When an outbreak of a deadly, communicable disease threatens the health and well-being of the public and public health services, one of the infection control measures available to public health officials is a required quarantine. While quarantine and isolation are designed to protect the population’s health, they also conflict with the individual rights of liberty and self-determination. The medical profession, in collaboration with public health colleagues, must take an active role in ensuring that such interventions are based on science and are applied according to certain ethical considerations, since they do involve serious infringements on basic civil liberties. Questions raised in these situations include:
How are these interventions justified?
What is the point of balance between concerns for public safety against limitations on personal freedom?
Is this balance tipped by the added concern that quarantined individuals often suffer also stigmatization?
What other considerations may apply?
During the Ebola outbreak of 2014, the city of Dallas, Texas issued a forced 21-day quarantine for the family of Thomas Eric Duncan, the first Ebola patient diagnosed in the United States. Later, the 21-day quarantine was extended to all of the staff who had come into contact with Duncan at Texas Health Presbyterian Hospital, where he was treated.
This assignment has two parts:
Part 1: Ethics
First, you will analyze the ethical considerations related to the public health practice of forced quarantine. Begin with an overview of how this practice may be evaluated from the perspective of each of the ethical theories covered in this unit. Then, focus on the Duncan case and discuss the ways these theories were adhered to, or violated, from the standpoints of each of these groups of people:
The family of Thomas Eric Duncan.
The staff who treated Duncan at Texas Health Presbyterian Hospital.
The general public.
Were ethical conflicts inevitable in this case? Explain why or why not. Then, design a quarantine strategy that you think would be the fairest possible solution in this situation, and cite ethical theories to defend it, making note of its weaknesses as well as its strengths.
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