What is a person’s responsibility toward keeping fellow humans safe and healthy? How much of that responsibility falls onto an employer when it means sick people working because they don’t have sick leave, exposing coworkers and customers? And how much of that is personal responsibility that means a worker won’t get paid for taking a sick day that they didn’t have or even risk losing that job because they’re sick?
We have lots of questions with not as many answers as we would like, but having a conversation is a start towards figuring out the solutions.
Originally, this blog post was going to include discussion with Ebola as the jumping point, and this article, The Ethics of Infection from The New York Times, offered so many good points and ways to consider where individual rights versus the greater good of society should intersect.
Unfortunately, for at least 81 people with whooping cough (pertussis) in Lancaster County, where Lincoln, Neb., is located, this discussion is now more than just an academic exercise, with very concrete life ramifications. A recent Lincoln Journal Star article had a lot of interesting details. “Whooping cough cases in Lancaster County are nearing an all-time high, and that number is expected to keep climbing for the foreseeable future, according to the Lincoln-Lancaster County Health Department.”
There has also got to be an economic effect, as loved ones must be taking care of many of these sick people and missing work, even if they’re not sick themselves. “According to health records, 65 percent of confirmed cases in Lancaster County have been kids ages 6 to 19.” And whooping cough is “extremely contagious, especially in the first few weeks.” Here’s what the article said about the span of time needed to stop the spread of the infection to others. Dr. Phil Boucher of Lincoln Pediatric Group and Tim Timmons, communicable disease specialist with the health department were quoted:
“People receiving antibiotics should stay home from school, work or day care for the full five-day course of treatment, Boucher said.
Those not receiving antibiotic treatment should stay home for three weeks after the onset of violent coughing, Timmons said.”
So whoever is taking care of those with whooping cough (or is sick themselves with pertussis) is looking at between five and 15 sick days. And if the caregiver then gets sick, random interactions, such as those highlighted in the article in the Times, can mean exposures for people who have no sick days. Then for workers with no sick days, and often no health insurance, the best of many really bad decisions has to be made. A previous blog post addressed the challenge of no sick days, in reference to the flu, but it can easily be adapted to the whooping cough situation above.
When it comes to offering solutions to the very real issues that arise with infections, we continue to urge employers to realize the value of paying sick employees to stay home and not expose others, regardless of the contagion. In addition, though it is a pretty controversial conversation, getting vaccines for infections often lessens the severity of the sickness, when it doesn’t outright prevent the sickness, in a person. Herd immunity also protects those who, for various reasons like allergies to vaccine ingredients, cannot be vaccinated themselves.
Finally, experts quoted in The New York Times article urge people to consider the greater good for society, a theme that shows up in many contexts time and again in the firm’s blog posts. Because citizens of the United States are focused on how tough they are as individuals and how they will just “get over” a sickness, many don’t realize that attitude is a luxury for many people for many reasons – some that are more obvious than others. Because a sick person doesn’t necessarily know, and sometimes doesn’t seem to care, about a worker’s immune-compromised family member and what exposure could mean in the long run.
Lawrence O. Gostin, a professor of law at Georgetown University who specializes in public health law and human rights closes the NYT article by talking about how far there is to go.
“America has gotten so focused on rugged individualism and the autonomy of the person that we forget we have wider ethical responsibilities to our families and communities and our country,” said Professor Gostin, who bows rather than shaking hands when he is sick and sends home ill students attending his classes. “This me-first mentality is what I think promotes irresponsibility when it comes to public health.”
Let’s hope all those with whooping cough get better as the infection runs its course and that all humans can have a safer and healthier holiday season and 2015.
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