Tuberculosis: epidemiology, pathogenesis, and clinical management

Tuberculosis’ policies, finance, global prevention, and treatment initiatives related to Tuberculosis by their applicable ethics principles.
Considerable headway has been achieved in the battle against tuberculosis in the 21st century – a total of forty-nine million patients’ lives have been saved. But the disease continues to pose a major health threat, especially to highly vulnerable population groups worldwide (Organization, W 2009). Tuberculosis prevention, diagnosis, care and treatment gives rise to both ethical and technical problems which must be appropriately dealt with. For example, the latest involuntary quarantine of tuberculosis-diagnosed individuals across the globe raises the issue of balancing public health protection with individual freedoms and rights.
The End Tuberculosis Strategy of the WHO (World Health Organization) and the Sustainable Development Goals of the United Nations aimed at eliminating this endemic by the year 2030 demand due focus on ethics, equity, and human rights. To this end, a WHO-published tuberculosis ethics code “Ethics Guidance for the implementation of the End TB Strategy” serves to make sure the program is implemented in keeping with superior ethical standards. Human rights and ethics form the core of a client-focused, humanitarian tuberculosis treatment and care approach. It is imperative that ethical problems be tackled, to acquire patients’ as well as practitioners’ cooperation and trust, which is vital to program success. This encompasses patient support, engagement and education.
Tuberculosis is a disease largely found among the poor. A social justice focus implies taking care of the world’s most marginalized and vulnerable groups, and dealing with societal factors underlying the disease. Further, providers need to be offered adequate protections for ensuring a dedicated, healthy healthcare workforce. Nations’ governments are ethically duty-bound to offer free, universal tuberculosis diagnosis, care and treatment access (Donnell, O. 2008), besides offering practitioners a safe work atmosphere and appropriately supporting patients. Global Fund backs initiatives dealing with obstacles to identifying missing tuberculosis cases, promoting best approaches and tools, and integrating tuberculosis screening into other regular check-ups.
How application of ethics principles to the health issue has resulted in population disparities
Health resources and disease burden has been found to be distributed unevenly across America. Frontier and rural populations and ethnic minorities reveal a trend of lesser or inferior resources and greater disease burden, giving rise to significant health disparities. Given the large rural population of roughly sixty million and over fifty million individuals belonging to ethnic minorities, increasing health inequities in these groups with time are growing societal issues.
Rural populations show higher incidence of chronic diseases, deadly medical conditions, motor vehicle accident cases, environmental hazards and self-care and physical limitations linked to disability, as compared to individuals residing in urban and suburban areas. Further, rural inhabitants tend to consume alcohol more regularly, thereby experiencing more serious alcohol addiction side-effects such as cirrhosis, fetal alcohol syndrome and nutritional compromise, in addition to more swiftly growing substance dependency/abuse rates in comparison to urban and suburban dwellers.
Major disease burden related inequities may be found in ethnic minority groups. A number of minority groups display significant disparities in terms of their infant mortality rates, overall mortality rate, violent death rates and mortality rates for a majority of major ailments like cancer, asthma, diabetes and cardiovascular disease. Moreover, a number of minority populations exhibit disparities with regard to several stigmatizing conditions like substance abuse, depression, HIV/AIDS and other sexually transmitted problems (Major, B., Dovidio, J. & Link, B. 2018).
How existing disparities might be eliminated using alternate ethics principles.
Healthcare providers largely aim at doing what works to patients’ best interests. The main ethical principles which lie at the core of healthcare are trust, non-maleficence (“doing no harm”), and beneficence (“to do good”).
Deciding on the quantity of prevention, diagnosis and treatment related information provided facilitates elimination of extant inequities. Providers need to know how to communicate complex clinical information to ailing or frightened patients who might struggle with evaluating alternative options, risks and benefits. They need to ascertain whether every patient even desires to know so much or would simply prefer to leave it to the professional to do what’s best. Further, whether practitioners are allowed to withhold certain information from patients is also to be considered.
Another key consideration is whether provider recommendations or views may be given more importance as compared to patient rights to engage in free, voluntary decision-making with regard to accepting or refusing a particular treatment. Is paternalism or acting in order for doing good for the patient allowed? Practitioners needs to know the right conditions when evaluating whether patients are capable of deciding appropriately on their treatment. How much information and preparation ought proxies or surrogates to have prior to deciding for a patient?
Are the applicable ethics principles are consistent with the ANA's Code of Ethics for Nurses.
Relevant ethical principles do not adhere to the ANA nursing ethical code which calls for nurses to practice their profession compassionately and while respecting all individuals’ intrinsic worth, dignity, and distinctive attributes.
Furthermore, health inequalities exist in the over-fifty million strong ethnic minority cluster despite ANA’s ethical code stating that the chief commitment of nurses is to their patient, whether urban or rural, whether a single person, group, family, or community.
A number of minority groups display significant disparities in terms of their infant mortality rates, overall mortality rate, violent death rates and mortality rates for a majority of major ailments like cancer, asthma, diabetes and cardiovascular disease, in contradiction to the ANA mission of ensuring nurse collaboration with community members and other providers for safeguarding human rights, decreasing health inequalities and promoting health diplomacy.







References
Donnell, O. (2008). Analyzing health equity using household survey data : a guide to techniques and their implementation. Washington, D.C: World Bank.
Major, B., Dovidio, J. & Link, B. (2018). The Oxford handbook of stigma, discrimination, and health. New York, NY: Oxford University Press.
Organization, W. (2009). Global Health Risks: Mortality and Burden of Disease Attributable to Selected Major Risks. Geneva: World Health Organization.