yet. This contribution describes applicable South African health law.