A general approach to compensation for losses incurred due to public health interventions in the infectious disease context

Monash Bioeth Rev. 2020 Dec;38(Suppl 1):32-46. doi: 10.1007/s40592-020-00104-2.

Abstract

This paper develops a general approach to how society should compensate for losses that individuals incur due to public health interventions aimed at controlling the spread of infectious diseases. The paper falls in three parts. The first part provides an initial introduction to the issues and briefly outlines five different kinds of public health interventions that will be used as test cases. They are all directed at individuals and aimed at controlling the spread of infectious diseases (1) isolation, (2) quarantine, (3) recommended voluntary social distancing, (4) changes in health care provision for asymptomatic carriers of multi-resistant microorganisms, and (5) vaccination. The interventions will be briefly described including the various risks, burdens and harms individuals who are subject to these interventions may incur. The second part briefly surveys current compensation mechanisms as far as any exist and argue that even where they exist they are clearly insufficient and do not provide adequate compensation. The third part will then develop a general framework for compensation for losses incurred due to public health interventions in the infectious disease context. This is the major analytical and constructive part of the paper. It first analyses pragmatic and ethical arguments supporting the existence of an obligation on the part of the state to compensate for such losses, and then considers whether this obligation can be defeated by (1) resource considerations, or (2) issues relating to personal responsibility.

Keywords: Compensation; Infectious disease; Isolation; Public health ethics; Quarantine; Vaccination.

MeSH terms

  • Communicable Disease Control / economics*
  • Communicable Disease Control / methods*
  • Compensation and Redress / ethics*
  • Humans
  • Public Health / economics*
  • Public Health / ethics*