The plight of the individual versus the well-being of society is a common conflict noted throughout history. It creates division among modern politics, inspires debate among great philosophers, and is even manifested in public health.
In the case of KIRK v. WYMAN, the rights of the individual versus the community were brought to trial. The jury weighed both sides of this debate, ultimately ruling in favor of the individual. The plaintiff, Mary V. Kirk, was diagnosed with anaesthetic leprosy, which the Board of Health believed to be contagious and a threat to the community. They initially requested voluntary sequestration, but after her incompliance demanded compulsory isolation. Even still, Mary Kirk refused to comply, arguing that her form of leprosy was not proven to be highly communicable and the environment of forced isolation was unhealthy and inhumane. The Board of Health suggested an alternative location, only to be met with further resistance and an injunction by Ms. Kirk. Ultimately, they ruled in favor for the individual, arguing that isolation was unnecessary for her relatively non-communicable case. The Board of Health unsuccessfully tried to appeal.
This case exemplifies the cruciality of this debate and both sides argue legitimate points. The individualists view restriction by the government on the individual to infringe on personal freedom, thus contradicting the inalienable rights deemed in the Constitution. However, protecting the community brings greater benefits for a larger amount of people: a seemingly utilitarian approach. Furthermore, the individual has the potential to harm an entire community. As an ardent public health advocate, I support the rights of communities over those of the individuals in matters related to health. Many personal behaviors effect the health of not only the individual, but also of those they encounter in the community. This is exemplified in the case of communicable diseases, where people can easily infect those they encounter briefly and even indirectly. To effectively protect the population, infected individuals must be either quarantined or isolated, restricting their rights in the process. In such cases, we are called to examine the ethics of the debate: is it moral to protect many individuals by sacrificing the freedom of one?
The government is the entity responsible for defining instances where isolation and quarantine are ethical and should therefore enact laws to draw clear distinctions between the rights of individuals and those of the community in such instances. It is important when debating the issue of community versus individual in Public Health to differentiate between quarantine and isolation. Quarantine is used when a person has been exposed to an illness and they have become susceptible to developing the illness. Both share a common theme: ensuring the community remains unaffected by communicable diseases. However, forced quarantine or isolation should be a last resort. Comfortable and humane living conditions must be provided for the patient, their pride and dignity cannot be sacrificed, and confidentiality must be maintained to avoid potential discrimination.
The individual will inevitably be connected to the community, and vice versa; but it is learning how to justly balance the rights of the two that will determine much of the future of public health.
Hi Anna,
ReplyDeleteGood Post.
Isolation is a term used to describe the seperation of people with a contagious illness from the rest of the healthy population, while the term quarantine refers to the seperation of people from other members of society, who have been exposed to an illness, but who have not yet become ill.
You did a good job discussion the challenges in deciding when to quarntine someone and how to balance that decission.
Generally the state has the authority to isolate or quarantine an individual if that individual is a resonable threat to the community. While this might be placing the communities rights over that of the individual, I think that it is indeed better to err on the side of protecting the community, because there are more lives at stake. However, anytime someone is isolated or quarantined, there should be significant evidence to justify the act and the person should be well accomidated. In the reading, it seemed that there was not good evidence to justify seperating Ms. Kirk from the community, especially since she had had leprosy for so long and been an active member of the community without incidence.
Michael