The Ivy Apartments, where the confirmed Ebola virus patient was staying, is seen on October 1, 2014 in Dallas, Texas. The first confirmed Ebola virus patient in the United States was staying with family members at The Ivy Apartment complex before being treated at Texas Health Presbyterian Hospital Dallas. State and local officials are working with federal officials to monitor other individuals that had contact with the confirmed patient. Tom Pennington / Getty Images
What we know for sure about the confirmed case of Ebola in Dallas, Texas is that it occurred in a man who travelled here from Liberia to visit his family. And that is about it.
We need to know a lot more.
Privacy is a crucial value in medicine, but in times of potential panic and fear, privacy has to yield to securing public trust and confidence.
Arthur Caplan
Arthur Caplan is the Drs. William F and Virginia Connolly Mitty Professor and founding head of the Division of Bioethics at New York University Langone Medical Center in NYC. He is one of the nation’s top medical ethicists.
What more do we need to know about the Dallas patient? We don’t need to know his name or his family’s name or their address. But we do need to know; how he traveled here, was he screened in any way when he landed, did he take a taxi to get to his relatives, what symptoms made him think he was sick; what happened when he first went to the hospital, did he use a regular ambulance to go back to the hospital, and where else, if anywhere, did he go besides the hospital.
Why do we need to know all this information, which normally and appropriately is nobody else’s business? To secure trust.
People want to know if they were exposed or near the Ebola patient at any time. The CDC and every other public health expert says there is no need to know—no one is going to get infected without body fluid contact with a person with obvious symptoms. Moreover they are doing aggressive contact tracking to see where he went and who was near him. Now, I fully understand that and it makes scientific sense to reassure people that CDC and Texas health authorities are on the ball. But, a fuller, more transparent story will go a long way toward securing public trust in the message authorities want to send.
This afternoon Gov. Rick Perry said that some Texas school children may have come into contact with the patient. When? Where? Who? Partial facts like this only serve to fuel paranoia and worry.
Saying in some detail that the Liberian visitor came to Dallas this way, went here, went there and then went to the hospital and then went back again and still no one got sick will go a long way toward persuading a nervous and skeptical public that they can really trust what the experts say about the extremely low risk of exposure and contagion.
Americans have no idea–none–about what to do if they have the symptoms of Ebola or suspect someone might.
Why do we need to know how he got to the hospital? Because Americans have no idea–none–about what to do if they have the symptoms of Ebola or suspect someone might. Flu season is here. Should everyone with flu-like symptoms in Dallas, Atlanta or other cities where Ebola patients have been cared for run to the E.R.? Isnt it a good idea to get a flu shot so you lessen the chance of thinking you have Ebola. This is what the CDC needs to explain. If your family member comes here from a country with Ebola and gets very ill you should do what—call 911, call the police, call the CDC, call a taxi to the closest hospital, go to a particular hospital with an isolation unit, stay home and let someone come and get you, go alone or with help?
And beyond these practical tips, we need to be transparent about some other normally private matters. Everyone should know that insured or not, illegal alien or visitor or not, you will get cared for without cost if you think you have Ebola. Do not stay home for fear of an inability to pay or that INS might find you.
It is not polite to be a snitch. Right now, though, be one. If you sit next to someone on a plane or boat from a country with Ebola and they seem sick, say something to the airline personal or immigration. Being nosy and invading privacy is not a bad thing if someone is really sick and is travelling from a known Ebola-infected country.
Everyone should know that insured or not, illegal alien or visitor or not, you will get cared for without cost if you think you have Ebola. Do not stay home for fear of an inability to pay or that INS might find you.
And get ready to lose some privacy if you are known to have been exposed to Ebola or die from it. The key to controlling the disease is isolation. So if someone dies in quarantine from Ebola they won’t get the usual choices about private funeral arrangements. And if you are exposed your normal privacy right to be left alone and go about your business is going to have to yield to protecting others.
At yesterday’s news conference, Dr. Edward Goodman told reporters, “Because of the patient privacy, we are unable to share any information about the patient’s symptoms or his treatment at this time. I can say that he is ill, under intensive care, being seen by highly trained, competent specialists. And the health department is helping us in tracing any family members that might have been exposed.”
Privacy is a crucial value to Americans. To secure trust it has to be earned not presumed.
At a time when trust is fragile and panic is lurking in the shadows privacy ought not be the dominant ethical value guiding our response to Ebola.
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