Ethics of directly observed therapy for the control of infectious diseases

Interventions for infectious disease control, like directly observed therapy (DOT), embody the imbalance of power and capacity between the public health profession and the infected person, and lead to a moral debate over public health and civil liberties. The four ethical principles of autonomy, beneficence, non-maleficence and justice provide a basis for a rigorous consideration and resolution of this ethical dilemma. This paper descibes the ethical debate around the use of DOT for infectious disease control, using tuberculosis as an example.