Really big nets and lassos, maybe.
I don’t think this has been a huge problem in historical quarantine situations, though. Cops often face physical resistance because they often deal with criminals, drunks, and the like. For a quarantine, the infected person is most likely not a criminal (simply because most people aren’t criminals), and thus probably far less likely to physically resist the authorities.
Oh, I agree. As I said, I was just running through some worst case scenarios.
I do like the big net idea though, shot out of a gun, Courageous Cat style.
Would someone please enlighten me on the ambiguity that exists for the specific case of Kaci Hickox?
Given:
How exactly are her rights being trampled when she keeps threatening to act irresponsibly?
For one thing, this was a politically-led quarantine that did not have the support of the medical and health authorities and experts. For another, she was placed in a tent with a toilet that didn’t flush. No shower, no heat/AC, no TV, no computer, no nothing except a bed and a non-flushing toilet, and her cell phone.
If she’s not spewing vomit and bodily fluids, she’s no threat to anyone. Quarantining people simply because they spent time in West Africa is going to hurt West Africans and make the disease more likely to spread there, and which means fewer aid workers will want to go, which means the outbreak could be worse (and more dangerous to America in the long run).
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?
At least in the case we’re discussing, nobody apparently thought about this due process before confining her in this tent.
Also, most people in this thread seem fully unaware that such rights exist wrt quarantines.
Even if she has Ebola, she cannot transmit it to others if she is asymptomatic, which she is. If she develops a fever, or vomiting/diarrhea, or other symptoms of the disease, than quarantine (by force if necessary) is appropriate.
Three weeks’ quarantine for anyone who has been in contact with the disease but shows no virus or symptoms is counter-productive and unnecessary. It’s just a political pandering to an elevated but irrational fear of the disease.
As an example of how it should work - that doctor in New York who monitored his temperature every day and checked into the hospital when he developed a fever was exactly how these cases should be handled.
This part I understand and agree with. Christie is an ass.
I’m not sure I understand this as well. If I’m a volunteer, going to work with ebola patients in West Africa, I am already accepting the risk of contracting ebola. Furthermore, I understand the dangers of it spreading. How am I less inclined to go help knowing I will have to respect 21 day self-quarantine protocol when I return?
You might be poor, have a sick relative to take care of, or have one of a million other reasons in which you don’t want to be confined for three weeks.
It’s an imminent danger. In which case you take the necessary actions (say, entering a house without a warrant, or in this case isolating the person) first, and you check whether the action was appropriate and justified later.
And besides a judge isn’t qualified to determine whether or not there’s a need to quarantine someone. All he’s qualified to do is appreciate whether the law has been properly followed in this case. Or at most if the law regarding quarantines is constitutional to begin with (and I would bet there has already been many people who challenged it. If it’s still in the books, it’s very probably because courts actually decided it was).
Hence the acceptance of temporary detention pending authorisation.
If a judge can’t make a decision that it’s legal, based on the evidence provided by the medical personnel, and if they choose to the contrary evidence provided by the person being threatened with detention, then it shouldn’t happen. Denying someone their basic human rights is an extremely serious thing to do, and to do so extra-judicially is utterly unacceptable.
I’m not talking about US law here, I’m talking about what should be done. I’ve already said that any laws that allow locking people up without due process should be changed. That includes ones such as the ones where I live, which allow for locking up mentally ill people for over 6 months, and forcing them to be treated, without any judge or lawyer being involved.
This is the crucial issue. If we allowed politicians to substitute their judgment for that of trained epidemiology experts and imposing quarantines without requiring proof of actual danger, we would have Republican governors and secretaries of state locking down the Hyper-Melaninitis zones every Election Day.
OK.
Hickox has chosen to leave her quarantine and peddle her ass around a rather unpopulated part of Maine. The Governor says he will use the full extent of the law to deal with the situation. That means lawyers and court orders but not the how to actually apprehend a violator.
The military has developed NBC (Nuclear, Biological, Chemical) suits that allow soldiers to fight in considerably more strenuous and dangerous situations than rounding up one walker (Walking Dead reference :D. )
If it is determined that Hickox needs to be stopped, detained, and returned to quarantine, I would suggest NBC suits and Tasers, applied externally, and as often as required. 
How could he? He’s not a medical professional. He can say : “the law has been followed/not followed” (say, the guy has been seen by a doctor if the law states he must be), he can’t say : “well, in my opinion, this Ebola stuff is overblown, and this guy looks fine anyway, just let him go”.
Infecting a whole community is also an extremely serious thing. Firemen don’t wait for a judge’s order to enter your property and put out a fire. If you want to argue it was just a barbeque, and they shouldn’t have doused your house with 100 hectoliters of water, there’s ample time to go to court and seek redress later.
I’m pretty sure there are situations, in particular regarding mental health, where the law could be more protective of the rights of people. However, maybe it’s better to first lock up the person who hear voices telling him his children are in fact demons in disguise that he should eliminate. And, as bad as psychiatrists might be, they’re probably much more qualified than a judge to assess this danger. And similarly, a lawyer could argue “they locked him up illegally”, but it’s a medical expert you need to argue that you’re not, in fact, mentally heal and/or dangerous.
Similarly, here, it’s a potentially extremely dangerous situation that must be adressed. This case happens to be spurious. But what about a highly contagious disease? Can you let people go and infect maybe dozens of others, possibly starting an outbreak that will kill thousands while waiting for a judge decision? What if it’s a full blown epidemic in a city, with already hundreds or thousands of cases? Will you wait for individual decisions before quarantining each person?
And again, even assuming you do : a judge is wholy unqualified to determine whether or not this person is a potential carrier, whether or not letting him go freely presents a risk for the population at large, whether the disease is as serious as the black death or as inocuous as a common cold. All he is qualified to do is to decide things like : is the law constitutional? Does it applies in this case? Have the procedures been followed?
Protections afforded to people against arbitrary arrest/sentences/whatever and protective measures aren’t the same thing. Being mentally ill or a carrier of a lethal disease aren’t crimes, and quarantines or institutionalization aren’t detention or sentence. They’re safety measures, similar to the firemen picking up your children in your burning house, or the police blocking a street because a gas pipe might explode. You first do what seems to be needed to protect the person or others, and then only you go to court if it seems warranted to have the decision canceled, or to seek redress for the harm possibly done.
If I’m poor, how can I afford to fly to West Africa as a volunteer? Seem to me, most people who do this have some resources above meager means.
If I am looking after a sick relative, I’m not going to Africa to look after strangers.
I think people who do this have a calling and I admire them for their sense of selfless desire to help others. I don’t know if very many make this kind of decision without knowing the risks involved. Most are well enough educated to weigh these risks. 21 day self-quarantines on return are just part of the risk/benefit calculation. I imagine that the same social conscience that compels them to help West Africans would be the same sense of social conscience that would compel them to take steps to prevent the spread of the virus when they get home.
But I’m also cognizant of the protocol advised by NIH and CDC: Monitor your temp and get immediate medical attention at the first sign of fever and associated symptoms - otherwise feel free to move about freely.
My concern is this: He was fine when he got on the plane from NYC to SF. About half way through he got a fever and had to vomit and had gastric upset. So now there is contamination in the bathroom and potentially significant risk of transmission to other passengers. At the very least now they all have to monitor themselves for symptoms. Some are headed in the opposite direction of home so what are they to do to return home safely and quickly? And the plane needs a thorough cleaning so there is a daisy chain effect for the next scheduled flight. Crew is out of commission too… Etc…etc…
I guess some will say, “It hasn’t happened yet. Why panic?”
I’m thinking that the mandatory self-quarantined protocol is to prevent exactly this sort of panic.
The same way he decides any other case. Listens to the arguments, and decides whether the law allows the patient to be locked up.
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.
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.
Hence the brief detention whilst arguments are presented to the judge.
That’s a massive understatement…
Hence the brief detention whilst arguments are presented to the judge. (I’m going to keep posting this until you actually read it).
I’m not talking about the danger, I’m talking about the legality of the detention. The judge will consider the arguments made by the psychiatrist, and make a legal judgement on what may happen. A psychiatrist should not have the right to decide whether someone should be locked up, beyond a brief detention period if he feels it’s absolutely necessary to preserve life or limb. Basically, the same decision that someone should use when deciding whether to act in self defence, but on behalf of his patient.
You detain the potentially infectious people for a brief time, until a judge can decide whether they have been sufficiently proven to be contagious. Or, you declare a state of emergency, and martial law, and decide that nobody has basic human rights any more. In which case, you quarantine the entire city.
What you absolutely don’t do is decide that someone might be contagious, and lock them up.
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.
And that is precisely what needs to be decided, in every case.
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.
I want people to be protected. That’s precisely why I think people shouldn’t be locked up without cause. Someone who’s been tested for a highly communicable, serious disease should be quarantined, provided the test and the seriousness of the disease meet certain standards. 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.
Similarly, someone who says they’re going to kill and eat their children needs to be removed from them. Someone who says the voices in his head sometimes tell him his kids are demons does not, unless there’s any actual evidence that he’s an imminent danger to them. Again, it should not be up to a doctor to decide what level of madness or danger allows detention, but a judge.
Politically, a politician looked better by enforcing quarantine than not. Not saying it’s right, just saying that’s what public opinion wanted.
And therein lies the rub. There may not be a test capable of objectively doing just that.
So a decision must be made on whether to quarantine and whether to do so forcibly if the individual refuses to do so voluntarily. And all you have is information about the person’s symptoms (if any) and contacts.
The legal framework in law that provides for authorizing a quarantine order will specify who may issue that order. It is possible that an order would be issued in the name of one official who does so on the advice of another. (e.g. Governor issues an order on advice of head of the state health department.)
A patient in a voluntary quarantine does not need a judicial review. There is no dispute.
A patient may be placed in forcible quarantine but then decide, for whatever reason, not to fight the decision. If such happens there is no need for judicial review.
Only when a patient is placed in forcible quarantine and chooses to dispute that designation is a judicial review even possible. IANAL, but my brief reading indicates judges rarely overrule a quarantine order but do occasionally order a change in conditions of quarantine so that the detention has the desired public health result with minimizing the impact on the person so detained.
Actually that is exactly how a forcible quarantine works. It can be challenged after the fact, but no court order is needed to initiate it. If you know the person is definitely ill then the proper term is isolation.
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.
(Meanwhile, I’ve got Governor Rick & Loathsome Ted Cruz trying to Out-Texan each other. The midterm elections haven’t even happened & presidential campaign is already nauseating me. Far more deleterious to my health than Ebola will ever be.)
ITSM that if you give someone who is to be quarantined some decent surroundings and 3 squares they are more likely to stay put. Some will probably still want out but you may get more cooperation than if you leave someone stuck in a dirty, contaminated apartment with no food like in Texas with the Duncan case or stick someone in a tent with a toilet like this nurse.
I live in Texas and it just struck me as a really Republican politician attitude to leave people stuck in a dirty apartment with no way to get food and then be SHOCKED when it was revealed that the adults had been sneaking out of the apartment to get food. If you are so petrified of giving somebody something for FREEEEEEE that you can’t even think in terms of how it would benefit public health to provide aid for quarantined people then…I don’t know what to say.