Virtual Mentor. September 2000, Volume 2, Number 9.

Cases in Law and Ethics

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Medical Student Exposure to TB

An ethical case explores whether it's appropriate for a resident who was exposed to TB to discontinue his treatment regimen and potentially expose his colleagues and patients.

September Case Scenario

Brad is a third-year medical student who is on his internal medicine rotation. During the rotation, Brad learns that a patient whom he saw and admitted from the emergency room was diagnosed with active tuberculosis (TB). Brad was subsequently put on a regimen of isoniazid (INH) because he tested positive for TB exposure. After being on INH for 2 weeks, Brad experienced extreme fatigue, nausea, and diarrhea. With challenging clinical rotations coming up, Brad feels that he needs his full energy to get through the rotations and discontinues the therapy. He rationalizes that being infected with TB does not necessarily mean that he would get full-blown TB. If pulmonary symptoms ever arise, he will then seek medical attention.

1. What do you think of Brad’s behavior?

2. Is Brad potentially putting his fellow colleagues and patients at risk?

See AMA Code of Medical Ethics, Opinion 9.13 "Physicians and Infectious Diseases."