Can we infringe individual rights to promote public health? Should, say, individuals be allowed to determine for themselves when they are too infectious to get on a plane? What happens when an individual contracts a new disease that is of unknown virulence? How do we deal with patients who don’t take their prescriptions correctly and risk allowing dangerous pathogens to mutate?
These urgent questions are the domain of the bioethics of infectious disease. On this episode of Public Ethics Radio, we are aided in the search for answers by the philosopher and tuberculosis expert Michael Selgelid.
Michael Selgelid is a Senior Research Fellow at the Centre for Applied Philosophy and Public Ethics and the Menzies Centre for Health Policy at the Australian National University, where he is also Deputy Director of the National Centre for Biosecurity. He is also the director of the new World Health Organization Collaborating Center for Bioethics at the ANU.
In my introduction, I refer to the case of Andrew Speaker, the tuberculosis sufferer who traveled in violation of CDC recommendations. The New York Times has a collection of articles on his case here.
Christian opens the discussion by quoting Onora O’Neill. The passages he cites are from the introduction to her “Public Health or Clinical Ethics: Thinking Beyond Borders,” Ethics & International Affairs 16, no. 2 (2002): 35-45.
Michael’s reply to the O’Neill quotes refers to an paper he presented in 2002 on the inattention to infectious disease within the discipline of bioethics. That paper has since been published: Michael Selgelid, “Ethics and Infectious Disease,” Bioethics 19, no. 3 (2005): 272-289. (The full text is not available for free, but you can read the abstract on the linked page.)
Rony Brauman, the former head of Médecins Sans Frontières to whom Christian refers, described the opposition between epidemiological statistics and “people of real flesh and blood” in a debate at the Carnegie Council in New York. You can read the transcript here.
Michael mentions a colleague who advocates paying for compliance with TB medication regimes; the colleague is Dr. Lee Reichman. He serves with Michael on the World Health Organization’s Task Force on Addressing Ethical Issues in Tuberculosis Control Programmes.
For listeners who are unfamiliar with SARS—Severe Acute Respiratory Syndrome—Wikipedia has a very detailed entry on it.
The other colleague Michael mentions is Dr. Christian Enemark of the University of Sydney. He has published a number of articles on the securitization of infectious disease, including a piece with Michael in Bioethics.
The CIA report on infectious disease threats dates to 2000 and is available online: The Global Infectious Disease Threat and Its Implications for the United States. And background on the UN Security Council’s special session on HIV/AIDS as a security threat is here.
For details of the SARS riots in China, head over to the New York Times.