Legal Briefing: Coerced Treatment and Involuntary Confinement

for Contagious Disease

Thaddeus Mason Pope and Heather Michelle Bughman

      This issue’s “Legal Briefing” column covers recent legal developments involving coerced treatment and involuntary confinement for contagious disease. Recent high profile court cases involving measles, tuberculosis, human immunodeficiency virus, and especially Ebola, have thrust this topic back into the bioethics and public spotlights. This has reignited debates over how best to balance individual liberty and public health. For example, the Presidential Commission for the Study of Bioethical Issues has officially requested public comments, held open hearings, and published a 90-page report on “ethical considerations and implications” raised by “U.S. public policies that restrict association or movement (such as quarantine).”1 Broadly related articles have been published in previous issues of JCE.2 We categorize recent legal developments on coerced treatment and involuntary confinement into the following six categories:

1.   Most Public Health Confinement Is Voluntary

2.   Legal Requirements for Involuntary Confinement

3.   New State Laws Authorizing Involuntary Confinement

4.   Quarantine Must Be as Least Restrictive as Necessary

5.   Isolation Is Justified Only as a Last Resort

6.   Coerced Treatment after Persistent Noncompliance.