Life as an Extreme Sport

Considering Quarantine

The use of quarantine explicitly relies upon Mill’s harm principle: “the only purpose for which power can be rightfully exercised over any member of a civilized community against his will, is to prevent harm to others” (Mill). As Matthew Wynia notes in the February issue of the American Journal of Bioethics, there are many serial-distancing models that are also effective in disease control, but quarantine is an excellent boundary example that allows us to push the limits of restrictions of liberty in the interests of public perception. In quarantine, we restict the movement of or separate out from society those who might be infectious — those who have been or might have been exposed to infection. (Those who have been exposed and are showing symptoms of illness/diagnosed as sick and are removed/restricted are properly considered to be isolation, a typically unopposed move.)

Assumingand I acknowledge that this is a large assumption both that we have a civilized society and that it is in the best interest of society, regardless of the autonomous individual, to restrict movement of and remove from social settings those who may cause serious risk to others, then the harm principle clearly allows us to place people in quarantine in order to protect the public, and notions of civil liberty violations seem to be a hallmark of selfish thought that is not thinking outside the individual, rather than for the good of all.

Of course, the issue here is may, might and what constitutes risk. If I may have been exposed to chicken pox, should I be subject to the same reaction as if I had been exposed to ebola? Where, on the scale of disease and contagion, do we draw the line of acceptable risk versus need for public protection?

On top of this, we have to wonder how effective such infringements would be, anyhow. In the recent SARS epidemic, quarantine failed more than it succeeded — people either fled or simply ignored the orders. But given that contagion spreads exponentially, this might be a red herring. Even if half of those infected adhere to the quarantine, the prevention of spread of disease might be considered successful.

Ultimately, most of the people in quarantine will not get sick, and depending on the type of quarantine might actually be further exposed to illness in the very effort to prevent the spread of it. The question then becomes, not is a conflict between public health and civil liberties inevitable, but, as Wynia asks, how one should decide at what point we have to infringe on liberty to prevent the mere risk of harm to others (Wynia 2007).

Given general public attitudes toward quarantine in times of health crises, the most successful option is likely to resist the urge to panic on the part of public officials, and use the least restrictive means appropriate to protect the public. This means that

any limitations on civil liberties should be proportional and no more restrictive than is really necessary. In other words, don’t use involuntary quarantine or surveillance devices such as bracelets if voluntary measures will work; don’t restrict someone to one room if an entire house is available

and etc (Wynia 2007). Given public history with quarantines, it is not unlikely to anticipate that the public will support the idea of balancing the preservation of freedom with protecting and preventing the risk of harm to others.