Public health ethics expert on quarantine order for tuberculosis patient

Jun 1 2007

Marc Hiller, associate professor of health management and policy at the University of New Hampshire and a specialist in ethical issues in public health, is available to comment on the recent federal order that placed a Georgia man with a lethal form of tuberculosis into quarantine.

The order, by the U.S. Centers for Disease Control and Prevention, is believed to be the first federal order of quarantine in 44 years.

Although mandatory quarantine measures have not been invoked in recent years, Hiller believes that the risk of spreading such an antibiotic resistant strain of tuberculosis (XDR-TB) that has killed most of those who have been infected with it justifies such action in an effort to protect the health of the public at large. “It's a struggle to balance promoting and assuring the public's health and well-being while protecting individual rights and liberties,” says Hiller. “While the preservation of individual liberty is a long-cherished ideal in a democracy and in health care, it must be viewed as secondary when an individual's health (or disease) status threatens the health – and in this case, possibly the lives – of others, particularly potentially large populations.”

“If one reviews the history of public health in the United States, whether it be extreme pandemics such as the Spanish Influenza outbreak in 1918 or the infamous case of Typhoid Mary, clearly the need to restrict individual rights and spread of contagion is merited in order to protect the health and lives of the public, or the overall social good of society,” he says.

Hiller, whose primary areas of teaching and research are public health and ethical issues in health care, has been a National Endowment for the Humanities Fellow in medical ethics at the University of Virginia and a visiting faculty member in the ethics program of the University of Wisconsin School of Medicine and at the Muskie Institute of the University of Southern Maine. More biographical information is available at http://www.shhs.unh.edu/hmp/facultyhmp.html.