Public Health v.s Individual Liberty Essay Example

Public Health v.s Individual Liberty Essay Example Public Health v.s Individual Liberty Paper Public Health v.s Individual Liberty Paper Essay Topic: On Liberty In Typhoid Mary, Mary Mallon is isolated on North Brother Island from 1907 to 1910 and again from 1915 until she dies in 1938. Mary Mallon is striped of her civil liberties and is unwillingly quarantined to preserve public health. This brings about an interesting issue, an issue that is just as important today with regard to AIDS as it was nearly a century ago with typhoid. Many have suggested, then and now, that if an individual endangers the public health of the community that that person’s liberties should become secondary to the safety of the community. However, people that contract diseases are unwilling victims of it and they too are members of the community. There must be a balance. While protecting the larger community, the individual must too be protected. One’s individual liberties should not be denied in order to protect public health. When facing a public health concern like a contagious disease, isolating people with the disease does not guarantee its elimination but it does rob these people of their freedoms. The purpose of this essay is to suggest that protecting an individual’s liberties is just as important as protecting public health and that isolation should not be used as a method of preventing the spread of disease. Using two prime examples we will look at how isolation violates civil liberties. The first example is of Mary Mallon’s isolation. This example illustrates that a well-informed, cooperative carrier, can be a far more useful tool than isolation. The second example is of Cuba’s national HIV/AIDS containment program. From this example one can see the negative impact that isolation has on the stricken and the community and that isolation, as a means of preventing the spread of disease ultimately does not work. Mary Mallon arrives in the United States in 1896 at the age of fifteen. Although she is poorly educated and unskilled, Mallon is bright and spirited. She moves from job to job, always seeking to improve her life. After discovering her aptitude in preparing food she becomes a cook. In the summer of 1906, a wealthy banker by the name of Charles Henry Warren rented a large house in Oyster Bay, Long Island as a vacation home for himself and his family. He employs maids, gardeners, and a cook to provide the services at his new home. On the fourth of August, he hires Mary Mallon as the family cook. On the twenty-seventh of August, the household is stricken with typhoid fever. The owner of the house, George Thompson, fearful that he will be unable to rent the house ever again, becomes determined to learn the source of the disease. Thus, he hires George Soper, a sanitary engineer, to conduct an investigation. At first, Soper thought soft clams might have been the initial agent. He later, shifts his attention to household members, and finally to the cook. When he learns that Mary Mallon is only hired shortly before the beginning of the illnesses, he becomes convinced that she is a healthy carrier of typhoid fever. He tracks Mary Mallon to her new place of employment. He approaches her with all the finesse of a bull in a china shop. He tells her she is spreading disease through the food she cooks and demands that she provides him with stool, urine and blood samples. Mary attacks Soper with a meat fork and he is forced to retreat without any samples. Mary Mallon refuses to believe that she is spreading the infectious disease, typhoid fever. She declares that she has never had typhoid in her life. Soper is equally adamant in proving his theory. To do so, he reconstructs Mallon’s work history. He finds that in the previous ten years, Mallon had worked as a cook for eight different families. Of the eight, seven families had experienced typhoid outbreaks. He also finds that a total number of twenty-two people have taken ill and one has died. Soper’s data persuades the New York City Health Inspector that Mary Mallon is indeed a carrier of the disease. In March of 1907, she is carried off, kicking and screaming, to a hospital for testing. Her feces show high concentrations of typhoid bacilli and she is sent to an isolation cottage on the grounds of Riverside Hospital, located on a small island near Riker’s Island. There she remains for three years. This is when Mary Mallon becomes known as Typhoid Mary. After three years, Mary is released with the proviso that she will stay in touch with the health department and that she not work as a cook. For a time, she complies with the requirements. She works in a laundry; however, this job does not sustain her in wages or in satisfaction. Therefore she changes her name to Mrs. Brown and returns to cooking. For three months, she cooks at Sloane Maternity hospital in Manhattan. During her time there, at least dozens of doctors, nurses, staff, and even children contacted typhoid Fever. Two of the victims die. Mary Mallon is unmasked as Typhoid Mary. She is again sent to North Border Island where she lives for twenty-three years until she dies. Mary Mallon’s isolation is a prime example of how public health policies can be discriminatory and unfairly applied. Mary Mallon is not the only known carrier of typhoid, yet she is the only one to be robbed of her civil liberties because she is a healthy carrier. When she dies, in 1938, a newspaper notes that there are 237 other healthy carriers under observation by the health department. Mary Mallon is, however, the only person to be forced to live in isolation. Mary Mallon’s story, although very tragic, can be an extremely useful asset in the United States’ efforts to create a health care system that is in no way discriminatory. It is exemplary of the kinds of pitfalls that the United States should avoid. One can see from Typhoid Mary that there is a great need for fairness in the health care system. For example, if Mary Mallon felt health system was fair and non-discriminatory she would have had more confidence in the system. Thus, she would have been more likely to cooperate. There is also a need for better education on how diseases are spread. If Mary Mallon had been better educated on how to prevent the spread of the infectious disease, the combination of her willingness to cooperate with her knowledge of how to protect others from infection would have meant that both her rights and liberties would have been protected as well as the public’s health. Education is a far more powerful tool in preventing the spread of infectious diseases than isolation ever could be. However, the health system must first become fair, non-discriminatory, and trustworthy, and all citizens, especially those stricken with disease, must perceive it as such. This will lead more and more people to trust in the public health system. This trust then allows the system to effectively educate more people that carry a disease, so they can refrain from activities that put others at risk. Johan Giesecke, an infectious disease specialist, believes that â€Å"strong public confidence in a benevolent and non-discriminatory state and health care system is more valuable than repressive legislation† (Leavitt; 245). In the end, everyone benefits from this method of prevention. This method prevents the spread of disease better than isolation ever will. At the same time the rights and liberties of the infected are being protected along with the health of the community. In thinking about how far the government might take disease control, isolation emerges as a frightening possibility. Nevertheless, some states have actually considered quarantining people with HIV/AIDS. One can argue that this kind of action goes against democracy, against the Constitution, and against the very foundation the United States is built on. Clearly, isolating people deprives individuals of their god giving rights as human beings and as Americans. Isolation robs these individuals of cherished values like: liberty, privacy, freedom of speech, and freedom of choice. Cuba is another prime example of why the United States should not use isolation as a public health preservation tactic. In 1986 Cuba initiated a national program to contain AIDS. This program includes: systematic screenings, isolating of all HIV-positive people in sanitariums, and requiring all HIV-positive pregnant women to abort their babies. Cuba found initial success in containing AIDS due to this plan along with other determining factors. Drug use, which is a major means of HIV transmission, has been rigorously reduced in Cuba. Cuba also upholds a severely strict sexual conduct code. It also benefits from its position in the hemisphere; because of its economic isolation it is relatively underexposed to the disease. One can state that isolation of HIV-positive people has contributed greatly to the initial success of Cuba keeping the disease at bay, but this success comes at the expense of Cuban citizens. Citizens comply with the program not of their own free will. This program does more harm than good. It forces HIV-positive people to live away from their friends and family in sanitariums and deprives them of their civil liberties. These sanitariums seem to be nothing more than prisons. The people who are forced to live there are called â€Å"inmates† and they are kept in with walls and barbed wire. Some of these inmates have compared these sanitariums to concentration camps. The program also robs HIV-positive women of the right to choose because they must abort their babies, whether they want to or not. Also, the systematic screenings are an invasion of privacy. What makes the situation worse is that these people are striped of their liberties and isolated in vain. Recent studies show that the program has not been effective in stopping the epidemic. Instead, it leads people to believe that all the HIV/AIDS-positive people are isolated and they gain a false sense of security, which results in a reverse effect. Due to this sense of security they engage in unprotected sex and thus continue to spread the infection. The United States has two courses of action that it can take. The first is to legally decide to follow the lead of the Cuban government. Therefore, placing the individual rights and liberties of the sick at a secondary level, while deciding that the protection of the public health is a far greater national priority. Such changes would move the country in a direction opposite of the democracy all Americans love and believe in. This would foster discrimination of those that have a disease, like HIV, at state, community, and health care levels. Amilca Palmer, a journalist that did a study on Cuba’ sanitariums, writes, â€Å"It is a telling sign that Cuba is not an utopian socialist world where everyones needs are met, but one where the individual is erased, especially that individual who cant conform to the social norm† (Palmer; stg. brown. edu). This is certainly not the direction in which the United States should follow. Instead, the United States should look to other options, options that uphold democracy not dictatorship. The second choice it can consider is to make civil rights and liberties an equally dominant national priority as public health. Therefore, establishing policies of fair non-discriminatory health care. This kind of policy will earn the confidence of all American citizens, sick and well alike, and provide them legitimate, long-term protection that is accommodating. Such changes would move the country in a direction that fosters our value system of individual rights and liberties, while emphasizing the importance of public health. In conclusion, Typhoid Mary written nearly a century ago brings up an important issue, an issue that affects many people still today. Mary Mallon’s story teaches people that there must be fairness in public health policies, and that these policies must avoid discrimination and abuse of individuals who carry a disease. Many people believe that when deciding between an individual’s rights and the health of a community, the community’s safety becomes paramount and the individual’s liberties become simply secondary. Thus, isolation is not considered as a violation of one’s rights but as a right of the community to be protected from these carriers. However, it is imperative that one keeps in mind that the stricken are members of the community too and their rights are just as important. Isolation does not eliminate the spread of disease. In some ways it may actually help facilitate the spread of disease. Yet, some states in the U. S. are considering using isolation to lessen then spread of HIV/AIDS in the country. One can argue that isolation goes against democracy, against the Constitution, and against the very foundation the United States is built on. Bibliography : lihistory. com/7/hs702a. htm http://history1900s. about. com/library/weekly/aa062900a. htm stg. brown. edu/projects/projects. old/classes/mc166k/summarie/indys. html cubasolidarity. net/cubahol2. html Leavitt, Judith Walzer. Typhoid Mary. Beacon Press, Boston, Massachusetts, 1996.