Coker R J, Mounier-Jack S, Martin R
Department of Public Health and Policy, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK.
Public Health. 2007 Apr;121(4):266-73. doi: 10.1016/j.puhe.2006.11.003. Epub 2007 Feb 5.
Tuberculosis control is an important public health challenge in many European countries. Law is an important tool that policy-makers can draw upon to support control efforts and, according to the World Health Organization, represents a tangible expression of political commitment and will. Despite this, little national research, and even less cross-national comparative research, has been conducted to describe and analyse legislative approaches to tuberculosis control.
We conducted a survey of 14 European countries to identify, describe, map and analyse legislative tools used to support tuberculosis control.
We found a wide range of legislative models. Legal measures available to nation states, such as compulsory examination, compulsory screening, compulsory detention, compulsory treatment and compulsory vaccination, vary widely in both scope and number. We identified a typology of legal frameworks, from the most authoritarian to the least restrictive. It seems likely that the application of some laws might not withstand scrutiny under the European Convention for the Protection of Human Rights and Fundamental Freedoms.
Harmonization of legislative response to infectious diseases, based upon sound evidence, may be necessary if collaborative efforts in support of infectious disease control, as envisaged in the new International Health Regulations, are to be most effective and are to reflect more appropriately a globalized 21st century world.
结核病控制是许多欧洲国家面临的一项重大公共卫生挑战。法律是政策制定者可用于支持控制工作的一项重要工具，并且据世界卫生组织称，法律是政治承诺和意愿的具体体现。尽管如此，很少有国家开展相关研究，跨国比较研究更是少之又少，来描述和分析结核病控制的立法方法。
我们对14个欧洲国家进行了一项调查，以识别、描述、梳理并分析用于支持结核病控制的立法工具。
我们发现了多种立法模式。各民族国家可采用的法律措施，如强制检查、强制筛查、强制拘留、强制治疗和强制接种疫苗，在范围和数量上差异很大。我们确定了一种从最专制到限制最少的法律框架类型。某些法律的适用似乎可能经不起《欧洲保护人权与基本自由公约》的审查。
如果要使新的《国际卫生条例》所设想的支持传染病控制的协作努力最有效，并更恰当地反映21世纪的全球化世界，那么以充分证据为基础协调针对传染病的立法回应可能是必要的。
