When is a quarantine justified? A group of philosophers offers an answer.
Quarantines are worth the trouble to keep the next pandemic at bay but they need to be applied intelligently.
- A new essay argues that quarantines are often needed, but require strict guidelines on when they can be used.
- Pandemics are inevitable, and actions that can save lives must be planned now.
- The arguments in this essay will undoubtedly be of use during the next outbreak.
The use of isolation and quarantine has a history of success going back to the black plague. The practice of isolating sick people form healthy ones intuitively strikes many of us as useful, and many of us do it on our own accord when we fall ill. It seems like a simple step up from that to the idea of quarantining people who are sick or have been exposed to deadly diseases to stop them from spreading.
However, the impositions on individuals that quarantine requires, such as isolation from friends, family, and activity is a rather steep price to pay. Besides, the use of force to limit people's freedoms for the greater good is always a moral minefield. Deciding exactly when, where, and how to implement a quarantine is a tricky business.
A paper by Alberto Giubilini, Hannah Maslen, Tom Douglas, and Julian Savulescu of the Oxford Uehiro Centre for Practical Ethics might have a solution. By taking a moral approach to the problem, one that seeks the most robust possible foundation for intervention, the authors hope to provide sound guidelines to people considering the question of when to intervene and when to take no action.
What is a quarantine exactly?
Health workers are seen with a young patient under quarantine at the Nongo Ebola treatment unit in Conakry, Guinea on August 21, 2015. The World Health Organization WHO has lost track of 45 people under surveillance, who had been in contact with a patient who contracted Ebola, in Guinea. (CELLOU BINANI/AFP/Getty Images)
For the purposes of this paper, isolation and quarantine had two different meanings. As the authors define them: "Isolation separates sick people with a contagious disease from people who are not sick. Quarantine separates and restricts the movement of people who were exposed to a contagious disease to see if they become sick."
Why would quarantine be a good idea? After all, they aren't sick yet!
"Typhoid" Mary Mallon, far left, in quarantine. Her refusal to wash her hands while carrying typhoid fever bacteria may have killed fifty people. She was forced into quarantine for the safety of the public.
The first argument that the authors make is the obvious one, society benefits a great deal from quarantining a person who might be carrying a deadly disease at a relatively low cost to that society and a moderate cost to the person quarantined. A person who is exposed to Ebola might contract the disease and start spreading it before they are aware of their illness. Quarantines try to prevent this by hiding away anybody who might have been exposed to a disease, even if they are asymptomatic.
This consequentialist stance is the one typically invoked by governments and state agencies when quarantines are introduced, but the authors don't think it is the best ethical foundation. After all, it might be for everybody's benefit to lock away anybody exposed to the common cold for a week to keep infection rates down. This seems excessive, suggesting that the final answer lies elsewhere.
The authors then argue that, in many cases, the individual exposed to a potentially deadly disease will have a moral duty to quarantine themselves; making what the authorities do merely the enforcement of what a person ought to do anyway.
They use the example of Peter Singer's drowning child. Singer famously asked if we had a moral obligation to save a drowning child if the act of saving them was at a low cost to us. He concluded that we do, and many people agree with him. The authors call this the duty of "easy rescue" and argue that it applies in many quarantine cases since the cost of a person hiding in their room until they know they won't make others sick is typically low while the payoff could include saving lives.
The authors then suggest that, "when the cost to us of engaging in some activity is small, and the harm to others which is prevented is great, the state may permissibly compel us to engage in that activity." They place this inside of certain parameters, however.
Most of us would agree that we must keep other people from getting sick when we are ill. However, the suggestion here is that in severe cases, like when the illness in question is deadly, that the state has legitimate power to make sure we stay home. This is more limited than just comparing costs and benefits and doing whatever gives the best payoff, but still allows for interventions during the worst outbreaks.
But what about the freedom of the individual?
The authors don't suggest that the authorities should always start with quarantines and use them whenever the mood strikes. They make it clear at the beginning of their paper that, "we will argue that authorities ought to implement quarantine and coercion in such a manner that they have the strongest justification possible for those measures."
They also point out that any rational use of quarantines would be limited to severe cases. As they note, while it might be a social net-positive to quarantine people with the stomach flu, the lack of threat it poses makes the action unthinkable. Ebola, on the other hand, is enough of a threat to people that quarantines would be justified.
At some point though, the freedom of a person to do what they like would be infringed on for the sake of the public health. Many people are put off by this. The question is determining when an individual poses enough of a threat to the people around them that forcing them into quarantine is justified. The authors are of the mind that this is permissible when a person might have a very deadly disease.
In some cases, quarantine laws are overused and not based on a cost-benefit analysis, such as when New Jersey introduced a quarantine of people who had been in certain African countries during the 2014 Ebola outbreak. The poorly thought out law was changed after a lawsuit was brought against the state. This case should be a warning against over-application of quarantines, but not against their use when they are correctly implemented.
The idea of using force to lock people in their rooms to assure that others don't get sick is a tricky one. It makes perfect sense when we're healthy, but seems like a potential use of excessive force when we might be on the sick bed. Nevertheless, the ethics surrounding this issue are far from settled though. Given that we're already preparing for the next pandemic, we may be ruminating more moral questions sooner than we think.
The Lumina Foundation lays out steps for increasing access to quality post-secondary education credentials.
- America's post-high school education landscape was not created with the modern student in mind. Today, clear and flexible pathways are necessary to help individuals access education that can help them lead a better life.
- Elizabeth Garlow explains the Lumina Foundation's strategy to create a post-secondary education system that works for all students. This includes credential recognition, affordability, a more competency-based system, and quality assurance.
- Systemic historic factors have contributed to inequality in the education system. Lumina aims to close those gaps in educational attainment.
- In 2019, Lumina Foundation and Big Think teamed up to create the Lumina Prize, a search to find the most innovative and scalable ideas in post-secondary education. You can see the winners of the Lumina Prize here – congratulations to PeerForward and Greater Commons!
French newspapers report that the trial hasn't lived up to expectations.
- The French government initially invested in a rural solar roadway in 2016.
- French newspapers report that the trial hasn't lived up to expectations.
- Solar panel "paved" roadways are proving to be inefficient and too expensive.
During World War II, the U.S. incarcerated over 100,000 Japanese Americans in concentration camps throughout the West.
- Now that the issue of concentration camps in the U.S. has once again reared its head, it can be beneficial to recall the last time such camps were employed in the U.S.
- After Pearl Harbor, the U.S. incarcerated over 100,000 Japanese Americans in camps, ostensibly for national security purposes.
- In truth, the incarceration was primarily motivated by racism. What was life like in the U.S.'s concentration camps?
On February 19, 1942, President Roosevelt issued Executive Order 9066, which authorized and directed military commanders "to prescribe military areas … from which any or all persons may be excluded, and with respect to which, the right of any person to enter, remain in, or leave shall be subject to whatever restrictions the Secretary of War or the appropriate Military Commander may impose in his discretion." Under the authority of this executive order, roughly 112,000 men, women, and children of Japanese descent — nearly two-thirds of which were American citizens — were detained in concentration camps.
How did the camps get their start?
With the benefit of a nearly 80-year perspective, it's clear that the internment of Japanese Americans was racially motivated. In response to Japan's growing military power in the buildup to World War II, President Roosevelt commissioned two reports to determine whether it would be necessary to intern Japanese Americans should conflict break out between Japan and the U.S. Neither's conclusions supported the plan, with one even going so far as to "certify a remarkable, even extraordinary degree of loyalty among this generally suspect ethnic group." But of course, the Pearl Harbor attacks proved to be far more persuasive than these reports.
Pearl Harbor turned simmering resentment against the Japanese to a full boil, putting pressure on the Roosevelt administration to intern Japanese Americans. Lieutenant General John DeWitt, who would become the administrator of the internment program, testified to Congress
"I don't want any of them here. They are a dangerous element. There is no way to determine their loyalty... It makes no difference whether he is an American citizen, he is still a Japanese. American citizenship does not necessarily determine loyalty... But we must worry about the Japanese all the time until he is wiped off the map."
DeWitt's position was backed up by a number of pre-existing anti-immigrant groups based out of the West Coast, such as the Joint Immigration Committee and the Native Sons and Daughters of the Golden West. For many, the war simply served as an excuse to get rid of Japanese Americans. In an interview with the Saturday Evening Post, Austin Anson, the managing secretary of the Salinas Vegetable Grower-Shipper Administration, said:
"We're charged with wanting to get rid of the Japs for selfish reasons. We do. It's a question of whether the White man lives on the Pacific Coast or the brown men. ... If all the Japs were removed tomorrow, we'd never miss them in two weeks because the White farmers can take over and produce everything the Jap grows. And we do not want them back when the war ends, either."
Ironically for Anson, the mass deportation of Japanese Americans under Executive Order 9066 meant there was a significant shortage of agricultural labor. Many Caucasians left to fight the war, so the U.S. signed an agreement with Mexico to permit the immigration of several million Mexicans agricultural workers under the so-called bracero program.
Life in the camps
Hulton Archive/Getty Images
Circa 1943: Aerial view of a Japanese American relocation center in Amache, Colorado, during World War II. Each family was provided with a space 20 by 25 ft. The barracks were set in blocks and each block was provided with a community bath house and mess hall.
For the most part, Japanese Americans remained stoic in the face of their incarceration. The phrase shikata ga nai was frequently invoked — the phrase roughly translates to "it cannot be helped," which, for many, represents the perceived attitude of the Japanese people to withstand suffering that's out of their control.
Initially, most Japanese Americans were sent to temporary assembly centers, typically located at fairgrounds or racetracks. These were hastily constructed barracks, where prisoners were often packed into tight quarters and made to use toilets that were little more than pits in the ground. From here, they were relocated to more permanent camps — replete with barbed wire and armed guards — in remote, isolated places across the seven states of California, Arizona, Colorado, Wyoming, Idaho, Utah, and Arkansas.
Many of these camps, also known as War Relocation Centers, were little better than the temporary assembly centers. One report described the buildings as "tar paper-covered barracks of simple frame construction without plumbing or cooking facilities of any kind." Again, overcrowding was common.
As a result, disease became a major concern, including dysentery, malaria, and tuberculosis. This was problematic due to the chronic shortage of medical professionals and supplies, an issue that was not helped by the War Relocation Authority's decision to cap Japanese American medical professional's pay at $20 a month (about $315 in 2019 dollars), while Caucasian workers had no such restriction. As a comparison, Caucasian nurses earned $150 ($2,361) a month in one camp.
The U.S. government also administered loyalty questionnaires to incarcerated Japanese Americans with the ultimate goal of seeing whether they could be used as soldiers and to segregate "loyal" citizens from "disloyal" ones. The questionnaires often asked whether they would be willing to join the military and if they would completely renounce their loyalty to Japan. Due to fears of being drafted, general confusion, and justified anger at the U.S. government, thousands of Japanese Americans "failed" the loyalty questionnaire and were sent to the concentration camp at Tule Lake. When Roosevelt later signed a bill that would permit Japanese Americans to renounce their citizenship, 98 percent of the 5,589 who did were located at Tule Lake. Some apologists cite this an example of genuine disloyalty towards the U.S., but this argument clearly ignores the gross violation of Japanese Americans' rights. Later, it became clear that many of these renunciations had been made under duress, and nearly all of those who had renounced their citizenship sought to gain it back.
Since many children lived in the camps, they came equipped with schools. Of course, these schools weren't ideal — student-teacher ratios reached as high as 48:1, and supplies were limited. The irony of learning about American history and ideals was not lost on the students, one of whom wrote in an essay --
"They, the first generation [of Japanese immigrants], without the least knowledge of the English language nor the new surroundings, came to this land with the American pioneering spirit of resettling. ...Though undergoing many hardships, they did reach their goal only to be resettled by the order of evacuation under the emergency for our protection and public security."
Potentially the best part of life in the camps — and the best way for determined prisoners to demonstrate their fundamental American-ness — was playing baseball. One camp even featured nearly 100 baseball teams. Former prisoner Herb Kurima recalled the importance of baseball in their lives in an interview with Christian Science Monitor. "I wanted our fathers, who worked so hard, to have a chance to see a ball game," he said. "Over half the camp used to come out to watch. It was the only enjoyment in the camps."
When the camps finally closed in 1945, the lives of the incarcerated Japanese Americans had been totally upended. Some were repatriated to Japan, while others settled in whichever part of the country they had been arbitrarily placed in. Those who wished to return to the West Coast were given $25 and a train ticket, but few had anything to return to. Many had sold their property to predatory buyers prior to being incarcerated, while theft had wiped out whatever else they had left behind. Many, many years later, the 1988 Civil Liberties Act mandated that each surviving victim be paid $20,000, though that seems like a small fine to pay for irrevocably changing the courses of more than 100,000 lives.