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Post subject: TB patient thrown in prison  PostPosted: Apr 11, 2007 - 10:37 AM

Joined: Sep 06, 2006
Posts: 1195
Location: Valhalla Mountains, British Columbia, Canada
Health officials call it a "quarantine", but is it an ominous sign of things to come?

(Phoenix) Behind the county hospital's tall cinderblock walls, a 27-year-old tuberculosis patient sits in a jail cell equipped with a ventilation system that keeps germs from escaping. Robert Daniels has been locked up indefinitely, perhaps for the rest of his life, since last July. But he has not been charged with a crime. Instead, he suffers from an extensively drug-resistant strain of tuberculosis, or XDR-TB. It is considered virtually untreatable.

County health authorities obtained a court order to lock him up as a danger to the public because he failed to take precautions to avoid infecting others. Specifically, he said he did not heed doctors' instructions to wear a mask in public.

"I'm being treated worse than an inmate," Daniels said in a telephone interview with The Associated Press last month. "I'm all alone. Four walls. Even the door to my room has been locked. I haven't seen my reflection in months."

Though Daniels' confinement is extremely rare, health experts say it is a situation that U.S. public health officials may have to confront more and more because of the spread of drug-resistant TB and the emergence of diseases such as SARS and avian flu in this increasingly interconnected world.

"Even though the rate of TB in the U.S. is at the lowest ever this last year, we live in a globalized world where, if anything emerges anywhere, it could come to our country right away," said Mark Harrington, executive director of the Treatment Action Group, an American advocacy group.

Now, there's several things here that go beyond the case of Robert Daniels. First, if the state tried to lock up victims of SARS, or avian flu, would it even be possible? I think it would just spread like wildfire, and they would end up having to quarantine entire neighbourhoods, or possibly even cities. Even at that, I doubt they could contain a major outbreak without declaring martial law, as everyone would seek to flee the infected zone.

Secondly, as a gay man, a large red flag goes up when I hear about locking people up as a health-related safety precaution. There are already thousands -- hell, millions -- of people spreading lies about how queers are disease-ridden, are carriers of all manner of plagues and illnesses (AIDS only being the most obvious)... and there is a rather unpleasant camp in Poland that I think of whenever I read or hear such talk. Just who is this "Treatment Action Group" which is characterized as "an American advocacy group"? Advocates for whom, precisely? The medical profession? Or yet another Christianist front group?

And sure enough, here comes the next part of the argument:

The World Health Organization warned last year of the emergence of extensively drug-resistant TB. The new strain, which has been found throughout the world, including pockets of the former Soviet Union and Asia, is resistant not only to the first line of TB drugs but to some second-line antibiotics as well.

HIV patients with weakened immune systems are especially susceptible. In South Africa, WHO reported that 52 of 53 HIV patients died within an average of 25 days after it was discovered they also had XDR-TB.

Okay, so we have TB + HIV = ***Danger Will Robinson, DANGER!!!!*** My spidey-senses are tingling, and the danger I'm sensing has nothing to do with drug-resistant TB.

And whoopie, we even have a "Canadian connection" going on here...

Dr. Ross Upshur, director of the Joint Centre for Bioethics at the University of Toronto, said authorities should detain people with drug-resistant tuberculosis if they are uncooperative. "We're on the verge of taking what was a curable disease, one of the best known diseases in human endeavors, and making it incurable," Upshur said.

But a paper Upshur co-wrote on the issue in a medical journal earlier this year has been strongly criticized. "Involuntary detention should really be your last resort," Harrington said. "There's a danger that we'll end up blaming the victim."

Blaming the victim? We're already doing that, as the case of Robert Daniels (and others) shows. My worry is that Harrington and his Treatment Action Group will regretfully find it necessary to turn to their "last resort" -- or that others will do so rather gleefully. Paranoid? That's what they said about the German Jews who were expressing alarm in the late '30s too. And as we can see from this story, the legal precendents -- and moral justifications -- are being set in place already.

Just because you're paranoid doesn't mean they're not out to get you...

"The dignity of an animal is measured by his capacity to revolt in the face of oppression." -- Mikhail Bakunin
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