Washington Law Review


This Article examines the tension between protecting public health in light of personal liberty interests in the context of these :recent reforms. Legislative reform was initiated based on changes in the nature of TB itself. Part II of the Article briefly examines the nature of TB and its new, multidrug resistant strains as well as its local and global incidence. The transmissibility of TB from a clinical (medical) perspective is discussed because the modes of transmission are critical to determining the nature of the public health risk. The clinical relationship between TB and the human immunodeficiency virus (HIV) is noted, including the contribution of HIV to the rise in the incidence of TB and the spread of multidrug resistant strains. These new TB strains present increased dangers for society because of their resistance to drug therapy and their life-threatening nature. Part III records and analyzes the legislative history of recent reforms as recommended by the interdisciplinary TB Planning Group (TB Group). This part of the Article also examines the various political influences and legal issues significant in this legislative drafting and rulemaking process. Part IV gives an overview of the current law in Washington relating to TB. Part V compares the new law with the law it replaced and with Washington State approaches to othe: public health issues, including HIV/AIDS and mental illness. Part VI examines federal and state constitutional case law regarding the scope and limitations on the powers of public health officials and agencies to act on behalf of the common good. This part explores the due process standards set forth in these cases. This Article concludes by recogaizing that the changing nature of TB and its air-borne transmissibility create a public health clanger that has significant legal implications. Indeed, the "dangerousness" of TB and its attendant clinical and social factcrs is critical to consider in crafting appropriate legislative, judicial, and public health responses. Society's reasonable safety concerns provide legal justification for intrusion on an affected individual's constitutionally protected liberty. The authors conclude that current Washington State TB law successfully provides a reasonable and flexible legal framework balancing due process interests while empowering public health officials to control the spread of this disease and to provide humane and effective treatment.

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