Provider perspectives on liberty and harm in the treatment of persons with tuberculosis and mental illness
DESIGN: Qualitative study of 20 semi-structured interviews with HCWs and decision-makers working in public or mental health from three public health units and two psychiatric hospitals in the Greater Toronto Area in Ontario, Canada. Interviews were evaluated using thematic analysis.
RESULTS: Three themes were identified: 1) the contextual nature of liberty restrictions; 2) the concept of liberty as a matter of degree; and 3) the challenges of balancing the treatment and care goals of TB and mental health for persons with both TB and SPMI.
CONCLUSION: Harm is understood by HCWs caring for persons with TB and/or SPMI in a context-dependent manner. This is compounded in the case of persons with both TB and SPMI. Liberty restrictions to advance public health goals entail reciprocal obligations from society, including social protections and additional resources, to ease the effects and range of liberty restrictions. Attention is required to ensure that treatment and care for SPMI does not impede that of TB and vice versa.
Document Type: Research Article
Affiliations: 1: Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia 2: Leslie Dan Faculty of Pharmacy & Joint Centre for Bioethics, University of Toronto, Toronto, Ontario 3: Lunenfeld Tanenbaum Research Institute, Sinai Health System 4: Joint Centre for Bioethics & Institute of Health Policy, Management and Evaluation 5: Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario
Publication date: April 1, 2019
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