The Medical journal of Australia
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OBJECTIVE To describe the epidemiology, clinical features, health care resource use, treatment and outcomes of multidrug-resistant tuberculosis (MDR-TB) cases diagnosed in Western Australia, compared with matched controls with drug-susceptible TB. ⋯ MDR-TB remains uncommon in WA but its challenges are increasingly recognised. Despite delays in commencing effective therapy, MDR-TB is usually associated with treatment success. Adverse effects of medications are common, and treatment courses are long and complex. Specialist TB services should continue to be involved in management and prevention of all cases of MDR-TB.
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Generally, a patient may only be assessed and treated with his or her consent. It is difficult to interpret the law regarding doctors' powers and duties to assess and treat in cases where a patient refuses to accept medical advice but it is unclear whether the patient has decision-making capacity (DMC) or whether they are mentally ill. ⋯ Doctors have a duty to provide appropriate advice to patients who want to leave their care in circumstances where medical assessment or treatment may be required. Whether there is also a duty to detain someone in this situation is less clear, but we provide guidance to health care practitioners faced with this situation.