What measures should be taken to control the spread of infectious disease? How do you weigh public health and individual rights to make appropriate decisions?
This issue has come up before, in the inoculation debates in 1721. It became a more serious problem in the late 19th and early 20th century as microbiologists quickly realized that many diseases (cholera, tuberculosis, typhoid, diphtheria, etc.) were caused by contagious bacteria.
Both the “Discussion on the Advisability of the Registration of Tuberculosis” and Leavitt’s “Typhoid Mary” discuss what powers health officials should have over the lives and rights of individuals.
These debates recurred repeatedly throughout the 20th century: can states require children to receive immunizations? Can patients with tuberculosis be confined to hospitals to receive antibiotics? (the answer to these questions is yes). They are again emerging as active policy questions: with COVID-19, will individuals be hospitalized involuntarily, can cities be quarantined? etc.
Many of the most contentious past debates are related to HIV/AIDS.Should public health authorities have the right to confine people, as was done with Mary Mallon, to keep them from spreading the disease?
Should all patients with AIDS be reported to health officials, as has been done with tuberculosis and syphilis, do that their behavior can be monitored?