By Adil E. Shamoo, Ph.D. (guest blogger)
Public health policy is derived from promoting public good to protect millions of people from pain and suffering; an effective policy ultimately should enhance health and happiness. The coercive powers of federal and state governments and to enforce public health policy are derived from police powers to provide safety and security to the public. The President has those powers from the plenary powers, unnamed in the constitution, but implied in those powers that protect the security of the nation. The Bill of Rights is the cornerstone that protects individual liberties against the tyranny of the coercive power of government. Here lies the tension between autonomy (self-determination/civil Liberty) and public good (safety and security). There must be strong justification to override self-determination, and in the case of contagion of a deadly disease, this must be examined.
Several parameters were raised by ethicists regarding the conditions where public health policies are needed, especially in national crises such as HIV and Ebola (Barbera et. al., 2001, Kass, 2001, Shamoo, and Moreno, 2002). In short, the conditions for the promulgation of a new policy in public health should attempt to answer the following: Is the policy needed? Is there adequate means to carry out the policy? Is the benefits/risk ratio favorable? Can we guarantee transparency? and, Are the procedures least restrictive to liberty?
Let us examine the recent Ebola case and attempt to answer the above questions and discuss those questions that are in dispute. The potential for a deadly Ebola epidemic is real and therefore there is a national crisis.
The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.