Plagues and Morality

Abstract

Plagues and Morality Anthony Quinton (bio) as soon as the idea takes hold, rightly or wrongly, that a disease can be communicated by sufferers to people who are not infected, an array of morally significant reactions is provoked in those who entertain the idea. The most straightforward response is to prevent the contact through which the disease might be communicated. The practically simplest way of eliminating contact is to segregate the infected from the rest of the community. That, of course, was the rule laid down in the book of Leviticus to contain the spread of leprosy. From the point of view of effectiveness it was not a bad scheme, given that leprosy appears to be communicated from one person to another by close and prolonged physical contact. The additional sufferings it imposed on lepers, however, at least invite the question whether there might not be some less draconian way of achieving the same result. Isolation of sufferers already within a community is one thing; the exclusion of bearers of disease, actual or possible, from entering the community is another. That is what we first think of, I suppose, when we encounter the word quarantine. l start from this ancient example of response to a plague because we are trying here to view lethal epidemics in part in a historical way and also because a few years ago some public-opinion survey conducted by the Los Angeles Times recorded that 51 percent of the respondents were in favor of quarantining AIDS sufferers. The isolation of sufferers from a disease is obviously pointless if it can be or usually is communicated by someone who carries the agent of infection without showing any signs of the fact. That is the case with measles. It is also a very conspicuous feature of AIDS. The HIV virus can be carried for years without manifesting itself in the form of visible symptoms in its carrier. [End Page 451] The period of incubation is just one of the dimensions along which epidemic diseases may vary. Another is their mode of transmission: whether by infected human beings (as with smallpox and typhoid) or by mosquitoes (as with malaria and yellow fever) or by fleas dwelling on infected rats (as with plague proper). Isolation is altogether useless to contain diseases spread by nonhuman carriers. Sanitation is what is needed. Other dimensions are: their amenability to treatment, the degree of their fatality, their susceptibility to containment by inoculation. The different modes of transmission of diseases means that there will be great differences between what is sensible to do to prevent their spread, quite apart from the question of what is morally acceptable to do. That question arises only about courses of action which come up for serious consideration, in virtue of being well judged to bring about a result acknowledged to be good, and concern the human costs of the side effects of the beneficial courses of action. RIGHTS OF THE DISEASED If there were such things as rights of the diseased in general they would have to be of a very vague and flexible nature to allow for these differences. I, like most of my reflective compatriots except for Locke, do not really believe in rights in the abstract, the rights of human beings at all times, everywhere and in all circumstances, but only in legal rights and, in a more qualified fashion, in the customary rights of the members of particular historic communities. That does not imply that I claim not to understand, or pretend not to use, the vocabulary of human rights in general. But I interpret statements about such rights as statements about what human beings generally ought to be allowed to do or be provided with, so long as there is no overwhelming reason they should not. To invoke, for example, a human right of privacy to rule out a course of action which would serve some admittedly good purpose is not, in my view, to end the matter by the production of some kind of argumentative trump card. It is not selfevident that the protection of privacy should always outweigh other [End Page 452] considerations. But that is not to deny that privacy...