Friday, January 02, 2004

Infectious disease and individual rights 

Tech Central Station has an interesting article denouncing the litigation that has put an end to Department of Defense's program to vaccinate soldiers for anthrax. The lawsuit that is the subject of the article is but one example of resistence to a basic public health program couched in terms of individual rights. There are whole organizations devoted to objecting to mandatory vaccination programs. The absurdly overdone obsession with privacy in medical matters, as evidenced by the popular support for the health information privacy rules under HIPAA, is another example.

While I am a committed individualist, I think that these rights-based objections to sensible public health measures are both troubling and ironic.

They are troubling, because sometimes it is important to take strong measures to contain the spread of an infectious disease before the threat is so obvious that it is popularly understood. The litigation over the anthrax vaccination program began in 1999, two years before some lunatic turned the United States Postal Service into a delivery system for anthrax spores. If SARS or a more deadly contagious disease were to threaten the United States, would our courts even allow us to take the sensible measures that were standard operating procedure before the antibiotic era, including mandatory vaccination and quarantine? Even if most judges were sensible, how many silly injunctions would issue from our 500 federal district judges before the appellate courts sorted it all out?

These rights-based objections are ironic, too. It is no coincidence that the rise of legally cognizable individual rights in the United States and Europe during the last 50 years corresponded with the antibiotics era. When virulent infectious diseases posed a mortal threat to virtually all Americans -- as they did before World War II -- we needed government to act swiftly, and without anything resembling due process, to quarantine infected or even merely exposed individuals in order to isolate outbreaks before they spread widely. We understood instinctively that we had to impose harsh measures on individuals in order to protect the public. We didn't give a damn that sometimes we had to board people up in their houses or make them take a shot because we knew that the consequences of doing otherwise could be devastating. Does anybody believe that smallpox could have been confined to its tiny little lockbox if vaccination for the disease had been voluntary?

The defeat, or at least the subsidence, of infectious disease since World War II meant that we no longer needed our government to impose these harsh obligations on individuals for the public good. As a result, we see very few examples today of individuals who are required to bear great (or even small) individual burdens for the benefit of the public, so any such circumstance looks like a great injustice and therefore becomes the subject of litigation.

So it was antibiotics and vaccine that created the political climate necessary for today's individualist and litigious culture. It is therefore ironic that individualism is the basis for attacking programs to control the spread of infectious disease.


Post a Comment

This page is powered by Blogger. Isn't yours?