24 October 2014

An epidemic of bad faith

The diagnosis of Ebola for a Doctors Without Borders physician who recently returned to New York City from Africa has reignited the debate over the doctor's and the government's public-safety responsibilities. One side of this debate believes that the doctor should have been quarantined for the 21 days from contact with Ebola patients during which the virus may incubate in his body. His critics contend that it's especially irresponsible for a physician not to take this prudent measure, and some make this another occasion to denounce the CDC and the Obama administration for not forcing the doctor and his peers into quarantine. The other side argues that a sweeping quarantine is unnecessary. If one side bemoans the doctor's freedom to ride the subway and go bowling, the other points out that he didn't begin to show symptoms until after his various excursions, and they're adamant on the point that he and other victims of the virus are not contagious until they show symptoms. Reading a comment thread on one news site, I saw this belief -- that asymptomatic carriers aren't contagious -- dismissed as an "article of faith" and defended as an empirical observation. The skeptics appear disinclined to believe what the CDC says on this subject. This skepticism seems based on an overall suspicion of authority, or a suspicion of the motives for not doing what the skeptics consider a matter of common sense. Common sense seems to ask "Why take chances?" while suspicion sometimes imagines sinister reasons for taking chances. An objective, nonpartisan debate on the wisdom of a quarantine should be possible, but a lot of nonpartisan things should be possible. If some people automatically denounce the lack of a quarantine (or ban on flights from the afflicted countries in Africa) because they doubt Obama's competence or question his ultimate motives, others may rush to defend his policies on a knee-jerk impulse.  The latter wouldn't say these policies are automatically right because they're Obama's, but they may say they must be right because right-wingers or apparent paranoids oppose them. Yet it seems like an argument for a mandatory quarantine could be made without being labeled paranoid, hysteric or partisan. After all, what if you start to show symptoms in the middle of a public event? A lot of variables would remain, and I suspect that there's research to be done about susceptibility to Ebola that might mitigate if not minimize current fears. As we recently learned, the housemates of the Liberian who died in Texas have passed the incubation period and are Ebola-free, while so far only two of the nurses who supposedly breached protocols in treating the victim have contracted the virus, and one is already declared cured. Many factors apart from proximity to a blatantly sick patient may make some more likely to catch Ebola, some less. But while this is purely my own speculation, there seems to be no reason to dismiss out of hand pragmatic arguments for a quarantine for doctors returning from the hot zones. It may well be that many arguments for quarantine are made in bad faith -- out of irrational distrust of authority, or for partisan advantage -- but to dismiss the idea of quarantining returning doctors because some or even many making the argument are partisans or crackpots is to make an ad hominem argument, which according to logic is a fallacy. At this time we should be careful that bad faith doesn't spread further on both sides of the debate.


Anonymous said...

This doctor showed extreme negligence, especially for a medical professional who, having worked with Ebola victims, should know better. This, as far as I'm concerned, shows depraved indifference and negligence towards everyone else. His license should be revoked and, if anyone has contracted Ebola from him, he should have to be tried for knowingly passing on the disease, just as an A.I.D.S. victim who knowingly passes on the disease would be tried.

Samuel Wilson said...

They say the doc monitored himself for symptoms all along and reported promptly once he noticed some. But I wonder why he'd think some sort of quarantine during the known incubation period wasn't justified. I guess I know the answer: you're not contagious until you show symptoms. But isn't the real question whether you're infected, not whether you're contagious? I would think a doctor would want to know that as soon as possible instead of idling around town until he gets the runs.