American tradition is rooted in individual freedom, liberty and the belief in a balance of power between the federal and state governments. It is a proud tradition that has stood the test of time, but the changing global climate tends to question this approach in concern to the public health. Since the tragic events of September 11 and the anthrax attacks of October in 2001, America has been forced to deal with the stark reality that, in a growing global economy that promotes international travel, it is left more vulnerable than ever to terrorist attacks. More specifically, the United States is more susceptible to bioterrorist attacks on its populace. The unfortunate outcome of this vulnerability is its propensity to create a limitation of those freedoms and liberties that have been so foundational in establishing America’s identity. The question many people raise is whether or not the federal government should be given the power to limit or eliminate individual freedoms in the event of a bioterrorist threat or attack. The Model State Emergency Health Powers Act (MSEHPA), promoted by Lawrence O. Gostin, seeks to provide state governments with this power over private liberty in the event of a bioterrorist threat. The other side of the debate, George J. Annas believes that the MSEHPA approach is greatly flawed in that the decision making process is done on a state-to-state basis while the problem is national and that it infringes upon foundational values of Americas. On the other hand, the developers of the act argue that the power lies with the individual states, as granted by the Constitution, and that the changing culture dictates that certain individual rights be surrendered in favor of the common good of society. I agree with the writers of the MSEHPA in the idea that the changing global climate commands the forfeiture of particular freedoms in the search for national security, but differ on the grounds that power should rest with the individual states. Instead, I believe that the power ought to remain with the federal government due to the national nature of terrorist attacks.
Both Lawrence Gostin and George Annas agree that there must be measures taken to ensure security in a world that poses a bioterrorist threat. Gostin supports the suppression of civil liberties in order to maintain the American way of life. It is at this juncture that the two dichotomize into two separate trains of thought. Gostin sides with the model set forth in the MSEHPA, claiming that individual states must follow guidelines in restricting individual citizens’ liberties in a terrorist attack. Annas counters this argument by claiming that the handling of bioterrorist threats must be handled on the federal level and that the removal of an individual’s rights should not be considered except in the direst of circumstances. He further asserts that the most effective way to ensure peace is through mutual participation between the government and it’s citizens.
The purpose of the MSEHPA is to provide a competent model for individual states to use when developing a plan to combat the threat of bioterrorism. It tends to promote the placement of public health over individual liberties in the event of a bioterrorism threat. The basis for the development of the act is a lack of preparedness. Gostin develops this theory in two major ways. First, he explains how the foundation of the American health care system is crippling the effort to thwart bioterrorist incidents. He sites the allotment of funds by the federal government as the cause for this problem because the vast majority (95%) of expenditures goes towards biotechnology and health care. This comes as a result of the political and social views that place individual freedom and choice at the epicenter of national health care. The dilemma that arises from this antiquated view is that it tends to neglect collective health, safety and security. Secondly, Gostin sites law concerning public health, more exactly those concerning individual freedoms, as being a source of problems during a possible attack because individuals often have a choice as to whether or not they are screened and if their information is released to high authorities. By allowing these choices, the law promotes a breakdown in the chain of command similar to that of the 9/11 incident. Promoters of the MSEHPA use these two arguments to support the suppression of liberties because of the threat of bioterrorism.
In response to the formation of the MSEHPA George J. Annas, counters the arguments of Gostin by introducing the aspect of federal public health and attacking the loss of freedoms stating that, “public health must rely not on force but on persuasion, and not on blind trust but on transparency based trust.” Annas takes the position that allowing public health, in the wake of the bioterrorist attacks of 2001, to be left in the hands of individual states denies the fact that such an attack is a matter of national security and thus a federal concern. Through this definition, Annas argues the premise that public health policy should be controlled at a national level. This argument is put forth because of the possibility that individual states would be overly worried about their own state and create a communication problem throughout the nation. Cases may possibly be reported to state officials and not to neighboring states; leading to a higher chance that the disease/virus would expand. Another major objection to the act is that it limits personal rights. Annas asserts that by restricting freedom the government will in fact create a rift between the citizens and the government. The act allows for certain government officials, in the event of an emergency, to assume supreme authority over health care operations without regard for the presence or lack of evidence. Annas explains that these problems are inherently caused by the state from which the act was created. At the time the nation was ruled by fear and rational decisions were overshadowed by the immense fear of another attack. It is in this state that the formation of the act occurred and in this state that, as Annas argues, the natural right to choose was abandoned. Instead of balancing the need for human rights and disease prevention, the act completely neglects human rights.
In evaluating both positions thoroughly, I have come to the conclusion that the argument against the MSEHPA is the most effective. This argument does an exceptional job at criticizing and dismantling the foundation of the act. I believe that the motivation behind the act is both noble and needed, but that the formation was, as suggested in the Annas essay, rushed without the necessary editing process. I believe that he makes a very strong case regarding the innate problems of a state-to-state based system. I view his reasoning as very thorough and well supported in that it, in my opinion, truly recognizes the overarching national concern. What Annas recognizes is something that the MSEHPA overlooked; infected citizens are able to move from one state to another without much effort. With the power given to the states, as in the MSEHPA, the potential for a breach of containment is greatly heightened. This rupture would be a result of individual states attempting to concentrate their resources towards their own needs and disregarding the needs of other states. I do not believe that Annas’ argument is the answer to the problem of civil liberties in a bioterrorist threat, but I believe that it is the lesser of the two evils I was presented with.
In my examination of the two essays, I found that each had substantial merit and was meticulously scrutinized. I believe that each represented a polarized position and that the answer lies solely in the middle where the national concerns are realized and the changing culture dictates that freedoms may be withheld in the name of mutual security. Threats to national security, such as a bioterrorist attack, are just that, a national problem. I feel that this must be one of the first concepts realized when dealing with such a topic. Once this primary need is understood, it becomes necessary to delegate power to the correct authorities. In my ideal plan each state would be divided into sections based on population and land. The sections would be controlled at the state level. The state level would be controlled at the regional level and the regional by the Department of Homeland Security who answers to the White House. In my opinion, these authorities must be trained to maintain proper and quick lines of communication in the event of mass hysteria. I tend to take a very Machiavellian or Hobbesian approach to handling problems that can escalate to hysteria and a type of mob mentality. As a result, it is my belief that power should rest with those designated government officials, and that absolute power, within the laws and guidelines set by the legislature, must be granted to them in such a situation. My affinity towards such a setup is due to what I feel is man’s innate tendency to break down the rules of civilization and revert to a survival-first reflex. I also hold the view that although people may follow positive leadership they are also susceptible to negative influence in a time of utter chaos. As a result of these views, I find that it is a necessity to suspend civil liberties in the event of a bioterrorist threat. It is very obvious that placing societal concerns above individual problems will create a great disturbance within the nation, but the changes in the global economy and heightened international travel dictate such a change. The suspension of rights is because it is impossible to handle each individual concern in the event of a bioterrorist attack. If an attack were to occur, I would argue that government officials must make decisions in the best interest of society. Another major aspect that I believe must be given priority is that of prevention. In order for the United States to never be in a situation where civil liberties are withheld, we must make the prevention of such an attack a top priority. Officials must take care when implementing a “neighborhood watch” type program. The last thing the nation needs is a witch hunt or a repeat of McCarthyism or bin Ladenism as the case may be. Instead, the public must be informed of those suspected terrorists that have entered the country. They must know who the government is looking for because three hundred million eyes are better than a few thousand. Don’t give the public open reign to accuse whomever they choose, but give them specific targets and easy access to government officials. Annas’ argument made a very important point that hospitals must be trained to recognize many of the basic bioterrorist agents that may be used in an attack. I feel that this plan is the most efficient marriage of the two plans.
I have found much merit in Gostin’s essay in favor of the MSEHPA and also in Annas’ essay against. Each offered insight in to the debate on how to better protect the nation against a bioterrorist attack. However, I believe in another answer to the posed dilemma. There must be a union of certain key ideas from each essay. Prevention should be of high importance, but in the event of an attack civil liberties may be withheld by the order of the federal government. There is only one true certainty that arises from this debate and that is bioterrorism is a real threat that we must prepare for.
• 
• 
• 
• 
• 
• 
• 
