I guess I’m trying my hand as a public commentator, because I now have a second piece in Slate. Check it out here. Also, here’s an excerpt:
After the Dallas Ebola patient Thomas Eric Duncan died last week, public comments ranged from expressions of sadness and condolences to his family to vitriolic condemnations of his behavior for lying to airport screeners. It may be helpful to revisit the rationale that likely brought him here, especially in light of the Centers for Disease Control and Prevention’s new airport screening procedures, as well as Liberia’s and Texas’ earlier proposals to prosecute Duncan for evading airport checkpoints. Thinking carefully about his mindset can help us understand how better to address this outbreak and keep it from spreading further.
One method of encouraging honesty is to change the self-interest calculus: to penalize those who lie, as was proposed by Liberia and Texas. But if that calculation is off—if, for instance, the stakes are so high that the penalty is not a real penalty in comparison—then there is little risk to the self-interested party. “If I lie, I may survive. If I don’t lie, I stand a much greater chance of staying behind and dying.” Even if you do not believe that you have contracted the disease, there are plenty of excellent reasons, including the collapsing infrastructure of Liberia and ongoing risk of contracting the disease, to leave the country immediately.
A different, but no less important, method of encouraging honesty, however, is to change the moral calculus so that there is no reason to lie. This, remember, is not about shifting one’s calculations of self-interest, but rather about demonstrating that the best, most careful way to keep other people safe is to seek help from competent medical professionals immediately.
This is yet another reason why it is critical to address the Ebola epidemic swiftly and immediately in West Africa. We need to set up non-threatening isolation units and care facilities so that the clearest path for keeping other people healthy—families, loved ones, neighbors—is to enter isolation voluntarily and not to make the trip to other better facilities. What this means, frankly, is that to keep the infection in West Africa we must bring the full expertise of our medical system to West Africa. Any lesser option will permit and encourage more accidental transmissions across borders.