Technologies of compliance: Surveillance of self‐administration of tuberculosis treatment, 1956–1966

Abstract

The development of antibiotics for tuberculosis in the 1950s liberated patients from prolonged hospitalization and enabled physicians to bring treatment to underserved populations. However, outpatient treatment programs could only be as effective as the reliability with which patients self‐administered medications. This anxiety with non‐compliance quickly became ubiquitous in medicine. Several physicians, treating tuberculosis among the Navajo, attempted to use technologies of surveillance to overcome this limitation. They used fluorescent tracers, urine testing, and radioactive pill dispensers to expose non‐compliance. Although successful, these techniques threatened patient‐doctor relationships with secrecy and distrust. Physicians turned instead to personal surveillance through directly observed therapy.

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