Woman with tuberculosis ordered to jail for refusing treatment
arstechnica.com
arstechnica.com
From the article:
> But, the department seemed to reach a breaking point this January. In addition to the woman's defiance hitting the one-year mark, on January 11 she was involved in a car accident as a passenger. The incident clearly showed the woman was violating her self-isolation order, which put the driver at risk of infection. Additionally, the woman went to the emergency department a day later complaining of chest pain and did not tell doctors about her active tuberculosis case, putting them and other hospital staff at risk. When they did lung X-rays, they initially suspected she had cancer. But in fact, the images showed that her tuberculosis case was worsening.
Ordering her isolation and treatment is well within the historical powers of governments.
If you believe something is a right, giving more notice before abrogating it does not factor into whether it is a rights violation.
Everything I’ve said here, by the way, is true regardless of your position on the court’s action (on which I’ve stated no position). If people believe (six people here and counting, and I’m not saying you’re one of them) that they need to downvote a basic factual observation because it vaguely seems to contradict their opinions, maybe they should examine why they so lack confidence in their opinions.
The notice is relevant because it’s indicative of due process and an attempt to respect her individual rights and balance it with the public good, which she has repeatedly ignored and results in the escalation to the rightful isolation.
Ignoring all details and focusing on just the end result as if that’s all that matters leads to foolish ignorance.
Furthermore, they didn’t order her to get medical treatment. They ordered her to stay away from potential victims if she didn’t get treated.
A “massive difference” in many contexts but not for those who oppose mandatory medical treatment.
Who else would possibly argue that this is government overreach than people with that belief?
I would absolutely be against mandatory medical treatment. But that’s not the truth here.
It’s the same old chestnut: people who wrongly think their freedoms are more important than everyone else’s freedoms. They are upset at the idea of being confined to their home when they have tuberculosis or covid or whatever. They don’t value the lives of the rest of their community and so they see themselves as victims.
“Sorenson ordered a civil warrant for her arrest, to be enforced on or after March 3, and again ordered her to jail to undergo involuntary testing and treatment until health officials deem it safe to release her.”
However, what’s the practical solution? What do you think they should do to protect the jail staff and population if she refuses treatment? Maybe we just drop her off on a deserted island?
Exaggeration aside, I’m truly curious. How do we protect everyone else’s freedom to be safe and secure from her without impinging upon hers?
This is often the point where people start bending reality rather than recognizing the hypocrisy of their beliefs. They’ll start to suggest that covid or tuberculosis isn’t actually that dangerous, or perhaps isn’t real at all, so we aren’t actually faced with this predicament.
You yourself have taken a stronger position in your prior comment: “I would absolutely be against mandatory medical treatment.” Does that mean you are now against this order, now that you are aware that it forces medical treatment?
Any predicament that boils down to “one of these parties’ freedoms needs to be impinged” demands flexibility of values. The world isn’t perfect like that.
If she refuses to cooperate and find a compromise (like staying away from people if she continues to be a risk to their lives), then regrettably, the least evil option is probably mandatory treatment. But I’m truly eager to find an alternative. Any alternative. As long as it isn’t “just let her hurt people.”
P.S. I appreciate this discussion. Please don’t think I’m coming after you— just the argument.
But you said two comments ago you were “absolutely” against forced medical treatment. This clearly has softened?
I bring this up not to dunk on you but to acknowledge a prior point you made which I think is a strong one: “people start bending reality rather than recognizing the hypocrisy of their beliefs”
I hasten to add I’m also not calling you a hypocrite! But I quote that, and in particular the “bending reality” part, because I think this goes both ways, not for just one party in a debate.
One lesson from me from Covid was that no one side in a debate has a monopoly on the practice of subordinating hard facts to emotion or prior belief and that we all have to bend over backwards to point out flawed reasoning even when it supports a position we are inclined to like. That was the whole point of my very first post in this thread.
Whatever word communicates, “only when there is no less evil alternative.”
Jailing her is what could be interpreted by a reasonable person as overreach, and for that concern the amount of notice she was given is absolutely relevant.
The linked article seemed to me to clearly state if she goes to jail it’s to isolate and definitely also to get treated (“ordered her to jail to undergo involuntary testing and treatment until health officials deem it safe to release her”). Hence my focus on people who are against forced treatment - I don’t think notice and warning ameliorates their concerns at all.
This is not overreach, it's the exact right touch to restrict harm to the other individuals in the community.
I can't help to wonder if it's a modern spin of Typhoid Mary (https://en.wikipedia.org/wiki/Mary_Mallon).
Contrary to today, germ theory is taught in elementary schools and is well understood by basically everyone. And this woman was clearly experiencing symptoms bad enough to require an ER visit! Visiting the ER likely also means that most of the common religious reasons such as being a Christian Scientist are out the window.
At a certain point it becomes willful negligence and not ignorance.
I don't disagree with the court's sentiment, she's absolutely a public health hazard. But I also don't think people should have a right to bear arms, freely insult others beyond the point of harassment etc, etc.
What do you mean by this?
IMO: It's okay to hold the opinion, it's okay to air the opinion, but picketing funeral processions? You're being a dick. Straight to jail.
I think that's a problem with freedoms in general is that there's no scope to measure people being a dick to people who aren't. The law should have leeway in both directions for outliers.
Just my take, anyway. It probably is worse than outright freedom but it might feel fairer for a few minutes.
But what about protest? I don't know.
I understand the need for protest, and I would defend most of it. But the last few years has also seen a lot of protests that go too far; people hiding under the skirt of protest when they're actually just there to riot, instigate violent confrontation.
Is it okay to superglue yourself to a road to protest oil? Is it okay to break shit, block or delay thousands of normal people to get a message across?
The law doesn't do "sometimes" very well, and people don't do "balanced and unbiased" very well. I'm not sure what's right.
*I shot an arrow into the air,
It fell to earth, I knew not where;
For, so swiftly it flew, the sight
Could not follow it in its flight.*
Incarcerating someone is not an ideal outcome, but an understandable one in the presence of other pressures (like the absence of adequate mental health facilities). It would be interesting to see more reporting on those pressures.
[1]: https://www.thenewstribune.com/news/local/article272657405.h...
If 2020/2021 taught us anything, it's that millions of people are totally fine with denying, ignoring and spreading a deadly, infectious disease, and actively fight/protest measures to stop it.
People can believe all kinds of pigheaded and ignorant things about COVID because, in parts, they (1) either deny it exists or (2) minimize its effects. Tuberculosis denialism or minimalization aren't similarly common, to my knowledge.
[1]: https://www.who.int/news-room/fact-sheets/detail/tuberculosi...
To listen to some of the people here, you would think that it's all-or-nothing: either you believe everything that comes out of the health care system or absolutely none of it. That's not accurate, and treating people that way doesn't help solve the problem.
I think this is too charitable. So many points of contention have both sides using morality as the justification for their position, and if they are on the side of "what is right" then there's no point even considering the words of the other side, because clearly the others are on the side of "wrong".
This is, of course, not an entirely new phenomenon. What is different is that we can communicate more, and faster, than in the past- one might hope that would help us more readily understand each other, but the opposite is proving to be true.
Most COVID skeptics are somewhere in between "deniers at all costs" and "mildly suspicious that the government's recommendations are politically motivated". As in any normal curve, the vast majority are in the latter end of the spectrum and would be very happy to accept that TB is deadly.
As far as I know, no one really knows why TB is not a major problem in the US. But saying that half of active TB patients is a bit like saying that car accidents kill half of the people who are critically injured by a car accident — it may be true (although I made up that last statistic), but it rather overstates the severity of the underlying problem (TB and car accidents).
Could it be the mandatory vaccination programme? I even had to get a booster as condition for my greencard because it had been 10 years.
The TB vaccine (BCG) is barely used in the US. It is not on the CDC schedule, it’s not routinely given in any school I’ve ever heard of, and it doesn’t seem to be recommended for US-born people at all.
I find it surprising that the US even bothers giving it to green card recipients, given that the US has no particular shortage of people with TB infections that can potentially infect people domestically.
And the BCG vaccine isn’t even particularly effective.
that is BONKERS I've gotta read up on this more.
'TB latent infections vs. active infections'Simply because it was (Oct 2023) way leas than 55% effective and still falling.
I have never understood why, and I still don't understand people's behavior during the pandemic.
What could it be besides the money?
her active, contagious case of tuberculosis
I think the public policy lesson there is: you can't just tell people to stop doing things they have to do in order to exist. If it's necessary in rare cases to tell people to stop working, then it's up to the state to provide them the financial resources to survive.
Contrary to today, germ theory is taught in elementary schools and is well understood by basically everyone. And this woman was clearly experiencing symptoms bad enough to require an ER visit! Visiting the ER likely also means that most of the common religious reasons such as being a Christian Scientist are out the window.
Even if she did fully understand that she's supposed to socially distance and observe a lot of very strict precautions to not infect anyone, it's not clear if she had the financial means to actually follow all those rules, which likely prevented her from working.
This is a perfect case of how sometimes people need to be forced into treatment for their own good, and for the good of others.
The issue of government overreach is absurd in these extreme situations. This woman is brazenly ignoring public health, probably because of a mental health issue. There needs to be a way to declare some people as being unfit to care for themselves. I, for one, think that if you are so addicted to drugs and/or alcohol or are so mentally ill, that you drop unconscious on the sidewalk, you should be put into forced mental health care for at least 60 days or longer.
Yes there were issues, but a lot of those were due to under-funding.
Not to mention the community support that was supposed to replace institutionalisation never materialised.
There was a “crisis” that caused that practice to end just as there is now a “crisis” bringing it back. If it’s brought back it should be done outside of this framework of panic.
There is in the law of each state; it varies from state to state. For obvious reasons, it's a pretty high bar to clear and usually requires an advocate for commitment to be dedicated to the cause to make sure that the involuntary commitment process goes all the way through to completion.
You have the same (if not more) risks but have lost your personal liberty to boot.
The social contract has always been a balancing act between the most benefit for the most people, and the ability to enjoy life as you see fit.
I find it disheartening how "cool" it has become in recent times to attack the fundamental concept of liberty.
It's like, folks feel like it's ok to reverse hundreds of years of progress on liberalism just as long as it's their tribe that's in charge.
We had all the needed tool to eradicate it.
But we didn't.
Mainly because of organizational and monetary reasons.
Now this illness many have treated as "conquered" is coming back with more and more antibiotics resisted strands.
And this trend only gets accelerated due to many poor areas not being able to provide the needed treatment for many of the more vicious strands anymore as they don't have the kind of antibiotics necessary for it.
I wonder if 50 or so years in the future we have to have tuberculosis isolation centers again where we have to place patients with it again due to some extra bad fully antibiotic resistant strands which we can't treat anymore... would be horrible.
The direct analogy in this case is criminal non-disclosure of HIV positivity to sexual partners. While you will find some disagreement about second order effects of laws against it, and it raises serious questions, there have been prosecutions: https://en.wikipedia.org/wiki/Criminal_transmission_of_HIV.
Basically, it's impossible to "internally give" consent when done under any sort of threat.
In other words, she may "express" consent, but not "internally give consent."
What does that mean? Probably, she'll get strongly supervised treatment and nothing untoward happens. But then what happens if she suffers a serious side effect of the treatment?
This edge-case could be pretty easily worked around by providing the same level of anonymity to doctors involved in state-ordered medical treatment. Can’t sue without a defendant!
The issue is ethical, is it possible for a patient to give consent if it's given under threat (of incarceration or otherwise). I think medical consent as a concept has been weakened in the west this past decade, the first obvious example is Covid with people having to get vaccinated to have access to certain services and to keep their employment in some cases, the second example that struck me at the time are opt-out systems for organ donations.
The least harm to all is to force their treatment without their informed consent.
It's either that or keep paying for their total isolation until they die. Not treating a treatable fatal illness would be malpractice. If they wanted to kill themselves by some other means later, then that's a mental healthcare matter later.
In this case I'm 100% okay taking the money either way. The threat is immaterial to my internal consent.
I edited my post to clarify a bit more that informed consent is a specific term in medical ethics, and probably doesn't mean what you think it means. Thanks!
https://www.ncbi.nlm.nih.gov/books/NBK430827/ https://en.wikipedia.org/wiki/Informed_consent
Compulsory quarantine and isolation is allowed by federal law.
https://www.hhs.gov/answers/public-health-and-safety/what-di...