New at Reason

June 6, 2007

Jacob Sullum digs into the Andrew Speaker TB scare, a real example of what the public health system is for in an era of 24/7 TV news.

Comments

|6.6.07 @ 8:56AM|#

Speaker's father-in-law, [is] a tuberculosis expert at the U.S. Centers for Disease Control

I hadn't heard that bit of the story before. Rather an extraordinary coincidence, don't you think?

|6.6.07 @ 9:00AM|#

Yeah, I'm pretty sure his father-in-law doesn't like him too much. I think he tried to off him.

|6.6.07 @ 9:09AM|#

TB is an awful way to off somebody you don't like. It's slow and kills you over a looooooong period of time, plus you risk infecting people you do like. That's why they call them coincidences...

|6.6.07 @ 9:15AM|#

Mr. Sullum writes:

Activists and politicians use the language of public health to legitimize government efforts to discourage a wide range of risky habits, including smoking, drinking, overeating, underexercising, gambling, driving a car without a seat belt, and riding a motorcycle without a helmet. Unlike typhoid fever and tuberculosis, the risks associated with these activities are not imposed on people; they are voluntarily assumed.

While this is true, I believe one rationale for discouraging such activities is that a society where a large number of people are unhealthy negatively affects all members of that society, even if indirectly. Not just due to the monetary costs of health care, but because unhealthy people don't function as well in general. So at least to some degree, an individual's health is the business of the rest of us since we all depend on one another to make things work.

Also, some behaviors such as smoking and some drug use are not exactly voluntary considering their addictive natures.

So I think that it's fair to use the "public health" label to describe things that make the public less healthy, even if they're not communicable diseases per se.

Not really Dan T|6.6.07 @ 9:30AM|#

...wide range of risky habits, including smoking, drinking, overeating, underexercising, gambling, driving a car without a seat belt, and riding a motorcycle without a helmet.

but underexercising is immoral!!

|6.6.07 @ 9:37AM|#

"...unhealthy people don't function as well in general."

As tempting as it may be to blame Big Tobacco and the morbid obesity of the employees behind the counter for the fact that it takes all the doodah day to get a set of license plates in Marion County (Indianapolis), I continue to point my finger at AFSCME and a culture of utter indifference to results.

Workbreak|6.6.07 @ 10:16AM|#

I've not commented on this guy (Smiley the dickhead lawyer), so we'll get that out of the way here and then I will say no more about him.

1) Who the hell would tape a discussion with a doctor unless it was a fucking asshole lawyer knowing they were putting someone in danger, trying to avoid the liability later? God I hate those bastards, they put the fucks to everyone and everything around them with their arrogant word twisting.

2) What kind of an dickhead, when told he had the really bad stuff (extreme resistant) and "Don't fly" without any qualification (which was while in Italy, any ambiguity was in the US), proceeds to say "hey, fuck you" and head on back by themselves? The justification? "I have cooperated but for that isolate yourself in Italy thing"...and "It was about me, fuck all y'all, I thought I was going to die, so I figured I'd expose another couple hundred people to save my skinny rich lawyer white ass"

You don't even get to civil liberties, he loses at simply being a responsible adult which includes not trying to kill others just because you're legally ok.

If we, not him as he's an asshole as noted above, but "we" being the other people who don't seem to matter to him, are fortunate enough to not have anyone else infected by his actions, that would be a good thing. You can throw statistics around about how he can't spit contaminated spit, and how 20% of the TB infections ar passed by those who can't spit contaminated spit, all that's nice. The bottom line is you simply should not put others at risk for deadly disease simply because you're an arrogant fuck who believes that the rules of being a civilized and responsible human being don't apply to you, even if you taped your doctor most probably being backed into some comment that the transmission probability was low. It does not make it ok simply because you wanted to do something different than what they said.

You can kill yourself by not following the doctor's advice, I have no problem with that. All the comments on smoking (at least firsthand smoke), obesity, drug use, etc, go in that hopper. I have a major problem if you try to kill me or my kids because you're simply an asshole. Cho is a good example of another version of carrying around something deadly, no different from this jerk but for the fact he (apparantly, we really dont' know yet as I understand it) managed to "infect" (shoot in his case) a few more people.

As an aside, I have further problems with laws that prevent me from returning the favor if you do in fact expose myself or those who I view as close to probable death, but that's a whole nother discussion.

Ok, back to your regularly scheduled snark about smoking or eating too much and as promised I'll say no more about this goat fuck asshole.

|6.6.07 @ 10:33AM|#

Uhm, Workbreak, I tape important phone conversations all the time, mainly so that I can review them later and produce detailed notes. I'm not a lawyer, and I'm not interested in using them to "fuck" my interlocutor. Rather I use it as a memory aid.

Additionally, it can be possible to tape a conversation inadvertently. I had an answering machine which specialized in that.

Dave W.|6.6.07 @ 10:34AM|#

knowing they were putting someone in danger, trying to avoid the liability later?

Have you ever seen a product liability thread around here? A thread on liability for risks of modified food processes or products?

How certain does the danger have to be before you deserve liability because you "know you are putting someone in danger"?

thoreau|6.6.07 @ 10:37AM|#

Good article, Jacob.

fyodor|6.6.07 @ 10:42AM|#

I believe one rationale for discouraging such activities is that a society where a large number of people are unhealthy negatively affects all members of that society, even if indirectly.

Stupidity negatively affects others too. Lucky for you not enough people buy your own ideology to stick you in a re-education camp.

thoreau|6.6.07 @ 10:43AM|#

fyodo wins the thread.

|6.6.07 @ 10:50AM|#

Yep, it's fyodor 1, straw man 0

Edward|6.6.07 @ 10:53AM|#

We have become a very risk-averse society, but rather than whining about it, smart entepreneurs are cashing in.

|6.6.07 @ 11:12AM|#

Also, some behaviors such as smoking and some drug use are not exactly voluntary considering their addictive natures.

That is horseshit. I smoked for 10 years and haven't smoked in two. Addiction is voluntary.

Edward|6.6.07 @ 11:12AM|#

Think about it. As people become more and more risk averse, folks who make crash helmets, health foods and supplements, diet aids, toys (safe ones), alarm systems, etc, etc. make bundles. They advertise their stuff and reinforce the tendency to be risk averse. So why blame the government? Maybe government action--like market action--is just responding to reality.

|6.6.07 @ 11:14AM|#

TB is an awful way to off somebody you don't like. It's slow and kills you over a looooooong period of time, plus you risk infecting people you do like. That's why they call them coincidences...

Yeah, I was joking. But maybe he doesn't like his daughter much either...

Superficial Dickhead|6.6.07 @ 11:25AM|#

I think everyone is missing the most important part of this story. Smiley McLawyer's wife looks totally hot with the hospital mask on but without it she has a face like ten miles of bad road.

|6.6.07 @ 11:34AM|#

I smoked for 10 years and haven't smoked in two. Addiction is voluntary.

Addiction by definition is not voluntary.

That doesn't mean that it can't be overcome, but not everybody is able to do it.

|6.6.07 @ 11:48AM|#

Actually, the effects of smoking are imposed on me when I have to breathe someone's secondhand smoke. The effects of alcohol and drug use are imposed on me when some junkie takes a piss in my yard or, some drunk gets behind the wheel.

It's in my interest (and therefore the public interest) not to get cancer just by standing near someone who smokes, not to get killed by a drunk driver and, not to have my yard smell like a toilet.

Also, I'm not sure how fyodor wins an argument by effectively calling someone stupid. Perhaps that wins an argument in 3rd grade but, not in a discussion among adults.

thoreau|6.6.07 @ 11:52AM|#

Winning a thread is about humor value, not logic.

Dave W.|6.6.07 @ 12:01PM|#

Winning a thread is about humor value, not logic.

T. is a wide eyed, innocent Luke. Someday he will be a mighty warrior, but he has a lot of learning to do first before he can use the Force.

|6.6.07 @ 12:03PM|#

While this is true, I believe one rationale for discouraging such activities is that a society where a large number of people are unhealthy negatively affects all members of that society, even if indirectly. Not just due to the monetary costs of health care, but because unhealthy people don't function as well in general. So at least to some degree, an individual's health is the business of the rest of us since we all depend on one another to make things work.

I don't know exactly what you mean by "functioning well". But if it means being able to do your job then:

1 - Many jobs don't require you to be healthy to do them.

2 - If a job does require that, and an employee is too unhealthy to perform the job well, an employer could fire that person for poor performance and hire someone else.

3 - Nobody has an obligation to do any particular job (example: If alot of engineers or scientists suddenly started quitting their jobs and moving onto rural communes to live, they wouldn't be violating anyone's rights or defaulting on any public obligation). If I have no obligation to do a job, then I have no obligation to avoid behaviors which allegedly make me less likely to be able to do that job.

Also, some behaviors such as smoking and some drug use are not exactly voluntary considering their addictive natures.

It is true that with certain habits, you have to either continue doing them or suffer substantial unpleasantness (at least temporarily). This is what is generally meant by addiction (if you have a different definition, you can post it in your response). However, I don't think that makes it involuntary.

It is certainly voluntary when one starts. The risk of becomming addicted is commonly known and people assume that risk along with others when they take up a potentially addictive habit.

Also, not all smokers or drug users are addicts, so those behaviors themselves are not always the result of addiction.

As for people who are already addicted and would like to quit, society can help them by providing quiting assistance on a voluntary basis. For example, we could provide detoxification and treatment and other things to mitigate the short-term hardships associated with stopping an addictive habit. However, if an addict is given that treatment option and wants to continue using instead, he or she should be allowed to do so.

|6.6.07 @ 12:03PM|#

"Also, I'm not sure how fyodor wins an argument by effectively calling someone stupid. Perhaps that wins an argument in 3rd grade but, not in a discussion among adults."

Ummm, fyoder's point wasn't that Dan T. was stupid (annoying and statist doesn't necessarily equal stupid), but rather that Dan T.'s statist logic leads step by step to such lovely things as reeducation camps, thus stifling the openmindedness he purports to value so highly.

And what makes you think that the people who post here are all adults? Is there some hidden age-checking software that screens posts?

|6.6.07 @ 12:04PM|#

Good post Workbreak, I have heard anyone else properly state what an ass this guy was in his actions

|6.6.07 @ 12:17PM|#

Actually, the effects of smoking are imposed on me when I have to breathe someone's secondhand smoke.

If someone is smoking in your house, you can order that person to either stop or leave your house. If someone is smoking outside, down the block from you (or even next to you for a few seconds as you pass eachother); then the amount you get from that is too negligable to have an effect.

The effects of alcohol and drug use are imposed on me when some junkie takes a piss in my yard or, some drunk gets behind the wheel.

Someone pissing in your yard or driving drunk is a mere "effect or alcohol and drug use". Those things require an additional decision by an intoxicated person. Merely ingesting drugs or alcohol is not sufficient to generate those kind of effects.

|6.6.07 @ 12:52PM|#

Workbreak's post would be more convincing if he hadn't missed the part about there being no TB in his sputum (TB is transmitted primarily by sputum) and little chance of his infecting someone else.
That does not mean his actions were ok. It does mean that they are understandable. But shrieking through the net isn't really an exercise in thinking, is it? It's more akin to flinging poo while screaming "Notice me!"

|6.6.07 @ 1:09PM|#

Addiction by definition is not voluntary.

With very few exceptions, the behaviors that we call addictions are all behaviors chosen by the "addict." Including smoking.

Just because an addict really really likes their addiction, and really really doesn't want to quit, and is willing to make really really big sacrifices to indulge their addition, doesn't mean they aren't acting voluntarily, and even rationally once you recognize the subjective value their addiction has for them.

|6.6.07 @ 1:12PM|#

Also, some behaviors such as smoking and some drug use are not exactly voluntary considering their addictive natures.

Dan T, this is one of the stupidest things you have ever said.

|6.6.07 @ 1:17PM|#

Addiction by definition is not voluntary.

Addiction by definition is compulsive, not involuntary.

|6.6.07 @ 1:22PM|#

"Not just due to the monetary costs of health care, but because unhealthy people don't function as well in general."

Try to take a BigMac out of a fat guys hand and see how happy he is about it.

Unhappy people "don't function as well in general". So really if the goal is to make sure people function well, they should be allowed without question to do what makes them happy.

|6.6.07 @ 1:54PM|#

Even if indulging an existing addiction is not voluntary, becoming addicted in the first place is. Especially when the activity in question is widely known to be addictive.

Ventifact|6.6.07 @ 3:58PM|#

"[S]moking, drinking, overeating, underexercising, gambling, driving a car without a seat belt, and riding a motorcycle without a helmet" are not necessarily "habits" as Sullum terms them. While that word is a common way to refer to them, it is a bad idea to use it because it accedes to the widespread view that participation in a risky behavior must be habitual, i.e. that any instance of edgy behavior is the mark of an overall out-of-whack lifestyle. This notion fuels drug prohibition, for example. BG sort of moved toward mentioning this in his post.

|6.6.07 @ 4:37PM|#

Addiction by definition is not voluntary.

Wow. Ok, well some have already addressed this, but just to make it clear: unless someone straps you down, puts a lit cigarette in your mouth, and somehow gets you to breath it in, it IS voluntary. People are not robots that act involuntarily. If you smoke, do drugs, etc, it is your CHOICE. It may be hard not to do it, but it is not involuntary.

Are we seriously so far gone that this has to be explained?

Paul|6.6.07 @ 11:45PM|#

Not just due to the monetary costs of health care, but because unhealthy people don't function as well in general. So at least to some degree, an individual's health is the business of the rest of us since we all depend on one another to make things work.

Only in a socialist or communist state, Dan T. In a capitalist state, I don't care one whit if my neighbor sits on his couch all day. But in a socialist economy, then he'd better get off his dimpled ass and get to work.

Get it?

|6.7.07 @ 8:22AM|#

I heard Mr. Sullum speak this morning on NPR, and I was actually appalled by the lack of logic and reason in his argument against government being involved in restricting public cigarette smoking as a public health concern.

Let's step through this logically:

What's the concern of T.B.? One would obviously say that it is a disease that can be spread to other people. So it only stands to reason that the government should step in to control this problem.

What's the problem with first and second hand smoke? Well, let's see, it's only been definitively linked to causing cancer; not just to the person smoking, but to those people who come in contact with it.

Just as there is no guarantee that everyone on the plane with Mr. Speaker was going to get T.B., not everyone whoe comes in contact with smoke is going to develop cancer. But the risk is still definite.

The government is not saying that you can't smoke anywhere, just not where you increase the risk of injuring someone elses health.

Seems pretty logical.

SP|6.8.07 @ 2:12PM|#

I'm new here so please forgive me if I sound naive. But what do we do as a society when unhealthy parents subject their children to potentially dangerous, unhealthy behavior. Children generally don't chose to smoke, yet they cannot chose to leave when someone smokes around them. And if left to their own devices, they also do not overeat until they are taught to do so. Yet 1 in 3 children are now overweight, with the drastically increased risk of diabetes, etc.

I don't want someone to tell me how to raise my child. Yet I worry about all those children - who will determine the health of our society for the future - whose parents seem unwilling or unable to provide a healthy environment and habits. Don't we have to make some sacrifices or take some responsibility for them?

|6.10.07 @ 10:01PM|#

Opinion is getting in the way of facts here.

First, he was told that he had TB, but not a serious strain, so his chances of infecting others was low. He goes on his trip, safe in this knowledge.

Then, later, he was told that it WAS a serious strain -- this means that everything that he was told earlier about low probability of infection was null and void. As an attorney, he KNOWS this. He was told to go into isolation, and informed that he was on a no-fly list. Any residual thought that he posed a low risk to others is wiped out at this point.

Then he decides to ignore the doctor's order, and instead jumps on a plane for several hours of isolation with a couple of hundred other people, who were not given an opportunity to make an informed decision. Proof that Mr Attorney was aware of the situation comes from his driving to another country (thus to escape Italian health authorities) to fly to Canada (thus to avoid the US no-fly order).

From where I'm sitting, this adds up to an assault on the several thousand people who came in contact with him while he was dodging doctors. Whether or not he had the bug in his spit means nothing, once he was told that he was a danger to others around him. Even if nobody else gets sick, he is as guilty of endangering the innocent just as much as if he was shooting a gun randomly but didn't hit anyone.

The first thing that should happen is a very public trial for a couple of hundred cases of attempted manslaughter. Then he should be disbarred.

If he were sitting next to my lady or one of my kids, and they got sick because of his refusal to act responsibly, he wouldn't have to worry about dying from TB. I would give him the copper-clad, ballistic innoculation myself.