Civil Liberties vs Public Health

Back to literature I go...

Currently I am reading Asleep: The Forgotten Endemic that Remains one of Medicine's Greatest Mysteries. It is a nonfiction book following Encephalitis AKA "The Sleeping Sickness" - it follows several case studies and the doctors involved in the spread between 1915 and 1927.

In order to better understand health issues at the time, we are given some history into NYC public health standards and practices.  One raises a particularly interesting ethical question in my mind - the case of Typhoid Mary.

Mary was a cook for several wealthy families, and the Health Department - through much searching - found out that she was spreading Typhoid through the food she prepared for these families.  She did not suffer from the disease, but she was a carrier of the germs and gave those to the families for which she worked. Mary had fears of the department catching her (not sure what would happen if/when they did), so she continued to bounce from job to job, cooking for families all while spreading the disease.  Since Mary would not quite her job as a cook despite the fact that she was spreading this horrible illness, she was finally arrested and forced to live out her life in an isolation hospital.

Now, the ethical question I have is this: is it right for the officials to imprison Mary for the remainder of her life?  She did not purposefully murder anyone.  She simply was stricken with something that she could not get rid of.  For the record, I think that, yes, they did have to imprison her.  If they had not done so, they would have been knowingly allowing more and more people to die (would they then be murderers??).  If Mary would have just stopped cooking for families, she would not have been imprisoned.  Of course, that was her way to make money.  She did not exactly have many other options in life as a poor Irish immigrant.

What about a larger picture?  Does the government have the right (or maybe the need) to take away some/all of our freedoms in order to keep the public safe? Well, they are doing these types of things right now. Bans on smoking and trans fats are two recent examples. But at what point is it too much? Have we begun to open the Pandora's Box of banning? And - most importantly - how will we know when to close it?