Markkula Center of Applied Ethics

An Ethical Analysis of Preventing the Spread of Seasonal Influenza

By Sarah Ludwig

These comments refer to the case study Seasonal Influenza: The Ethics of Staying Home.

The seriousness of influenza is frequently underplayed in our culture. A mild case of the flu is often difficult to distinguish from a common cold, so there is little thought put into attempting to prevent the flu from spreading. It would be much easier to decide what Greg should do if he had a disease that was considered serious and highly contagious, such as tuberculosis or whooping cough. If more people took the flu seriously, more would say that Greg should stay home. The enormous risks of infecting other people would outweigh the difficulties that Greg individually faces by missing the presentation.

Influenza is a serious disease which kills thousands of people every year. It is especially problematic for asthmatics or people with weakened immune systems, such as Greg's friend Alison 1. It arguably should be taken seriously just like tuberculosis or whooping cough, in which case Greg should stay home. However, by going and giving the presentation, Greg may not infect many people, and most college students are not at-risk for any serious complications from the flu.

Greg has been placed in a very difficult position by his professor's strict policy. Professors are frequently forced to create firm policies to prevent students from taking advantage of relaxed standards and skipping classes or turning assignments in late. However, their harsh policies sometimes affect students in unintended ways. This is a faulty system, which needs revision. At Santa Clara, policies about missing class are currently determined by individual professors and departments, but a university-wide policy about skipping class while ill would better serve the Santa Clara community.

Greg must weigh his grades, his scholarships, and his group members against the health of his classmates, his professors, and the many other people with whom they will come into contact. Based on what is referred to as a rights approach to ethics, an individual has the right—generally speaking--to decide what to do with his or her own life, including deciding whether or not to stay home when sick. Each person is and should be his or her own best advocate, and a rights approach claims that "we have the right to do… whatever we choose in our personal lives so long as we do not violate the rights of others" 2. This approach is based on the Kantian idea that humans have the inherent right to choose freely what to do with their own lives. However, Greg should still seriously consider the effect that his actions will have on his classmates. They each have their own rights as well, including the right to attend class in a safe, disease-free environment. Greg is infringing on their rights by coming to class when he is sick. The question is whether his right to prioritize his own grade and scholarships outweighs the rights of his classmates to a disease-free environment.

Another way to approach the question is from a utilitarian perspective. Utilitarianism argues that the right action is the one that brings about the most amount of good and the least amount of harm 3. Policies should be in place that do not require people to come to school or work if they are sick, but require students, professors, employees, and employers to abide by these guidelines and keep everyone safe. Greg and his professor should be held to a standard which requires Greg to stay home and his professor to not penalize him for his illness. The professor, when told the circumstances, should make arrangements for Greg that allow him to get better—he is hurting himself by not getting rest, etc.—and not jeopardize his grade.

An individual can also make similar personal judgments about maximizing good and minimizing harm. Greg should certainly avoid coming into close contact with Alison since he knows that she is particularly at-risk for complications from the flu. It takes relatively little effort on his part to avoid close contact with her, and it may protect her from serious harm. Greg also has a particular interest in keeping Alison safe from getting sick because they are friends. Virtue ethics is the concept of acting in such a way as to embody a virtue, such as loyalty 4. To be a loyal friend, Greg needs to do everything he can to avoid infecting Alison.

If I were in Greg's position, and my grade, my group members' grades, and my scholarship were all on the line, I would not be able to stay home. He should speak with the professor to make sure there is no other option, and if he is forced to present he should announce to the class that he is sick and that they should take precautions to prevent getting sick themselves, such as hand washing and avoiding close contact with him. However, it seems that the consequences for Greg personally are too high compared to the possibility of consequences for other people.

Resources

Ethical Issues in Dealing With Seasonal Influenza
Santa Clara University policy during the 2009 H1N1 epidemic
1. "Flu Symptoms & Severity." Centers for Disease Control and Prevention, 29 June 2011. Web. 22 May 2012. http://www.cdc.gov/flu/about/disease/symptoms.htm.
2. Velasquez, Manuel, Claire Andre, Thomas Shanks, and Michael Meyer. "Thinking Ethically: A Framework for Moral Decision Making." Thinking Ethically: A Framework for Moral Decision Making. Santa Clara University. Web. 22 May 2012. http://www.scu.edu/ethics/practicing/decision/thinking.html.
3. Driver, Julia, "The History of Utilitarianism", The Stanford Encyclopedia of Philosophy (Summer 2009 Edition), Edward N. Zalta (ed.), http://plato.stanford.edu/archives/sum2009/entries/utilitarianism-history
4. Hursthouse, Rosalind, "Virtue Ethics", The Stanford Encyclopedia of Philosophy (Summer 2012 Edition), Edward N. Zalta (ed.), http://plato.stanford.edu/archives/sum2012/entries/ethics-virtue/.

Sarah Ludwig created these case studies on seasonal influenza when she was a senior at Santa ClaraUniversity as her Honzel Fellowship project at the Markkula Center for Applied Ethics.

June 2012