Tags: Ebola Outbreak | Exclusive Interviews | MidPoint | quarantines | mandated

Bioethics Expert: Urge, Don't Mandate, Aid Worker Quarantines

By    |   Thursday, 30 Oct 2014 06:57 PM

The row over quarantines between a Doctors Without Borders nurse, Kaci Hickox, and officials in two states proves the value of a less confrontational approach toward confinement of aid workers who return here from Ebola duty abroad, a medical ethicist told Newsmax TV on Thursday.

"We have the wrong attitude here," Arthur Caplan, director of medical ethics at New York University Langone Medical Center's Department of Population Health, told "MidPoint" host Ed Berliner. "We're trying to bully these people into something they know isn't medically necessary because we're worried."

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Caplan said that a 21-day quarantine — which Hickox is fighting in Maine — is not bad policy, provided offcials are "using it to manage fear, not Ebola," which has occurred in the United States in just a handful of known cases.

Critics of quarantining have said it will deter doctors and nurses from going to Ebola epicenters where they're desperately needed.

Caplan said that three weeks is not necessarily an undue burden on someone like Hickox. The issue, he said, is how it's presented.

"I'm not sure if 21 days is a big deal if you make it easy to isolate. They didn't do that in New Jersey," he said, alluding to Hickox's removal to a hospital tent after she landed at Newark Liberty International Airport.

Hickox fumed at her New Jersey quarantine in a first-person newspaper article she composed while under isolation.

Caplan didn't blame Hickox — who has so far tested negative for the Ebola virus and shown no symptoms — for speaking out.

"They put this nurse in a tent with no running water and no TV," he said.

New Jersey Gov. Chris Christie, who had ordered isolations for all returning Ebola aid workers, relented under pressure from the federal government and from Hickox herself, and allowed her to continue on to Maine.

Officals there want her to observe the remainder of the quarantine, which she defied on Thursday with a bicycle ride, while the state said it would consider taking her to court to enforce a stay-at-home order.

This approach is all wrong, said Caplan.

"If you go to court, you're not going to be able to persuade the judge to keep [an aid worker with no symptoms] quarantined," he said. "I'll predict the state of Maine will lose in court because they're not going to be able to prove that there's any reason to quarantine her."

Caplan recommended, instead, telling aid workers from the front lines in west Arica, where Ebola has killed as many as 5,000 people, "We're going to give you some r&r because you're a hero and you've been through some hellish conditions — like they would veterans from Afghanistan and Iraq."

By "trying to make it easy for them to recuperate, we'd get a different attitude," he said. "Quarantine doesn't have any scientific or medical basis. You don't need it as long as you're not showing any symptoms — touching, exchanging bodily fluids, you're not going to put anybody at risk."

But he said there's a way to encourage Hickox and others to limit their dealings with the general public.

"You'd do better if you said, 'Here's your respite situation: We're going to encourage you to stay home. You can ride your bike around. Don't touch anybody. You can jog. You don't even have to stay in your house. You can come out; just don't go into public places. Don't mix with others, and we'll make this easy for you to do. We'll even pay you. We'll give you three days of pay to do it.' "

"I understand 21 days isn't a lifetime," said Caplan. "But when you push [aid workers] to the wall, like this nurse, and say, 'You got to do this because you're infectious', she's going to say, 'No, I'm not.' "

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The row over quarantines between a Doctors Without Borders nurse, Kaci Hickox, and officials in two states proves the value of a less confrontational approach toward confinement of aid workers who return here from Ebola duty abroad, a medical ethicist told Newsmax TV on Thursday.
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Thursday, 30 Oct 2014 06:57 PM
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