Detention for tuberculosis: public health and the law

In reply: We concur with the principle that patient privacy should be protected in case reports. As recommended by the International Committee of Medical Journal Editors,1 measures in place at the Journal include asking authors to obtain patient permission for publication where possible, and directing authors to remove potentially identifying patient information.

The article in question was not a case report. Case details were given to exemplify the circumstances that might lead to detention of a patient for public health reasons in New South Wales, and dates and some details were retained to illustrate the temporal flow of the story. We agree that this may have made the patient identifiable, if not to the general public, to himself or his family. We regret this editorial lapse, and have reworded the patient details in the electronic version of the article.2

Although chastened by our anonymous colleagues’ observations, we are somewhat puzzled as to why, given their concern about their patient’s privacy, they are determined to draw further attention to the exposing details. We assume that, in this case (as in the cases of detaining patients for treatment of tuberculosis), public interest prevails.

We also agree that case reports of detailed clinical histories require the input of the primary treating team, but the question of authorship should be determined by the involved parties, not the Journal. Be that as it may, as the article was a public health report (and thus not meant to be a detailed clinical exposition), we do not believe that the input of the treating team was required.