Beware of Medical Dictatorship

This story ran on page D4 of the Boston Globe on 10/31/2001.

By Bloomberg News,, 10/31/2001

WASHINGTON - States would be able to force patients to take medication under

model legislation outlining when and how governors can use emergency powers

to address public health crises such as recent anthrax attacks.

The model law, commissioned by the US Centers for Disease Control and

Prevention, also would give people the right to appeal states' decisions to

quarantine or isolate them. Individuals with contagious diseases, such as

smallpox, wouldn't be able to appeal orders for treatment or vaccination

under the law.

State governments are concerned that laws are inadequate to address new

kinds of public health threats such as the Sept. 11 terrorist attacks on

buildings in New York and Washington or the use of germ or chemical weapons.

Fifteen Americans have been infected with anthrax, a deadly bacterial

disease, and thousands more are taking antibiotics as a precaution.

Lawrence Gostin, chief author of the model law and a professor at Georgetown

University Law Center, said the academic panel that drafted the proposal

tried to balance the need to control disease with individuals' civil

rights - something he said isn't done under many current state laws.

''We felt if we were too Draconian and didn't respect people's rights, that

meant the terrorists would win,'' Gostin said.

Emergency powers allow governors to suspend normal government temporarily,

letting states swiftly address disease epidemics or natural disasters such

as earthquakes. Legal and public health experts at Georgetown University and

Johns Hopkins University examined all states' emergency-powers laws in

crafting the model.

Under the model law, states could quarantine or isolate individuals who are

infected with a contagious disease, though the patients would have the right

to appeal that decision in court. The patient would remain quarantined or

isolated until the appeals process was exhausted, Gostin said.

Patients could be forced to take medicines or receive vaccines for

contagious diseases that pose a public health threat, such as smallpox,

under the model law. Patients wouldn't be allowed to appeal a state's

decision, though the state would likely quarantine anyone who refused to

comply, triggering an appeals process, Gostin said.

States would avoid civil liberties violations if they enact laws that spell

out penalties such as the loss of public benefits, instead of incarceration,

for patients who refuse treatment, said R. Alta Charo, a professor at the

University of Wisconsin Law School.

© Copyright 2001 Globe Newspaper Company.

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