A very significant development in the world of infectious disease policy occurred earlier this week. Nurse Kaci Hickox settled her lawsuit against the state of New Jersey which irrationally detained her for an erroneous forehead temperature reading as she returned home after battling Ebola in West Africa. The detention she suffered was a prominent part of the news cycle and her struggle to have her individual rights respected was something I intransigently defended in the press. Ms. Hickox never had Ebola and never posed a risk to any individual.
The most significant aspect of Ms. Hickox's lawsuit settlement is that she got the state to establish a sort of bill of rights for those detained under New Jersey's quarantine power including the right to counsel, the right to contest the detention, the right to be notified of hearings, and to send/receive correspondence. The terms of the settlement will form the basis to hopefully change other states quarantine policies.
The government, as the protector of individual rights with a legal monopoly on the use of force, should and does have the power of quarantine. This power is exercised to protect individuals from infection from others in the context of a contagious infectious disease that poses a demonstrably serious threat to health. In this context, infectious agents must be viewed as projectiles emanating from the body and, as such, when they impact others, are violation of their rights compelling government to act.
However, the government cannot arbitrarily wield this power and it must be based exclusively on the actual threat posed. To quarantine someone is to delimit their liberty and must absolutely be justified and exercised in a stepwise fashion based on risk and compliance for the absolute minimal time possible. What cannot enter into this decision -- and unfortunately it does and will -- is political expediency, pandering to public fear, or an "abundance of caution" overreaction.
Ms. Hickox's work moves us closer to this ideal and she deserves praise for her heroic struggle to reform quarantine laws that were used capriciously, irrationally, and unjustly against her.