The resurgence of tuberculosis confronts policy-makers with difficult
legal and ethical questions about the proper use of state power and re
sources to protect public health. This chapter examines the implicatio
ns of expanded use of invasive or coercive measures-including directly
observed therapy, involuntary detention of noncompliant patients, and
forced administration of medications-designed to reduce the risk of t
uberculosis transmission and to ensure that those with TB are fully tr
eated. These measures focus attention on the limitations of government
power and obligation and on the delicate balance between the demands
of civil liberty and the demands of public health.