Index Entries

Lawrence O. Gostin, Eric A. Friedman, and Sarah A. Wetter
March 26, 2020

"Ethical Physical Distancing: Gaining the Public's Cooperation

... In this unprecedented period of social separation, loneliness, emotional detachment, and disruptions to social and economic life will produce profound harms. Vital cultural practices such as faith‐based services, family bonding, and social connectedness are vanishing from public life. We are also witnessing something all too common in disease epidemics—blaming 'the other.' Racial and ethnic discrimination, in this case against people of Asian, and especially Chinese, descent, may result from the spread of misinformation or sheer ignorance. Governments must be prepared to address these harms ...

For the well‐off, with well‐stocked pantries and generous telework or paid leave, staying home may be feasible. But for poorer families and individuals, physical distancing can be harmful if they are cut off from sources of income, assistance, and support. Once out of work, individuals may not be able to afford necessities like food, housing, and medicine. With many schools closed across the United States, parents without paid family leave will struggle to find childcare and to provide meals that children would normally receive at school. For people who are elderly or with physical or mental disabilities, ordering food online or going to the grocery store can be difficult or impossible. 

Where compliance with physical distancing is directly at odds with meeting basic needs, societal harms are inevitable and must be mitigated...

Isolation, Quarantine, Cordon Sanitaire, and Physical Distancing

Balancing public health and civil liberties. Quarantine, isolation, and cordon sanitaire are extreme measures that entail stringent restrictions on freedom of movement, association, and travel and can cause massive economic and social disruption. When balanced against public health interests, a basic rule is that governments should employ the least restrictive means necessary to protect public health. Meeting this standard requires that any Covid‐19 isolation, quarantine, and cordon sanitaire must be based on rigorous scientific assessment of risk and effectiveness. Quarantine and isolation for Covid‐19 should be ordered only if the person is known or highly suspected to have been exposed to the disease, and only for the maximum duration of incubation (fourteen days for Covid‐19). Procedural due process requires that a person has proper notice and an opportunity to challenge a containment order, where feasible ...

Deciding how far governments should go. Compulsory orders for quarantine, isolation, and cordon sanitaire bring enormous legal, ethical, and logistical challenges and should be used only as a last resort ... 

[W]e are witnessing large‐scale quarantines imposed without any individualized risk assessment ...

Further, monitoring and enforcement through surveillance modes, including thermal scanners, electronic bracelets, and web cameras such as those used during the SARS outbreak,implicate privacy interests. Enlisting armed police and citizen informers to control large populations in cities like New York or Chicago seems so contrary to American values and the rule of law that it is difficult to conceive opting for that route in the days and weeks ahead."

document
bioethics,COVID-19,human rights,lockdowns,poverty