Table 1 Overview of ethical issues related to migrant TB screening

Care obligation linked to TB screening

The human rights issue of providing appropriate medical care to all people, irrelevant of TB or LTBI

 Enacted TB stigma

Exclusion, rejection or devaluation by others based on beliefs of inferiority or social unacceptability

 Perceived TB stigma

Patient and family fears of inferiority stemming from the anticipation of an adverse judgment related to a TB diagnosis

 “At-risk group” stigma

Magnify a migrants sense of being “out of place”. This requires careful attention to appropriate service design and communication strategies. How best to communicate with migrants to inform them about the potential benefits and risks of TB and LTBI screening requires more research.

Privacy and confidentiality

Needs to be respected and protected at all times

Racial vilification

Irresponsible media reporting of TB in migrants is implicated in the production of stigma and should be avoided; and racial vilification banned/censored on social media

Health equity

All migrants (whether they have TB or otherwise) should have access to basic health services that are both medically and culturally appropriate.

Trust in the health care system/provider

Migrants come from countries with weak health systems and often mistrust health systems. Building trust is essential to build constructive and respectful relationships between service providers and migrant communities.