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The Basics of Arguing with Ebola Quarantine as the Example

30 Oct

What with everyone arguing right now over the relative pragmatism and humaneness of quarantining Ebola health care workers, I thought it would be a perfect way to examine how to best argue on the subject.

The Two Different Stances

They can be boiled down to these two basic statements: Quarantining Ebola heath care workers is wrong or Quarantining Ebola health care workers is right. But these two statements are not enough. Both sides need to explain why, because if they were simply to restate those opinions that would be a fallacy called ad nauseum. There are two main reasons backing both: Quarantining Ebola health care workers is wrong because it is inhumane/violates human rights and makes no sense from a medical standpoint and Quarantining Ebola health care workers is right because it is pragmatic and promotes public health safety. But even that is still not enough to be a cogent argument. The first couple of bold, italic statements are opinions on an issue; the second couple of bold, italic statements are thesis statements.

First Thesis Statement, Explanation, and Counter-arguments

The following is the basic claim as to why quarantine may be inhumane or violate human rights: . . . because the authorities are holding health care workers against their will. The explanation: Being held against one’s will is the basic definition of kidnapping, which is illegal. One must also question the authority in holding a person against their will. What legal statutes allow U.S. authorities to hold a person against their will when that person is not under suspicion of committing a crime? The fourth amendment itself protects people from the act of quarantine by allowing people protection against illegal search and seizure including of their person.

Counter-argument: The U.S. allows certain authorities to hold people against their will dependent upon specific conditions, such as authorities witnessing crimes committed by such persons or other civilians reporting the witnessing of crimes committed by such persons. But the witnessing of a crime is not the only instance in which authorities are allowed to hold a person against his or her will. It is also allowed when suspicion of a crime has taken place or public safety may be at risk, such as a person suspected of planning a mass attack. It is not unreasonable to extend, or even consider the issue already covered by, the public safety umbrella to cover infectious diseases.

The first argument is a bit of pathos (an appeal to emotion) in that we find being held against our will inherently wrong and logos (an appeal to logic) in that we have a legal document protecting against seizure. The counter-argument is logos (an appeal to logic) in that it shows that only illegal seizure is protected against and that in certain instances a person can be held against their will.

 

My thoughts on the specifics: Quarantine can be inhumane if improperly handled, but I do not believe it was improperly handled to the point of being inhumane in this case. The nurse was able to contact CNN while under quarantine, meaning her first amendment rights were not impinged upon. While she was possibly delayed in eating and comfort, it was not to the point of inhumanity, which would be when it is physically damaging. We can compare her conditions, if she had stated them in detail, to the depiction of inhumane quarantine in Jose Saramago’s Blindness wherein patients did not have access to working plumbing, adequate food, sanitary conditions, authority to prevent patients from stealing, raping, and murdering fellow patients, and medical attention. That is inhumane.

 

The following is the basic claim as to why quarantine may be nonsensical from a medical standpoint: . . . because the disease in question is not communicable when not showing symptoms. The explanation for this point must include more than just an appeal to logic as the first one did. Instead it needs a resource, which can be from a medical paper on Ebola or from a statement from a person of authority. If no resource is given by the arguer, then the logical counter-argument is akin to Sheldon Cooper’s argument about infectious diseases:

 

“If influenza was only contagious after symptoms appeared, it would have died out thousands of years ago. Somewhere between tool using and cave painting, homo habilis would have figured out to kill the guy with the runny nose.”

 

 

That’s a joke, but it makes the point that many diseases are communicable when no symptoms are present. The counter-argument is only applicable when the first arguer does not present a source to back up this claim, but the immediate response to the claim without a source will bring up this counterpoint, typically using Typhoid Mary as an example. If the argument is an actual exchange as opposed to a paper (which would get a failing grade most likely for opting to skip sources), the person making the unsupported claim cannot then tell other people to “look up” sources for their claim. This is lazy arguing. An unsupported claim when the person who made the claim knows this claim as theory presented by reliable sources is poor arguing. But let’s say they do have sources and list them. The sources still have to be reliable. One can find anything stated by someone else without real research. In this instance, a reliable source has to be a medical scientist whose career is focused on infectious diseases and specifically Ebola.

Not even this guy is expert enough.

But let’s say that the person making the claim didn’t just use a source to back it up but also got a real expert opinion on the disease. Counter-argument: Micro-organisms are not static beings. They evolve to defeat adversity, and they do it at a much higher rate than non-micro-organisms. This is why new flu vaccines need to be developed every year. This is why antibiotic resistant bacteria exists, now making UTIs resistant and pneumonia possibly fatal even when treated. The flu that survived the year before adapted and changed to evade the previous vaccine. The bacteria that survived previous treatment adapted and changed to evade the medicine designed to fight the bacteria. This is evolution. Medical scientists cannot predict when or how a virus, bacteria, of fungus will evolve to become more suited to their current environment, but all evolution is preceded by a change in environment which may wipe out the species if the species does not adapt. Currently, Ebola’s environment is controlled by humans. We prevent Ebola from spreading by quarantining symptomatic patients, but if this environment of prevention threatens Ebola as a species, it could adapt to spread under different conditions. This may not happen for years. It may not happen at all, but it is a possibility. With such a fatal disease, it is impractical to not take the safest approach while still treating patients and quarantined individuals with dignity and respect.

Both the argument and counter-argument are based on logos because one presents evidence and the other has cause-and-effect development.

My thoughts on the specifics: I was quite annoyed when on Monday I saw an RN being used as “expert” opinion on the subject of Ebola quarantine in some news broadcast. Even if a doctor or nurse has worked heavily with Ebola patients, they are not as expert as someone who has made it their career to study the Ebola virus, experimenting with it, studying its favorite environment and gestation rate, mapping its genome, and formulating hypotheses and testing those hypotheses, all so they can then go to the doctors and nurses who are treating Ebola patients and tell them the best procedures to take. Just because someone is a doctor or nurse, I’m not going to take their every medical opinion as gospel. They disagree, on many subjects. And if you’ve ever been to the doctor, which I imagine you have, you’ve probably heard some pretty dumb things come out their mouths sometimes. I’m not saying we should disregard everything medical professionals say to us and listen to celebrities and politicians instead, but that we should take what medical professionals say with a grain of salt. I can’t remember the number of times I’ve had a upper and/or lower respiratory bacterial infection and a doctor or RN has assumed I had a cold or the flu. I also have a serious problem with people who treat Ebola like a static species, which by the way there is no such thing. Small pox is contained but given the proper food supply and a chance to procreate, its evolution would no longer be on hold.

The Second Thesis, Explanation, and Counter-arguments:

The following is the basic claim as to why quarantine is a pragmatic action: . . . because it prevents all chance of the spread of the disease. The explanation: While Ebola is not currently spreadable when patients are not symptomatic, quarantining all individuals who have come into contact with the virus prevents relying on patient communication of symptoms. Many times a patient can experience symptoms they are unaware of, such as happens with many individuals who develop cancer. For example, an Ebola patient may have a slight fever and not realize he or she even has it, but he or she is now symptomatic. Health care workers who have worked with Ebola patients may be reluctant to volunteer symptoms they believe are not Ebola caused but from stress, overwork, or another illness. This is not to say that health care workers are going to purposely deceive, but they may in their own minds be downplaying symptoms and do not tell health officials of their symptoms to avoid a quarantine they believe to be unnecessary. Most of them will be right, but it is not an acceptable margin of error for the safety of the health care workers and the people they may come into contact with.

Counter-argument: Health care workers, because of their profession, are more likely to be aware of their own symptoms than the average person. Those who have worked with Ebola will also understand the importance of not withholding or downplaying symptoms, for both their own health and the safety of others. Because of their professional training and experience with the virus, health care workers have a different experience than a typical patient and have a personal gain to volunteering their symptoms to health officials.

Both arguments are logos based because they outline the behavior of patients and health care workers.

My thoughts on the specifics: I believe everyone is human and thereby capable of denial and unhealthy habits. I’m sure we’ve all seen an overweight doctor or nurse in our lives. It’s important to understand that with their profession comes a little bit of arrogance. It’s needed. An unsure doctor or nurse is not helping anyone, but sometimes that arrogance transfers into bad personal health decisions. It sometimes even transfers into blind spots when examining their own patients. We have also heard the idea before that doctors make horrible patients because of what they know, and I think this is another offshoot of the arrogance required of the medical profession. As I said, the confidence in a medical professional is very important, but this can lead to over-confidence which is dangerous when dealing with a fatal infectious disease.

The following is the basic claim as to why quarantine promotes public safety: . . . because it prevents the accidental spread of the disease were symptoms to develop. The explanation: Some doctors have suggested quarantine periods (I’ve heard both 8-10 and 21 days) whether or not a health care worker is presenting with symptoms. This period would allow individuals to present symptoms in an environment that would prevent the spread of the virus. If a health care worker with non-symptomatic Ebola were to forego quarantine and went to a public venue, and then he or she developed symptoms, anyone within that public venue would be at risk to contagion. It would be better if he or she had developed symptoms in an isolated environment. They would also get medical attention much faster in quarantine because a proper quarantine is run by qualified and informed health care workers.

He made sure to touch every piece.

Counter-argument: Health care workers can be screened for the virus through testing and once a lack of infection is confirmed, they can be sent home without need of a quarantine. The general public can be assured at that point that authorities are not releasing Ebola infected individuals into the general public.

Both of these are logos again, with the first because of it’s scary prospect also displaying pathos. I can actually think of a counter to the counter-argument: lab errors.

My thoughts on the specifics: If the medical community is split on the relative need for quarantine, I think we should quarantine. I am actually less afraid of Ebola than I am of human response to it. By which I mean, panic or a lack or response. I want it to be taken seriously, but I also don’t want us stop living our lives and treating people with dignity because of it. I feel like the medical community needs to get it together when it comes to the practices involved in quarantine; otherwise, they will have those same two reactions: not treating quarantine patients well or not having realistic and helpful quarantine practices. It’s possible to fail on both fronts I admit, but that’s why they need experts on Ebola to help them make up the quarantine practices.

The Bad Arguments

There have been a lot of appeals to authority, appeals to the gallery, ad hominems, and slippery slope arguments going around. Below are some examples of all three for both sides.

Appeal to Authority against Quarantine: “My doctor/nurse said their was no reason for quarantine, so I don’t see why we are doing it.” This is a fallacy because every doctor and nurse can have an opinion, but without their also being experts on Ebola, they don’t have a leg to stand on as a support of an argument. The only reason the speaker/writer is bringing this up is that as a medical health professional a doctor or nurse can have an inflated appearance of authority. The speaker/writer believes in that appearance of authority, so they call on their opinion as “evidence.” The average health care worker does know more, most likely, than the average non-health care worker about Ebola, but only to the level of moderate knowledge.

Appeal to Authority for Quarantine: “If our politicians think that quarantine is in the public’s interest, it is something we should do.” Politicians can also appear to have “expertise” to some people, but their opinions shouldn’t be used as gospel as their motivations (especially near election time) are suspect. One should only trust a politician’s opinion when they have advisers who are expects on the issue. Only then are they the mouthpiece of expertise.

Appeal to the Gallery against Quarantine: “No one’s really all that worried about contracting Ebola, so why even talk about quarantine?” Pretending to know what everyone in a nation of 300 million people is very suspect. There are people who are worried, but even if there were not one person worried by the idea of getting Ebola, how people feel in general about it is not the issue. The fact that Ebola is contagious is the issue.

Appeal to the Gallery for Quarantine: “We are all scared, and for the safety of everyone in this country, we need to quarantine every health care worker who has come into contact with Ebola.” Again, acting as though a nation has a uniform thought and we all know what it is oversimplifies the people. Whether or not everyone is scared is also not the issue; again, the fact that a contagious and fatal disease may (and has in some instances) come into the country is the issue.

Ad Hominem against Quarantine: “All politicians are idiots. We cannot expect them to know what they are talking about.” This is also a generalization, but it is an attack on a group of people instead of a counter-argument to their points. Not arguing the points is bad because it clouds the issue and degrades the discussion.

Ad Hominem for Quarantine: “These health care workers only care about people in other countries. They don’t care about American citizens. If they cared about America, they wouldn’t go to Africa and bring in a deadly disease.” It’s much the same as the one against. It’s an attack on the person and doesn’t contribute anything to the discussion.

Slippery Slope against Quarantine: “What going to happen next? Are we going to detain every nurse and doctor that get off any international flight? Are we going to start grabbing people off the street because they could have been to Africa?” We have a lot of checks in place in the country to prevent this kind of thing from happening. Many of our government officials and doctors are against quarantine, so they will prevent things from going that far, but that doesn’t mean that any quarantine will result in this consequence.

Slippery Slope for Quarantine: “If we don’t quarantine every health care worker who’s coming in from abroad, they are going to infect millions of people. One person gets through and we will lose whole cities, states, maybe even half the country.” This seems like a fear response/tactic to me, but it disregards all the other people who are for quarantine and the fact that the illness sends people to the hospital pretty fast once symptoms occur. Most likely, in the event of an outbreak it will not get very far before a response happens to counter its spread.

Both Sides

I hope this exercise taught you a bit about how to argue without sounding like a screaming magpie. But I hope it also taught you the importance of compromise on an serious issue. In a situation like this, the middle way seems best. We shouldn’t be reactionary, nor should we have no reaction. Something serious needs even tempers, logical reasoning, and back and forth; otherwise, something will go wrong.

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