# What to do if someone refuses to adhere to quarantine? **URL:** \ **Category:** Great Debates\ **Created:** [October 29, 2014, 1:59pm UTC](https://boards.straightdope.com/t/what-to-do-if-someone-refuses-to-adhere-to-quarantine/702902 "2014-10-29T13:59:23Z")\ **Posts on this page:** 11\ **Page:** 4
**Author:** ![DingoelGringo](https://avatars.discourse-cdn.com/v4/letter/d/9d8465/32.png) [@DingoelGringo](https://boards.straightdope.com/u/DingoelGringo)\ **Post date:** [October 31, 2014, 12:14am UTC](https://boards.straightdope.com/t/what-to-do-if-someone-refuses-to-adhere-to-quarantine/702902/61 "2014-10-31T00:14:56Z")
> [@magellan01](#): > > Assume she was not in a tent. Assume it’s not Kaci Hickox. Assume the experts recommend the quarantine. And then I’ll assume you’re participating in the actual debate. Make all those assumptions I’ll assume you do it to remove it from rational debate. ---
**Author:** ![clairobscur](https://avatars.discourse-cdn.com/v4/letter/c/839c29/32.png) [@clairobscur](https://boards.straightdope.com/u/clairobscur)\ **Post date:** [October 31, 2014, 6:40am UTC](https://boards.straightdope.com/t/what-to-do-if-someone-refuses-to-adhere-to-quarantine/702902/62 "2014-10-31T06:40:00Z")
> [@Steophan](#): > > That’s _exactly_ what I’ve repeatedly said I want the judge to do. To decide whether there’s a legal basis on which to lock up the patient. He will do so by listening to the arguments from the medical professionals that the person is sufficiently dangerous, the arguments from the patient or his representative that he isn’t, and decide based on that. Again, if the case isn’t blatantly obvious, how can he do that without relying on the opinion of medical professionals? “Our current knowledge lead us to think this man might be a carrier and could transmit the disease”. How could he argue otherwise? > [@](#): > > In the case of an infectious disease, that would require test results that show the patient is infectious. It’s not complicated, and in most cases it would be nothing more than a rubber stamp, such as that for a warrant. But for cases such as the current ones, where there are proposals to quarantine non-infectious people, it would put an immediate stop to that. But that’s precisely the problem. It’s often more complicated than that. The test results aren’t forthcoming yet, we don’t have any test, it’s unclear whether the disease can be transmited this or that way, we’re not sure this person has been exposed… But the risk is stagering (again, not specifically in this case, but think about a highly lethal flu epidemic spreading through the land). Contrarily to what you seem to opine, if in doubt the general public must be protected, not the other way around. The risk of a single carrier starting an epidemic that will kill hundreds far outweight the right for an individual not to be quarantined for a couple weeks, possibly when he’s not infected. > [@](#): > > Hence the brief detention whilst arguments are presented to the judge. (I’m going to keep posting this until you actually read it). Brief maybe, if possible. Again, it’s an emergency. You can’t decide in advance that, say, the detention can’t exceed 24 hours or something and let the guy go if no judge could decide in time for whatever reason. Apparently, you want a mandatory judicial process (like for, say, arrests), but there’s normally no need for that. There’s a judge involved only if the individual contest the administrative decision to quarantine him, and it how it should be. > [@](#): > > What you absolutely don’t do is decide that someone _might_ be contagious, and lock them up. Sorry, but that’s exactly what is going to happen. You will quarantine this person if he _might_ be infectious, indeed. That’s what quarantine is. A precaution measure. And it’s the only way it can be of any use. Proven cases are hopefully already in an hospital. And even if a judge is involved, what he would have to decide, at best (because IMO again he will just decide if procedures have been correctly followed), if this person _might_ be contagious, no more than that. > [@](#): > > If it’s so hard to determine whether someone is contagious or not that someone who’s job it is to decide such things can’t make such a decision when the best expert evidence is placed in front of him, then it’s clearly not a demonstrable risk. Huh? It’s likely people will have no clue yet whether this person is infectious or not. Say, the person has been in close contact with infected people and a test requires several days to determine if he has been infected himself or not. Absolutely nobody can tell whether he’s infectious or not, but letting him out is clearly a demonstrable risk. > [@](#): > > Arbitrary detention, whether “justified” as an arrest, a quarantine, or being institutionalised, is not acceptable, beyond a brief detention where necessary to determine the legality of such detention. The presumption should be that it isn’t. Nope. The main issue is unlikely to be the legality of the detention (" X signed the order? OK, it’s legal") but rather the actual medical risk. Which is a matter for doctors, not judges. And this person isn’t accused of anything. It’s a matter of prevention of a major risk for the population, not of presumption of innocence. The principle of precaution should apply, and if anything people should err on the side of caution. It’s not your fault if you’re potentially a carrier of a potentially lethal disease, but your right to roam around freely for a couple weeks can’t outweight the risk of having dozens of people die. > [@](#): > > The person to decide that is a judge, not a doctor. Someone who does not test positive for such a disease should not be locked up. Yes, sure, and infect everybody else until a test result can be obtained (Assuming that you can then find the person to administer the test. Assuming the test exists.) There’s no point in even trying to quarantine anybody in this case. Just let the epidemic spread in the name of freedom of movement. > [@](#): > > Again, it should not be up to a doctor to decide what level of madness or danger allows detention, but a judge. And how is a judge supposed to decide what level of madness is involved? The reason why it’s a doctor who decides is that even if he can err, he’s the only one who has the slighest clue about the issue. And what makes you think that judges would be less prone to order a lock-up than doctors, anyway? “This guy thinks that trucks drivers are all out to kill him, and generally suspect more or less everybody is plotting against him. He sees dismembered bodies lying on the floor and in the streets. He’s typically carrying a knife for self-defence against the many imaginary dangers he perceives. He’s a drug addict. Should we send him back home or keep him locked, your honour?” (for the record this is an actual case I knew of, and he wasn’t locked up by the doctors. Now, try to guess what a judge would have decided upon hearing that. Especially in the USA where some judges are elected.) ---
**Author:** ![Lord\_Feldon](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/lord_feldon/32/341_2.png) [@Lord\_Feldon](https://boards.straightdope.com/u/Lord_Feldon)\ **Post date:** [October 31, 2014, 7:33am UTC](https://boards.straightdope.com/t/what-to-do-if-someone-refuses-to-adhere-to-quarantine/702902/63 "2014-10-31T07:33:53Z")
> [@clairobscur](#): > > Really? I would be curious to know about the details. You need the prior agreement of a judge to be kept in a psychiatric hospital following a suicide attempt? You have a right to a lawyer when a doctor decides whether or not you’re an infectious risk? A jury must determine whether you’re a danger for yourself or others before sedatives can be administered? Due process just means the government can’t arbitrarily do things that take away your rights. There has to be a good reason to do it, and a fair process for making sure it was done for a good reason. ---
**Author:** ![magellan01](https://avatars.discourse-cdn.com/v4/letter/m/45deac/32.png) [@magellan01](https://boards.straightdope.com/u/magellan01)\ **Post date:** [October 31, 2014, 1:52pm UTC](https://boards.straightdope.com/t/what-to-do-if-someone-refuses-to-adhere-to-quarantine/702902/64 "2014-10-31T13:52:36Z")
* * * > [@DingoelGringo](#): > > Make all those assumptions I’ll assume you do it to remove it from rational debate. Oh, so wanting to debate the lengths the government should and could go to to enforce a quarantine is outside the scope of “rational debate”? You have an interesting take on what “rational debate” is? Perhaps you can share it? Or you can read the fucking OP digesting the words that are actually there. Here, let me help you glean its meaning: > [@](#): > > **What to do if someone refuses to adhere to quarantine?** > > Obviously, this question was inspired by the healthcare workers who returned to the U.S. from West Africa. particularly the case of Kaci Hickox, which you can read a little about here. > > In short, she doesn’t want to be quarantined for 21 days. So, what do we do if **a person** who the experts and authorities agree should be quarantined do not want to be quarantined? > > Personally, I think that Kaci Hickox is losing sight of the fact that quarantine is a precaution, with the emphasis on “caution”. And she should do what the experts and authorities recommend. I find it particularly puzzling that someone in the healthcare field would not grasp the reasoning behind quarantine, and wouldn’t want to err on the side of caution. > > So, this debate is NOT about what the correct length of quarantine should be. **The debate is about once a length of quarantine has been established by the experts tasked to figure such things out,** how do we enforce it against an unwilling person? It seems that if **he/she** is determined to not be quarantined and tries to leave the area, she must be stopped. And she should be stopped by means that incur the least risk to those stopping her and society. So, a jail-like structure? Restraints? Medication? > > Thoughts? ---
**Author:** ![Steophan](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/steophan/32/9595_2.png) [@Steophan](https://boards.straightdope.com/u/Steophan)\ **Post date:** [October 31, 2014, 2:21pm UTC](https://boards.straightdope.com/t/what-to-do-if-someone-refuses-to-adhere-to-quarantine/702902/65 "2014-10-31T14:21:15Z")
> [@clairobscur](#): > > Contrarily to what you seem to opine, if in doubt the general public must be protected, not the other way around. That’s where we disagree, then. We should no more lock someone up if there’s serious doubt that they’re infectious than if there’s serious doubt that they committed a crime. In fact, quarantine in the circumstances you’re describing is more akin to locking someone up because they might, possibly, commit a crime in the future. If you don’t find that unacceptable then, well, there’s not even a basis for us to debate, really. The time to use quarantine is when people are contagious but not symptomatic. Not when someone might have been in the same country as someone who might have been infected. If they are symptomatic of a disease serious enough to consider quarantine, then they should (as you’ve rightly said) be in hospital in an isolation ward. If a disease is serious and widespread enough to require quarantining people who may well not be affected, then abandon human rights principles entirely and quarantine entire towns. And I’ll explain _again_ why a judge must be involved. It’s not to decide whether a particular test is accurate or whether a particular patient is infected. It’s to ensure that the patient has, in fact, been tested, with an approved test, and that all proper procedures are followed prior to locking that person up. Non-judicial imprisonment, _for whatever reason_, is unacceptable outside of actual states of emergency (as in, martial law situations). Even in wartime, there are rules as to who can be imprisoned. The idea that potentially ill citizens should have less rights than enemy soldiers is absurd, and disgusting. ---
**Author:** ![doorhinge](https://avatars.discourse-cdn.com/v4/letter/d/a5b964/32.png) [@doorhinge](https://boards.straightdope.com/u/doorhinge)\ **Post date:** [October 31, 2014, 3:45pm UTC](https://boards.straightdope.com/t/what-to-do-if-someone-refuses-to-adhere-to-quarantine/702902/66 "2014-10-31T15:45:22Z")
> [@Bridget\_Burke](#): > > And Christie still has delusions of winning the Republican nomination for President. If he can act sufficiently macho, the public might forget he’s a corrupt lardass. So you object to Christie because he’s fat??? ---
**Author:** ![PastTense](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/pasttense/32/14550_2.png) [@PastTense](https://boards.straightdope.com/u/PastTense)\ **Post date:** [October 31, 2014, 4:04pm UTC](https://boards.straightdope.com/t/what-to-do-if-someone-refuses-to-adhere-to-quarantine/702902/67 "2014-10-31T16:04:45Z")
> [@](#): > > The state of Maine obtained a temporary court order on Friday that places restrictions on the movements of a nurse who worked with Ebola patients in west Africa, but who has not shown any symptoms of the disease. > > The court order allows Kaci Hickox to leave her home, but she may not go to public gatherings and must maintain a 3ft distance from other people. > > In a decision issued on Friday morning, chief district court judge Charles C LaVerdlere wrote that the case had “critical implications for [Hickox’s] freedom”, and “the public’s right to be protected from the potential severe harm posed by transmission of a devastating disease”. > **[Maine nurse can leave home but must maintain 3ft distance from others, court...](https://www.theguardian.com/us-news/2014/oct/31/maine-nurse-kaci-hickox-cdc-ebola)** > > State obtains temporary court order forcing Kaci Hickox to follow CDC’s Ebola guidelines, but Hickox will not be subject to home quarantine Those restrictions seem reasonable. ---
**Author:** ![doorhinge](https://avatars.discourse-cdn.com/v4/letter/d/a5b964/32.png) [@doorhinge](https://boards.straightdope.com/u/doorhinge)\ **Post date:** [October 31, 2014, 4:34pm UTC](https://boards.straightdope.com/t/what-to-do-if-someone-refuses-to-adhere-to-quarantine/702902/68 "2014-10-31T16:34:09Z")
> [@PastTense](#): > > [Maine nurse can leave home but must maintain 3ft distance from others, court rules | Maine | The Guardian](http://www.theguardian.com/us-news/2014/oct/31/maine-nurse-kaci-hickox-cdc-ebola) > > Those restrictions seem reasonable. That’s only the courts opinion and we’ve seen what Hickox thinks of other peoples opinions. I wonder if Hickox think these reasonable restrictions are reasonable? ---
**Author:** ![bordelond](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/bordelond/32/150_2.png) [@bordelond](https://boards.straightdope.com/u/bordelond)\ **Post date:** [October 31, 2014, 6:37pm UTC](https://boards.straightdope.com/t/what-to-do-if-someone-refuses-to-adhere-to-quarantine/702902/69 "2014-10-31T18:37:15Z")
[Maine **Judge Rejects Ebola Quarantine for Nurse**](http://www.nytimes.com/2014/11/01/us/ebola-maine-nurse-kaci-hickox.html?_r=0) She’s won at least one legal challenge: > [@](#): > > FORT KENT, Me. — Less than a day after restricting the movements of a nurse who treated Ebola victims in West Africa, a judge in Maine has lifted the measures, rejecting arguments by the State of Maine that a quarantine was necessary to protect the public. > > Within an hour of the decision, state troopers who had been parked outside the nurse’s house for days had left. ---
**Author:** ![drkstar](https://avatars.discourse-cdn.com/v4/letter/d/edb3f5/32.png) [@drkstar](https://boards.straightdope.com/u/drkstar)\ **Post date:** [November 1, 2014, 9:11pm UTC](https://boards.straightdope.com/t/what-to-do-if-someone-refuses-to-adhere-to-quarantine/702902/70 "2014-11-01T21:11:39Z")
> [@PastTense](#): > > [Maine nurse can leave home but must maintain 3ft distance from others, court rules | Maine | The Guardian](http://www.theguardian.com/us-news/2014/oct/31/maine-nurse-kaci-hickox-cdc-ebola) > > Those restrictions seem reasonable. Given that these restrictions are the same ones prescribed by the CDC for her risk group, it was nice to see that the judge was deferring to experts. But why was this only a temporary order? Upon reading the article that bordelond linked to, the judge afterwards ruled that Ms. Hickox is required to abide by the CDC’s guidelines to “submit to daily monitoring for symptoms, to coordinate her travel with public health officials and to notify them immediately if symptoms appear” but made no mention that she would also be required to abide by the restrictions prescribed by the CDC for her risk group. Does that mean the judge ruled that the CDC’s own restrictions are unnecessary for Ms. Hilckrox to follow? Please correct me if I’m wrong. ---
**Author:** ![Stratocaster](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/stratocaster/32/16393_2.png) [@Stratocaster](https://boards.straightdope.com/u/Stratocaster)\ **Post date:** [November 2, 2014, 4:59am UTC](https://boards.straightdope.com/t/what-to-do-if-someone-refuses-to-adhere-to-quarantine/702902/71 "2014-11-02T04:59:28Z")
> [@magellan01](#): > > \*\*\*\*Oh, so wanting to debate the lengths the government should and could go to to enforce a quarantine is outside the scope of “rational debate”? I don’t think so. I think it’s a good question. But if you don’t want Hickox to be part of the discussion, if her case is not one where experts recommend a quarantine and that’s a prerequisite for your debate, then don’t invoke her in the OP (and then again) and don’t incorrectly assign that detail to her case. If you incorrectly brought her into the debate, just say, “My bad,” don’t sigh and scold when you’re the one who introduced her as an example. You helped to create the confusion in the OP that seems to be frustrating you, then double downed when you later basically asked, “Okay, so what should we do about Hickox?” [Previous page](https://boards.straightdope.com/t/what-to-do-if-someone-refuses-to-adhere-to-quarantine/702902.md?page=3)