Viewpoint by Thomas Elias: Do we need a bioterror bill?

December 26, 2001

As the anthrax scare spread across the country this fall, it was a given to most Americans that if biological terrorism became epidemic, any victims would have immediate access to the best in hospital and medical care. That was, in fact, the way victims were handled when they sought treatment.

But there remains a fear that doctors might refuse to treat patients and hospitals might "biopsy" the wallets of putative patients before accepting them, as medical centers do in ordinary circumstances.

Largely because of that fear, the federal Centers for Disease Control, the Atlanta-based agency in charge of fighting major threats to public health, last month began circulating a model law guaranteeing that bioterror emergency patients will never encounter such problems. Spurred by the Bush administration, the CDC asked every state to pass its plan or something similar.

Allow public health authorities to take over all hospitals in a bioterror plague, the CDC suggests. Let state health departments seize drug supplies, quarantine everyone exposed to infectious diseases, force patients to be vaccinated, use police to confine the quarantined in limited areas and draft doctors to treat the victims.


As a package, that sounds far more draconian than even the strong anti-terror measures for which President Bush and U.S. Attorney General John Ashcroft today draw criticism from civil liberties advocates.

But already the only physician in the state Legislature, Republican Assemblyman Keith Richman from the San Fernando Valley suburbs of Los Angeles, is circulating a similar bill he plans to submit when lawmakers reconvene after their holiday break.

Richman calls his planned bill "a work in progress," and it's plain the measure needs plenty of work, if it's needed at all.

The most basic of the key questions: Does California really need any new law?

Yes, state health officials need the authority to commandeer hospitals when any disease reaches epidemic proportions. But do they need this bill to give them such power? Probably not, as the governor already has emergency powers to take over and use private property when needed. He can also draft private personnel in emergencies, probably including doctors.

State government has the power to quarantine the infected when needed, but has not actually done it on a large scale since 1900, when a spread of bubonic plague was feared in San Francisco's Chinatown.

So California already has the basics of what the CDC and the Bush administration want.

Does this state or any other need the rest of the CDC's proposals? Should there be compulsory vaccinations when there's a danger, with criminal penalties for any who refuse shots? That proposal appears to run afoul of the beliefs of some religions. Taking bacteria-based inoculations like smallpox vaccine also might be hazardous for persons with impaired immune systems, including everyone with an organ transplant. It's still unknown whether taking such a vaccine in that circumstance might accidentally trigger the disease it was supposed to fight.

And what about provisions that appear to allow detention and isolation of infected citizens in places like stadiums or clinics, with no process spelled out to challenge any such decision? Or sections that exempt health officers and anyone working for them from liability for deaths or health damage suffered by quarantined disease victims? Or provisions that might demand publishing lists of the infected?

The central question here is whether existing civil rights including the right for adults to refuse medication or the right to sue someone who causes damage might get in the way of a legitimate and whole-hearted government response to bioterror.

These issues and others remain unresolved today. Public opinion now sides with strong government action to mitigate or prevent any kind of terrorism. That's the natural consequence of the Sept. 11 terror attacks.

But public opinion can change if the government abuses its newly decreed powers, which means passage of Richman's version of the CDC plan may not be certain unless legislators take great care in addressing the many thorny questions it raises.

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