!!!!
Kaci Hickox
Doctors Without Scruples
And why are soldiers being quarantined
Kaci Hickox, the nurse who was briefly quarantined at a Newark, N.J.,
hospital after flying into the state en route from Ebola-ravaged Sierra
Leone, now says she won’t comply with the three-week home-quarantine
requirements in her home state of Maine. “She doesn’t want to agree to
continue to be confined to a residence beyond the two days,” her New
York-based lawyer, Steven Hyman, tells the
Bangor Daily News.The
Associated Press quotes Hyman as saying: “She’s a very good person who did very good work and deserves to be honored, not detained, for it.”
At least two other medical professionals have acted as if public-health rules don’t apply to them. The
New York Post
reports that physician Craig Spencer—like Hickox a volunteer for
Doctors Without Borders, in his case in Guinea—“lied to authorities
about his travels around the city . . ., law-enforcement sources said”:
Spencer
at first told officials that he isolated himself in his Harlem
apartment—and didn’t admit he rode the subways, dined out and went
bowling until cops looked at his MetroCard the sources said.
“He
told the authorities that he self-quarantined. Detectives then reviewed
his credit-card statement and MetroCard and found that he went over
here, over there, up and down and all around,” a source said.
And
let’s not forget Nancy Snyderman, a Princeton, N.J., physician who
entered voluntary quarantine after a fellow traveler to Liberia was
diagnosed with Ebola. On Oct. 9 the
Planet Princeton
website reported that “Snyderman allegedly was seen sitting in her car
outside of the Peasant Grill in Hopewell Boro this afternoon. A reader
reported that a man who was with her got out of the car and went inside
the restaurant to pick up a take-out order. Another man was in the back
seat of her black Mercedes. Snyderman had sunglasses on and had her hair
pulled back, the reader said.”
The state issued a
mandatory quarantine order, and on
Oct. 13
Snyderman “issued an apology to the public . . . but did not indicate
that she had violated the voluntary confinement agreement . . . or take
personal responsibility for the violation.”
At least Doctors Without Borders is off the hook for Snyderman. She works for NBC as chief medical correspondent.
Meanwhile, the
Defense Department
has announced that all U.S. servicemen “returning from areas affected
by Ebola in West Africa” will be subjected to “a 21-day monitoring
period.” As
noted here yesterday,
that has already been the de facto policy. The Pentagon press release
doesn’t use the word “quarantine,” but every media report we’ve seen
does.
The statement quotes a Pentagon spokesman as saying
Secretary Chuck Hagel “believes these initial steps are prudent, given
the large number of military personnel transiting from their home base
and West Africa and the unique logistical demands and impact this
deployment has on the force.” It’s hard to disagree, though one might
add: and the irresponsible, if not downright dishonest, behavior of
various civilian medics.
But of course Hagel’s announcement means
that the Obama administration has two directly opposite policies on
Americans returning from Ebola lands: quarantine for those in uniform,
laissez-faire for civilians. And “laissez-faire” doesn’t quite capture
it: The administration not only is not imposing a quarantine on
civilians but is actively pressuring states to refrain from doing so.
Hickox was released after—and possibly because of—that campaign.
What
accounts for the double standard? Or, as a reporter put it to President
Obama yesterday: “Are you concerned, sir, that there might be some
confusion between the quarantine rules used by the military and used by
health care workers and by some states?”
Let’s go through the president’s response point by point.
“Well, the military is a different situation, obviously, because they are, first of all, not treating patients.”
According to the
Washington Post,
some of them will “test samples for presence of the virus,” but if they
are not going to have direct contact with Ebola sufferers, that would
seem to militate
against quarantining them upon return.
“Second
of all, they are not there voluntarily, it’s part of their mission
that’s been assigned to them by their commanders and ultimately by me,
the commander in chief.”
Perhaps the president is unaware
that the U.S. does not have military conscription. Which we suppose
would be understandable, since Obama was 11 when the last draftee
reported for duty.
“So we don’t expect to have similar rules
for our military as we do for civilians. They are already, by
definition, if they’re in the military, under more circumscribed
conditions.”
Press secretary
Josh Earnest had developed that argument further at a briefing two hours earlier:
There
are a wide range of sacrifices that our men and women in uniform make
for the sake of efficiency and for the sake of uniformity and for the
success of our military.
So to take a more
pedestrian example than the medical one that we’re talking about, there
might be some members of the military who think that the haircut that’s
required may not be their best, but that’s a haircut that they get every
couple of weeks because it is in the best interest of their unit and it
maintains unit cohesion.
We’ll return to the point, but
let’s note here that taking servicemen out of circulation for three
weeks obviously does not promote efficiency, and that instituting a
policy that applies only to the relatively small number of servicemen
stationed in Ebola lands obviously does not promote uniformity. That
leaves only the catchall “success of our military” category to justify
the quarantine.
Back to Obama:
“When we have
volunteers who are taking time out from their families, from their loved
ones and so forth, to go over there because they have a very particular
expertise to tackle a very difficult job, we want to make sure that
when they come back that we are prudent, that we are making sure that
they are not at risk themselves or at risk of spreading the
disease . . .”
It sounds here as if the president is
continuing his justification of the military quarantine, but it turns
out the “volunteers” he means here are the Doctors Without Borders
types, who, he said in his prepared statement “are doing God’s work over
there.” (Maybe, but didn’t God say something about bearing false
witness?) The sentence continues:
“. . . but we don’t want
to do things that aren’t based on science and best practices. Because if
we do, then we’re just putting another barrier on somebody who’s
already doing really important work on our behalf. And that’s not
something that I think any of us should want to see happen.”
All
of which leaves unanswered the central question: If a policy of
quarantining returning personnel runs counter to “science and best
practices,” how does it promote, in Earnest’s phrase, “the success of
our military”?
Absent a satisfactory answer to that question, the
answer to the question “Why are you quarantining servicemen?” seems to
boil down to: “Because we can.” Because it is in the nature of military
service to demand a considerable sacrifice of personal freedom. But if
the administration viewed that as
sufficient justification, it would not have pressed for legislation abolishing restrictions on service by homosexuals.
Anyway, we know of no one who denies that Hagel had the
authority to
establish the quarantine policy, absent a contrary order from the
commander in chief. But the White House also concedes that states have
the authority to order quarantines for civilians.
At his Monday press briefing,
Josh Earnest
answered a reporter’s question about the absence of “an overarching
federal policy that rules” by saying this: “You can sort of take this up
with James Madison, right? We have a federal system in this country in
which states are given significant authority for governing their
constituents. That is certainly true when it comes to public safety and
public health.”
What is at issue, then, is the administration’s
purely discretionary decisions to order quarantines for servicemen and
lean on states not to order them for civilians—a contradiction with no
obvious basis, and no basis the World’s Greatest Orator and his
spokesman have managed to articulate, in philosophy, law or science.
Either
servicemen are being subjected to burdens with no basis in “science or
best practices,” or the administration is risking public health by
prioritizing the personal comfort of civilian medical workers. Why in
the world are they doing this?
Odd as it to say about this
administration—especially with an election less than a week away—it’s
hard to imagine the motive is political.
CBS News
reports that 80% of respondents in a new poll “think U.S. citizens and
legal residents returning from West Africa should be quarantined upon
their arrival in the U.S. until it is certain they don’t have Ebola”;
just 17% disagree. (Though to be sure, that 17% is almost double the
proportion describing themselves in another recent poll as
“enthusiastic” about Obama.)
Let
us suggest two practical distinctions, either or both of which may
explain the disjunction in policy. The first is that forestalling the
military quarantine order would have required Obama to overrule a
recommendation of the Joint Chiefs of Staff—that is to say, to make a
decision. Pressuring the governors, by contrast, involves only
behind-the-scenes kibitzing and public bloviation.
The second is
snobbery. Recall that quote from Nurse Hickox’s lawyer: “She’s a very
good person.” She and others like her, according to the president, are
doing God’s work, and—in pointed if inaccurate contrast to military
servicemen—are “experts.” The logic would go something like this:
You can’t quarantine her. She’s one of us.
