Tag Archives: Kaci Hickox

Mandatory Ebola Quarantines: Constitutional or Fear-Mongering?

Last Friday, a federal judge ruled that the state of Maine could not force a mandatory ebola quarantine on nurse, Kaci Hickox, who recently returned to the U.S. from Sierra Leone. According to CNN:

District Court Chief Judge Charles LaVerdiere ordered nurse Kaci Hickox, who recently returned to the United States after treating Ebola patients in Sierra Leone, to submit to “direct active monitoring,” coordinate travel with public health officials and immediately notify health authorities should symptoms appear. Another hearing is scheduled for Tuesday.

Hickox was held under quarantine in New Jersey after she returned to the U.S. because she had broken a fever. Since then, Maine, New York, Florida, Illinois, California, Georgia, Connecticut, Maryland, and Virginia have enacted some form of mandatory quarantine of some level or another. I’ve heard a lot of people, even within libertarian circles, arguing in favor of the mandatory quarantines. I think that these views are largely based on fear and misinformation. First, are these mandatory quarantines even constitutional? Let’s do a brief constitutional analysis.

By forcing a mandatory quarantine on someone, the state is taking away their liberty. Under the Fifth and Fourteenth Amendments, the state may not deprive one of “life, liberty, or property without due process of law.” Therefore, quarantines are a matter of substantive due process. (For a brief tutorial on substantive due process, click here). The courts will have to apply a strict scrutiny test because one’s liberty is a fundamental right. There are three prongs to a strict scrutiny analysis:

  • (1)  The government must have a compelling interest in the law which would restrict one’s liberty;
  • (2)  The government must narrowly tailor the law to meet that interest; and
  • (3)  The government must use the least restrictive means possible to meet that interest.

Does the government have a compelling interest in enforcing mandatory quarantine laws for people who exhibit symptoms of ebola? Absolutely! The government certainly has an interest in protecting its citizens from a deadly disease. There really isn’t much of a question here. The government can easily prove this prong of the strict scrutiny test. No problems yet.

Are mandatory quarantine laws narrowly tailored to meet the government’s interest of protecting citizens from deadly diseases? Maybe. This is where it becomes a bit tricky. Some states enacted laws which would require anyone who has had any contact with an ebola patient or anyone who recently visited areas of Africa known to have the ebola virus to be quarantined for at least 21 days, despite not showing any symptoms of the virus. This is clearly not narrowly tailored to protect the public from this deadly disease. Other states require the quarantine only if there has been a known exposure to ebola such as splashing bodily fluids or a needle stick. This is much more narrowly tailored to meet the government’s compelling interest. In the case of Ms. Hickox, her quarantine was not narrowly tailored to meet the government’s compelling interest because she was showing no actual symptoms of ebola. Therefore, I do not believe that her quarantine was constitutional. However, I could see cases where a quarantine would be constitutional, such as the case of Thomas Eric Duncan, the first person to die from this disease, and the staff who treated him. In those cases, where the patients showed symptoms of ebola, a 21-day quarantine would be justified.

Are the mandatory quarantine laws the least restrictive means possible to meet the government’s compelling interest? No! Not in these cases. In the case of Ms. Hickox, she was originally quarantined in a New Jersey hospital for 21 days. This is certainly too restrictive because she showed no real signs of the ebola virus other than having a fever. When she returned to Maine, officials wanted her to stay in her home for 21 days. While this is less restrictive than the hospital, it is still unconstitutional because of the restrictive nature of the order:

Late Thursday, the judge had ordered stricter limits on Hickox, requiring that she “not to be present in public places,” such as shopping centers or movie theaters, except to receive necessary health care. The temporary order permitted her to engage in “non-congregate public activities,” such as walking or jogging, but said she had to maintain a 3-foot distance from people. And it forbade her from leaving the municipality of Fort Kent without consulting local health authorities.

I think that Judge LaVerdiere got it right when he lifted the restrictions that she not be present in public. I do agree that she should submit to regular checkups and screenings, but only because I think that it is the responsible thing to do and Ms. Hickox seems to agree:

Standing with her boyfriend Ted Wilbur, outside their home in Maine, Hickox told reporters the decision was a “good compromise” and that she would continue to comply with direct active monitoring.

“I know that Ebola is a scary disease,” she said. “I have seen it face-to-face. I know we are nowhere near winning this battle. We’ll only win this battle as we continue this discussion, as we gain a better collective understanding about Ebola and public health, as we overcome the fear and, most importantly, as we end the outbreak that is still ongoing in West Africa today.”

Therefore, mandatory quarantines are likely to be unconstitutional if the patient tests negative for the virus or shows no symptoms of having the virus. However, mandatory quarantines are more likely to be constitutional for patients who have shown symptoms of the virus or tested positive.

This is where we need to separate a legitimate concern from fear-mongering. I’m no doctor, so I’ll let the experts from the Mayo clinic explain what ebola is, its symptoms, causes, and risk factors. According to the experts, ebola is spread through blood, bodily fluids, mostly in Africa, and not through the air. Should we be concerned? Absolutely. Should we be fearful of every person who comes in from Africa and institute travel bans for anyone seeking to come into the country from those areas? Absolutely not! in fact, the chances of you getting ebola are about 1 in 13.3 million, which is less than being killed in a plane crash (1 in 11 million), being killed by a lightning strike (1 in 9 million), or being killed in a car accident (1 in 9100). So if you decide to be fearful of ebola, I would recommend that you don’t fly anywhere, stop driving, and don’t go outside while it’s raining. You’re more likely to die from those than from ebola. For the rest of us, we will just continue to live our lives.

Albert is a licensed attorney and holds a J.D. from Barry University School of Law as well as an MBA and BA in Political Science from The University of Central Florida. He is a conservative libertarian and his interests include judicial politics, criminal procedure, and elections. He has one son named Albert and a black lab puppy named Lincoln. In his spare time, he plays and coaches soccer.

Ebola: Saving Life As We Know It, But Not You Specifically

ebola-quarantine-area

As the first U.S. citizen remains forcibly quarantined over Ebola fears, now seems a good time to revisit the role of government in our lives. Some so-called “conservatives” seem to have undergone a sudden evolution to the position that it is the government’s job to keep us perfectly safe from all risk.

One cannot help but wonder, is this their new position on guns as well?

One person has died in the U.S. from Ebola.

We lose 32,000 times that many every year to guns. Is there no cost too high, no civil liberty that cannot yield, in the quest to defeat that risk?

What about cars?

In 2012, 92 people died every day in automobile accidents. How many civil liberties can be ceded to protect us from death-by-car?

Anyone who thinks there is no cost too high to pay to keep Ebola from tarnishing the pristine lands of America is a statist in sheep’s clothing.

The government’s job is to preserve Life As We Know It. To do that, it does not need to save you, specifically. And it certainly does not so direly need to save you, specifically, that it should declare marshal law and shut down global travel.

In the years since 1976, the U.S. has lost between 3,000 to 49,000 people per year to influenza. By my math, that means we could lose another 48,999 people to Ebola this year and still not suffer much impact to Life As We Know It.

But you know what would impact Life As We Know It?

Massive losses in wealth due to travel bans, “aversion behavior,” quarantines and fear.

For example, Michael J. Casey, writing for the Wall Street Journal reports an interesting study about the effects on the global economy of a flu pandemic:

One study led by U.K economists that modeled the global economic fallout from a hypothetical influenza pandemic predicted only a 0.5% GDP loss from the base effect of the disease itself but up to 8% due to policies intended to mitigate its spread, such as school closures.

Think about it. Tourism to and from Africa ceases. Tourism between the U.S. and the rest of the world slows. Hotel rooms sit empty. Restaurants close early. No one rides the bus or takes taxicabs. A lot of people who would otherwise be working—and spending—are quarantined for weeks at a time. Equity indexes fall. Shares in travel firms dive alongside companies heavily invested in Africa. International financial institutions with interests in the region take a hit. The prices of iron ore and oil rise.

Your job might cease to exist. Your retirement account might be wiped out. The value of your house might plummet.

Is there still no price too high to pay when it is clearer that it will be you who must pay it?

However distasteful it might seem, the government must weigh the lives saved against the cost (in both dollars and civil liberties sacrificed) of saving them. Just like the Federal Reserve has a conflicting dual mandate to maximize employment and keep prices stable, the government has a conflicting dual mandate when it comes to Ebola—to protect us from Ebola and to protect the worldwide economy and our civil liberties from collateral damage in the fight to stop Ebola.

Take heart, gentle lambs.

Just because it is not the government’s job to spare no cost keeping you safe, does not mean you cannot make it your own priority. Disabuse yourself of the notion that only the government exercises any control over the big stuff, the important stuff, the dangerous stuff. You are free, all on your own, to spare no expense keeping yourself safe. Wash your hands more and touch your face less. Drive your car instead of using public transportation. Start prepping.

Stay home from work, like you think all those returning aid workers should.

Well go ahead.

You first.

Sarah Baker is a libertarian, attorney and writer. She lives in Montana with her daughter and a house full of pets.