Many of us have had the pleasure of sitting next to a biological weapon at one point in our college careers. In my experience, it is usually a female plastered with a smattering of Greek letters, from her flip-flops to her personalized tote bag. She looks lucky to be alive – the personification of death itself. Her immune system collapsed the day she turned 18, and she is now battling the worst flu on record. But she is determined to come to class for the final exam. She arrives just in time and slips into the seat next to me, spewing more toxins into the air than ExxonMobil. She is obnoxious, and spreads her disease like wildfire, but is she a criminal? If she infects me with her flu, could I press charges?
It may seem ridiculous, but what if her flu strain kills me? What if she has drug resistant tuberculosis? After all, she came to class knowing of her illness. She has no mask and has taken no precautions to prevent disease transmission. Are her actions malicious and criminal?
In a world of what-ifs, it is hard to know what qualifies as a malicious action, a negligent one or even a harmless one when it comes to communicable diseases. There is a maze of public health laws designed to protect the public at large. But how far do these laws reach? A malicious action in one instance may be ruled completely innocent in another. Intent, it seems, is the illuminating factor that determines which is which. However, intent is also highly subjective, and in a world of confidential medical records, intent is ever more difficult to prove. At what point does public health justify the release of confidential patient information?
Public health laws are inherently thorny since they sacrifice one’s rights for the perceived good of the public. But who decides, and how? What is the extent of these laws? These laws are highly discretionary, unfair and ineffective, for they target the infected and fail to protect the public at large.
We can all recall the case of Andrew Speaker, the man who flew around the world while infected with a drug-resistant strain of tuberculosis in 2007. His actions prompted a nationwide panic and sparked a congressional debate. Upon his return to the U.S., the Centers for Disease Control and Prevention placed Speaker in involuntary isolation, an order last used in 1963. But there is evidence that indicates Speaker actually received clearance from the CDC to travel before he departed. In any case, the facts of the case are all relative. Did Speaker demonstrate blatant disregard for public health? Honestly, no one knows for sure. Intent is in the eye of the beholder. Every news network had access to Speaker’s medical history, though it is supposedly confidential information. Was this a public health emergency or a personal invasion of privacy?
The case of 23-year-old Joshua Weaver further highlights this prickly issue. He pleaded guilty to violating North Carolina’s public health control law by exposing others to HIV, the virus that leads to AIDS. According to The News & Observer “”North Carolinians diagnosed with HIV are obligated by law to change their behavior to limit others’ exposure to the virus that can lead to AIDS.”” For failing to alter his behavior, Weaver received 30 months of probation, and faces jail time if he violates his probation.
This law, however, is alarmingly discriminatory and unfair. It implies that HIV-positive people are exclusively responsible for the virus’s spread. But it takes two to tango, right? Thus HIV-negative people should also be required to alter their behaviors in order to minimize their own risk of exposure to HIV. Responsibility is the job of each and every citizen, not just those infected with a communicable disease.
Moreover, the state cannot monitor all of the high-risk activities that predispose its denizens to HIV. After all, doesn’t North Carolina have bigger issues than monitoring its HIV-positive citizens’ sexual proclivities? The state should not be allowed to decide who can have sex with whom, how and under what circumstances, and no state is in the position to disclose a person’s HIV status. At the very least, and regardless of his guilt, Joshua Weaver has the right to confidential medical care.
When you think about it, the actions of the sick college girl, Andrew Speaker and Joshua Weaver are very analogous. Each person acted out of his or her own self-interest. Are their actions illegal? It depends on the disease, their intent and who you ask. But criminalizing disease transmission does very little to curb the rate of infection, and it usually just exacerbates the problem.
It is not solely the responsibility of those infected with a disease to act in a manner that limits others’ exposure. It is our collective responsibility. Many of us have had the delight of sitting next to the deathly ill classmate, but we have all been that classmate, too.
– Justin Huggins is a senior majoring in ecology and evolutionary biology. He can be reached at letters@wildcat.arizona.edu.
