Abstract
This paper gives a self-defence account of the scope and limits of the justified use of compulsion to control contagious disease. It applies an individualistic model of self-defence for state action and uses it to illuminate the constraints on public health compulsion of proportionality and using the least restrictive alternative. It next shows how a self-defence account should not be rejected on the basis of past abuses. The paper then considers two possible limits to a self-defence justification: compulsion of the non-culpable and over-inclusive compulsion. The paper claims that objections to compelling the non-culpable do not greatly restrict the scope of the self-defence justification. The over-included are, however, innocent bystanders, and methods such as compulsory quarantine, vaccination, and screening are not justified in self-defence.
Keywords: compulsion, contagious disease, public health ethics, quarantine, self-defence
Footnotes
I am grateful to Julian Lamont, Jeff McMahan and Debbie Tseung for their help with this paper. An earlier version was given at the School of Public Health, the University of Texas at Houston; the Auckland Regional Public Health Service; and a conference at the School of Population Health, the University of Auckland. My thanks to the audiences for their comments.