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

• Published in: Developing world bioethics 2018-06, Vol.18 (2), p.182-189
• Main Authors: Giubilini, Alberto, Douglas, Thomas, Maslen, Hannah, Savulescu, Julian
• Format: Article
• Language: English
• Subjects: Coercion; Coercivity; Compulsions; Cost benefit analysis; Developing Countries; easy rescue; Emergencies; Enforcement; Ethical Theory; Ethics; Government; Government Regulation; Health education; Health Policy; Humans; International community; isolation; Justification; Moral Obligations; Morality; Obligations; Original; Public health; Public Health - ethics; Quarantine; Quarantine - ethics
• ISSN: 1471-8731; 1471-8847
• DOI: 10.1111/dewb.12165

We address the issue of whether, why and under what conditions, quarantine and isolation are morally justified, with a particular focus on measures implemented in the developing world. We argue that the benefits of quarantine and isolation justify some level of coercion or compulsion by the state, but that the state should be able to provide the strongest justification possible for implementing such measures. While a constrained form of consequentialism might provide a justification for such public health interventions, we argue that a stronger justification is provided by a principle of State Enforced Easy Rescue: a state may permissibly compel individuals to engage in activities that entail a small cost to them but a large benefit to others, because individuals have a moral duty of easy rescue to engage in those activities. The principle of State Enforced Easy Rescue gives rise to an Obligation Enforcement Requirement: the state should create the conditions such that submitting to coercive or compulsive measures becomes a fundamental moral duty of individuals, i.e. a duty of easy rescue. When the state can create such conditions, it has the strongest justification possible for implementing coercive or compulsive measures, because individuals have a moral duty to temporarily relinquish the rights that such measures would infringe. Our argument has significant implications for how public health emergencies in the developing world should be tackled. Where isolation and quarantine measures are necessary, states or the international community have a moral obligation to provide certain benefits to those quarantined or isolated.