How should a free society respond to an Ebola outbreak? Unfortunately, that question is not hypothetical. The deadly disease continues to ravage West Africa and future Ebola cases in the United States are to be expected. To get a handle on how to strike the proper balance between public health and personal liberty, asked four leading experts in the areas of law, health, science, and privacy to offer their recommendations for how U.S. medical and governmental officials should respond to the next domestic case of Ebola.

Don’t Sacrifice Civil Liberties

George J. Annas

It is important to begin with the conclusion: trade-offs between civil rights and public health measures are not always necessary, and are almost always counterproductive. That is because we can generally rely on Americans to follow reasonable instructions of public health officials for their own medical protection. Americans do not want to develop Ebola themselves, and have no interest in spreading it to their families or others. They will almost always demand treatment, rather than flee from it. Quarantine should only be considered for persons who are likely to have been infected with an infectious disease (like Ebola), and then only when they are a possible danger to others (in Ebola exposure, only after they have a fever). In all cases where quarantine is deemed medically reasonable, it should be done only in the least restrictive way possible. For example,  fever monitoring for those exposed should first be done by the individual, and only if this does not seem reasonable, overseen by a public health agency. The next step up in enforcement would be an agreement (like those in Dallas) to be monitored and not to travel out of the area or go to crowded places. Only if this agreement was broken should home quarantine be considered, and only if that was violated should quarantine in a state facility be considered. Individuals with disease are not the enemy and are not criminals; they a sick citizens and deserve to be treated with respect. That makes it most likely that government will retain the trust of the people, which is absolutely necessary to deal effectively with an epidemic. In other words, as the AIDS epidemic demonstrated, the promotion of human rights and human dignity can be essential for dealing effectively with an epidemic. We do not have to sacrifice our civil liberties for an effective public health response.

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