Originally published at: Woman arrested after not treating, isolating for active tuberculosis | Boing Boing
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The other big question here is what sort of resources does the state of Washington supply to its residents who are in need of support. I know for instance that if I were sick like this and unable to work here in NY I could receive public assistance, which would include medicaid coverage as well as cash assistance and snap benefits. That support would last long enough for me to recover from the illness preventing me from working.
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Make America 1759 Again!
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This article makes it sound like the health dept is willing to help with food and housing
People who don’t have reliable access to food or housing may also be reluctant to follow isolation guidelines, he said, so the health department may provide them with those resources.
In regards to the current patient, he said, the department is “really looking for every opportunity for them to comply with and work with us to resolve this as soon as we can.”
I think treatment is provided free if the patient cannot afford it
Your local health department provides treatment for patients with TB disease through DOT of medications and monitoring of potential side effects. This ensures successful completion of treatment and prevents the spread of the disease to others.
Even with resources, treatment can be rough. But if the ER thought she had lung cancer because her x-rays looked so bad, she’s probably at the point that she will die with out treatment
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An ethical dilemma that this country (and doubtless others as well) have been dealing with for a long time.
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Many states’ Public Health agencies have broad authority to do whatever is necessary to limit the spread of deadly pathogens - including incarceration in extreme cases like this one. Much of this power sprang from the early 20th century and the terrible death toll the Spanish Flu wreaked on the world.
Of course, after the recent mask mandates, Republicans are hell bent on rolling back this authority pretty much guaranteeing a lot more people will needlessly die.
Starting last year, mostly GOP state legislators in nearly every state proposed hundreds of bills to either specifically preclude the use of proven public health measures or more broadly tie the hands of state and local health officials, and governors, in a public health crisis.
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I apologize if my memory is at fault; but I think you’ve mentioned a proximity to legalmancy at some point. Do you know what the correct conclusion would be for the standards a TB isolation in WA would be?
They have a section on isolation or quarantine in general; which includes time limits and a procedure for challenging isolation or quarantine; but which specifically notes:
“State statutes, rules, and state and federal emergency declarations governing procedures for detention, examination, counseling, testing, treatment, vaccination, isolation, or quarantine for specified health emergencies or specified communicable diseases, including, but not limited to, tuberculosis and HIV, shall supersede this section.”
and the TB rules note that one of the things the local health officer or jurisdiction shall do is
“(d) Impose isolation of a person with tuberculosis in an infectious stage if that person does not observe precautions to prevent the spread of the infection” with no challenge procedure or timeline aside from “Release the person from isolation when appropriate”.
The text regarding TB procedures superseding says ‘this section’, while the section on relief procedures says ‘pursuant to this chapter’; so I’m unclear on whether that means that the relief section applies even though it isn’t specifically mentioned in the general procedure section; or whether the TB procedure is simply way more hardcore and simply doesn’t have an appeal mechanism?
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“Were arrest and incarceration the answers here?”
Given that drug resistance is growing in TB - probably yes.
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Caveat- this is not my area of law. But, reading what you’ve linked, yes, the TB provisions superceded even the appeal procedures. Possibly because the quarantine for TB is so long, it really requires the intervention of a court.
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I am stealing this word.
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Yeah… incarceration should never be the first approach but there comes a time when you have to weigh one person’s freedom of movement against a bunch of other innocent people’s lives. She doesn’t belong in a supermax prison but she does belong in some kind of sanitarium or isolation ward until she no longer poses a potentially deadly risk to others.
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Hell - a nice Airbnb with a yard & a view. Maybe even a hot tub.
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Wouldn’t it be cheaper to treat this woman through robust public health policies than sending her to jail? From what I’ve read, the treatment of tuberculosis, although long, is quite affordable.The only problem is maintaining adherence to treatment, as the symptoms of the disease disappear quickly after starting the medication. In my country, some people end up abandoning their medication and health authorities have created strategies to monitor patients and ensure their healing…
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Covid-19 vaccines are free but she has apparently refused those too. I’m guessing this is one of those cases (like the aforementioned “Typhoid Mary”) where it’s a matter of obstinance on the part of the patient rather than lack of access to health care.
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So there’s nothing to discuss. It would be driving under the influence of some substance that alters reflexes and perception. She can harm herself and others.
It is different from the case of Hansen’s disease patients who were removed from all social interaction and abandoned in colony-hospitals in distant places.
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Car crash, not car accident.
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People have been arrested/quarantined for refusing treatment/isolation for Tuberculosis for decades. Tuberculosis is not something to mess around with and the Medical and Legal Systems take it very seriously.
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Forced isolation from uninfected people was a rational response to leprosy back before treatments like antibiotics came on the scene, though obviously any compassionate society should try to make such quarantines as pleasant as possible under the circumstances.
If a member of my survival party gets bitten during the zombie apocalypse I’m not going to bash their head in (unless they ask me to) but I’m also not going to be sharing a tent with them that evening.
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All of society is weighing some peoples’ rights against others’.
This is the fundamental role of democratic government- to maximize freedom by serving the most rights of the most people as much as possible.
To me, this is a very clear case for locking her up (involuntary quarantine, not prison). Absolutely her right to walk around with an extremely deadly and extremely contagious disease is less important than the rights of everyone else not to get sick.
This is not a criticism, but it seems like a uniquely American thing to believe there is always some answer which never violates a single persons’ rights. That’s never true. All implementations of rights are in conflict. One person’s right to swing their fists will always end at the next person’s nose. I think part of the reason America struggles so much with achieving collective-good solutions for things is partly because of this belief that all rights are equal and that we should never do anything that violates anyone’s rights, ever. It becomes a paralyzing conflict in US society, such that the country ends up doing nothing in the midst of crises requiring collective action (pandemics, climate change, gun control, social justice reforms, etc).
Public health is a very clear case of where some personal liberty must be compromised to maximize rights for the most possible people. My right to live is greater than your right to choose to not get vaccinated. Non-American countries seem to grasp this way better than America does, as evidenced by respective COVID responses.
Speaking as a humble Canadian here, and please don’t shoot the messenger. I like America, but I think this is one thing it consistently gets wrong about freedom.
Edited for clarity
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Yeah probably. Ignoring isolation orders for infectious disease on a persistent and ongoing basis is one of the few crimes that makes you actively dangerous to everyone around you at all times.
Some of it was amplified then, but often the powers are a good deal older and TB was one of the classic diseases for state power. The US has recognized federal quarantine power since a cholera outbreak in the 1870s. City and state power has been recognized even earlier, with the Philadelphia yellow fever quarantines being super well known.
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