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Abraham Schwab is a medical ethicist and assistant professor of philosophy at IPFW. He wrote this for The Journal Gazette.

CDC role to assure risks are minimal

Dr. Ben Carson, neurosurgeon and commentator, recently called out the Centers of Disease Control. He suggested the CDC’s decision to bring Nancy Writebol and Kent Brantley, both infected with Ebola, back to the United States was a mistake. As he put it, we could quarantine, we could treat and we could build a part of a hospital elsewhere (in Africa) to treat these two individuals. So why bring them to the United States?

Tom Frieden, director of the CDC, provided no answers. As he put it to Sanjay Gupta, the journey is “arduous” and carries risks, and the medical benefits of being the United States are dubious. The treatments available in the U.S. are not significantly different from those available where they were.

So why did the CDC decide to bring these two individuals back home? Short answer — they didn’t.

The CDC occupies a limited role. In the words of Frieden, “Our role at the CDC is to make sure that in the transportation and the care (of the Ebola patients), any risk is kept to the absolute minimum.” To put this another way, their role is regulatory, not participatory. The CDC did not decide to bring these two Americans home; their sponsoring agencies (Samaritan’s Purse and SIM USA) did that. The CDC’s role was to ensure that the plan to bring them home included adequate safeguards.

Carson is not alone in seeming to misunderstand the role of the CDC in the transfer of these patients to the United States. For example, some have described the CDC as “bringing” the Ebola patients to the U.S. Others have described their role as “evacuating” the two Ebola patients to the U.S. A more accurate view of the CDC’s role is that of ensuring that the plans others have put together include adequate risk minimization.

What does this mean about Carson’s (and others) claims that the CDC has made a mistake? The first and primary option that the CDC had available to it was to refuse these individuals re-entry. To say that the CDC made a mistake is to say that it should have restricted the freedom of these individuals and agencies to achieve their goals. But why?

Carson puts it in terms of risk to the rest of the population. By allowing these two infected individuals into the United States, we put other people at risk of disease and possibly death. It is a mistake to allow the freedoms of some if those freedoms put at risk the health and lives of others.

I wonder how far those criticizing the CDC are willing to take this view. The science behind vaccines shows their effectiveness – would they then require vaccinations for all citizens? Failing to do so will put people’s lives at risk. Indeed, it seems, failing to get vaccinated puts lives at much greater risk than the return of the patients infected with the Ebola virus.

Or what about universal insurance coverage? Lacking insurance puts citizens’ lives and health at risk as well. Would these same critics require universal health care coverage of all citizens? And at what costs to the freedom of others?

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