[Use of coercion pursuant to the Communicable Diseases Act 1995-2013].

Background: The Communicable Diseases Act came into force in 1995. The Act authorises coercive examination and isolation of infected individuals. We wished to investigate how the provisions on coercion in this Act have been practised.

Material And Method: We reviewed all the cases that had been processed by the National Commission for Communicable Diseases from 1995 to the end of 2013. We contacted doctors in regional health enterprises to collect information on any emergency decisions having been made. We collected information from the tuberculosis register on treatment outcomes for tuberculosis, and investigated how many patients disappeared from treatment during 1995-2013.

Results: The communicable diseases commission had treated 15 cases involving a total of 12 individuals. Nine of these suffered from contagious pulmonary tuberculosis, one had primary tuberculosis, one was suspected of having tuberculosis and one was HIV positive. Three of the patients had multidrug-resistant tuberculosis. The commission made two decisions on coercive examination/brief isolation and nine on coercive isolation, as well as two decisions on extended isolation. No decisions were made regarding coercive treatment. Only four of the nine patients with contagious pulmonary tuberculosis completed the treatment sequence. One emergency decision has been made since 2006.

Interpretation: The provisions on coercion have been practised restrictively. Amendments to them should be considered, especially with regard to the opportunity to make emergency decisions on isolation of persons with a known diagnosis. There is a need for clearer regulations regarding extended isolation, and the time needed for processing of cases involving requests for a decision by the communicable diseases commission should be reduced.