Individual Rights vs. Public Health

Hi! This week we were asked to read an important court decision in public health. In this case, a woman suffering from leprosy, Mary Kirk, was fighting the Board of Health's decision to mandate her to move to the contagious division of the city hospital. At this time, the city pest houses were very dirty places. This particular one was also very close to the garbage dump and filled with people infected with small pox. Since Ms. Kirk was a woman of high social standing, the city offered to build her a cottage outside the city where she could live. However, since the cottage would not be ready immediately, the Board of Health requested that Ms. Kirk live in the hospital as temporary housing. Ms. Kirk argued that her leprosy was not a very contagious type and felt that being forced to live in the hospital was a violation of her personal rights. The courts ruled that it was within the powers of the Board of Health to decide what steps are necessary to protect the health of the public. Also, the court ruled that the individual rights to liberty and property do not hold when exercising this right harms others.

First of all, when talking about this case, it is important to make a distinction between quarantine and isolation. Quarantine is used when describing someone that has been (or may have been) exposed to a disease, but does not yet show symptoms. For example, United States immigration officials often quarantine entrants to the country that come from areas with high rates of endemic infectious disease. In this case an immigrant from an area with high malaria rates might be held for a period of time in order to ensure that he or she will not develop malaria and spread it. On the other hand, isolation refers to a person who already has an infectious disease. In this case, although the term quarantine is used, it would probably be more accurate to say that Ms. Kirk was ordered into isolation due to fears that she would cause others to contract the disease she already has (leprosy).

The decision of when an individual should be quarantined is a difficult one. In my opinion, the health department should set guidelines for when a person should be quarantined. These guidelines should be based on research regarding infection rates and virulence of different diseases. It is extremely important that these decisions be made based on scientific evidence. Physicians should be educated on these rules and asked to enforce them. Then, when a physician sees someone that should be quarantined, he or she can inform the patient and take the necessary steps.

While deciding who should be quarantined is a scientific decision, figuring out how to balance individual and community rights is more of an ethical and legal issue. These decisions should be made by the court system. It is the responsibility of the courts to interpret the constitution and decide when allowing an individual to exercise his or her rights violates the public well-being and vice versa. Another difficult decision is whether or not to err on the side of individual or public rights. In this case, I think it is important to do what is best for the most people. Of course, reason must be used to ensure that individual rights are not needlessly violated.

That's it for this week. Bye!