Graduation Year

2012

Document Type

Dissertation

Degree

Ph.D.

Degree Granting Department

Public Health

Major Professor

Raymond D. Harbison

Keywords

Communicable Diseases, Epidemics, Infections, Plagues

Abstract

Under the ancient threat of morbidity and mortality from infectious diseases, human societies have responded for thousands of years by imposing social containment measures. Even before theorists and laymen recognized the existence of pathogenic organisms, or fully understood the principles of contagion, many societies and individuals did empirically infer that such diseases were transmissible from human to human (as well as sometimes between animals and humans). Having few effective technological measures to prevent or treat contagions, they did devise a variety of socio-behavioral procedures for separating overtly ill persons or suspected disease-carriers from nominally uninfected people. These methods included various kinds of quarantines and isolations. By the early years of the American republic, all of the states and many other jurisdictions had the legal power to impose them, and they have long remained on the codebooks of much of the country even as secular trends and bio-scientific advances appeared to reduce the dangers of epidemic disease in the

Developed World. In recent years, however, there has been a recognized resurgence of infectious diseases in Western countries, and such developments as microbial resistance to antibiotics are threatening present-day control technologies. Under these circumstances, it is hypothesized here that societies must plan for the renewed usage of the ancient socio-legal contagion-controls, including quarantines and isolations, at least as part of a multi-pronged response to the renewed challenge of epidemics. However, the existing quarantine/isolation laws do not universally reflect modern scientific understandings of disease processes, and they have always conflicted with other socioethical and litical "goods" such as individual liberties and commerce.

Thus, it is submitted here that it has become crucial to

understand the historic character of quarantine-type measures on a

"macro" plane, in order to learn from past errors, and to help develop

modern quarantine/isolation laws and practices that reflect current

bioscientific and legal thinking. The instant Dissertation analyzes the

longstanding system of socio-legal controls over contagion, presenting a hypothetical structure that distinguishes them along several "Dimensions." In addition, it presents a functional schema that would help public health policy-makers, legislative drafters, and

administrators to address individual contagions in terms of another set of "Dimensions," which would be more responsive to evolving bioscientific and jurisprudential thought. To that end, this Dissertation presents a simple Algorithm that can be utilized when developing contagion-control laws that can be closely fitted to particular contagions, their specific manifestations, and their epidemic phases.

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