Quarantine, isolation and the duty of easy rescue in public health

Giubilini, Alberto; Douglas, Thomas; Maslen, Hannah; Savulescu, Julian

The severity of the harm to be prevented or contained through coercive or compulsory public health measures should be significant. For example, it does not seem justifiable to quarantine individuals who might have been exposed to viral gastroenteritis, because the harm of gastroenteritis is not severe enough, but it might have been justifiable to quarantine the village of Sella Kafta in Sierra Leone in order to detect symptomatic and therefore contagious cases of Ebola at the onset.Less restrictive measures for preventing or containing the infectious disease should be preferred to more restrictive measures; for example, ‘all other things being equal, a policy that provides incentives for persons with tuberculosis to complete their treatment until cured will have priority over a policy that forcibly detains such persons in order to ensure the completion of treatment’.23 There should be proportionality between the public health measure implemented and the threat to public health. In general terms, the more harmful a disease is, the more restrictive the measures that a state may be justified in imposing are. For example, it seems plausible to say that isolation is not a proportionate measure against viral gastroenteritis, although it would be effective, while it seems proportionate against Ebola or SARS: the significant threat that such infectious diseases pose justifies imposing a certain level of coercion or compulsion in order to avoid or contain outbreaks.