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The ethics of quarantine: Treading carefully

The AMA Council on Ethical and Judicial Affairs offers a timely framework from which physicians can consider their obligations if a crisis triggers implementation of this public health intervention.

Editorial. Dec. 26, 2005.

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It has been many years since the idea of quarantine has been such a hot topic. Still, with society's increasing concern about the dangers of emerging and re-emerging infections -- whether it be a smallpox attack by terrorists, SARS or, more recently, the threat of avian influenza -- this public health intervention is taking on greater prominence in the public discourse.

White House statements regarding pandemic preparedness now frequently touch on quarantine procedures. And the Centers for Disease Control and Prevention is in the midst of overhauling its quarantine regulations for the first time in at least 25 years. The proposed changes include provisions that would establish a clear appeals process for people subjected to quarantine and explicit authority to offer vaccinations and medical treatment to them.

Clearly, physicians, too, have an important stake in the overall dialogue. That's why a report issued by the American Medical Association's Council on Ethical and Judicial Affairs and approved by the AMA House of Delegates at its Interim Meeting in November is so timely.

Quarantine, according to the CDC, is the separation and restriction of movement or activities of people who are not ill but who are believed to have been exposed to infection. In an effort to prevent transmission of disease, people are usually limited to their homes but also might be quarantined in community-based facilities or, on a wider basis, by closing borders or erecting geographic barriers.