Thursday, 20 November 2014
Civic responsibility trumps personal liberty
The vast majority of Americans have regarded and continue to regard our civil liberties as accompanied by certain obligations. Examples include military conscription in times of national crisis and the regular payment of the taxes that support our governing institutions. Individuals insisting that personal liberty trumps these sorts of responsibilities have always been a part of our body politic and have been dealt with harshly or leniently depending of the tenor of the times and the particular circumstances involved. But no matter how widespread such resistance has been, it rarely if ever has weakened national security or occasioned governmental insolvency.
In the last several weeks, the country has been confronted with a situation which has much more potential to disrupt our society. The undetected arrival of a single individual infected with the Ebola virus into the United States and the subsequent mismanagement of infected medical institutional contacts has led to the potential first degree exposure of at least several hundred persons, with countless secondary exposures if by any chance, unlikely as it has proved to be, one of these actually contracted the disease. This should not surprise anyone, as the early markers of an Ebola infection are no different than those of the common ’flu, and that season is about to begin. It will prove extraordinarily difficult to separate the deadly from the benign. It will be necessary to err on the side of caution.
The experience at the Texas Health Presbyterian Hospital in Dallas shows how easily the diagnosis can be missed and how quickly the logistics in even a large institution called to manage a single case can be overwhelmed. Given the generous access to our country afforded by our traditional principles of liberty, it is inevitable that more cases will be encountered by our health care system before, hopefully, the current West African epidemic subsides. The remarkable success in managing the secondary cases identified after the Dallas event and in health workers diagnosed prior to arrival at our principle institutions suggests that the associated mortality may be quite low under ideal conditions. The key to continuing this success lies in the recognition that no institution, no matter how well prepared, will be able to handle large numbers of victims. The degree of necessary protection of attendant personnel is unprecedented.