Restrictions of the Person
and Criminal Punishment
Measures to control communicable diseases are not limited to biological approaches. Individuals known or suspected of being contagious may be subjected to civil confinement (isolation, quarantine, and compulsory hospitalization) or criminal punishment for knowing or willful exposure to disease. Society's methods of coping with epidemics, therefore, include separation of contagious persons from the rest of the population and punishment for engaging in risk behaviors.
We like to think that these are thoughtful public policies based solely on the sciences of public health and medicine. But the history of infectious disease control teaches a different lesson. Feelings about infectious disease are sometimes visceral — founded on fear, stereotype, and enmity. Individuals with disease are blamed for epidemics, viewed as vectors of infection rather than persons in need of care and support. During various times in history disfavored populations became targets of coercion — for example, racial or religious minorities, commercial sex workers, injecting drug users, and gay men. Animus toward those with infectious disease can be confounded with deep-seated prejudices against marginalized communities.
Even when the exercise of compulsory powers is necessary to prevent the transmission of infectious disease, it is important to consider the effects on individual freedom and dignity. Infectious disease control powers are among society's most coercive measures. Both civil confinement and criminal punishment deprive individuals of their liberty. In a democratic society, therefore, these coercive powers should be carefully