Ethics and Security Aspects of Infectious Disease Control

Interdisciplinary Perspectives

Michael J. Selgelid, Christian Enemark, Christian Enemark

• Publisher: Routledge
• Year: 2016
• ISBN:
  9781317141273
• Edition: 1
• Topic: Politics & International Relations
• Subtopic: Geopolitics
• Index: Politics & International Relations

The increasing emergence, re-emergence, and spread of deadly infectious diseases which pose health, economic, security and ethical challenges for states and people around the world, has given rise to an important global debate. The actual or potential burden of infectious diseases is sometimes so great that governments treat them as threats to national security. However, such treatment potentially increases the risk that emergency disease-control measures will be ineffective, counterproductive and/or unjust. Research on ethical issues associated with infectious disease is a relatively new and rapidly growing area of academic inquiry, as is research on infectious diseases within the field of security studies. This volume incorporates ethical and security perspectives, thus furthering research in both fields. Its unique focus on the intersection of ethical and security dimensions will, furthermore, generate fresh insights on how governments should respond to infectious disease challenges. Readers should include professionals and scholars working in infectious disease, epidemiology, public health, health law, health economics, public policy, bioethics, medical humanities, health and human rights, social/political philosophy, security studies, and international politics.

1 The Concept of Security

DOI: 10.4324/9781315580357-2

Jonathan Herington

Introduction

Being secure is one of the most widely acknowledged components of a good life. Henry Shue (1980 [1996]) describes the right to security as the first of our basic rights. Political philosophers from Hobbes to Rawls consider the provision of security the key task of political institutions. The concept is central to historic political documents such as the Déclaration Des Droits De L’homme Et Du Citoyen De 1789 and the Universal Declaration on Human Rights. Political leaders extol its virtues on a daily basis.

Security has also become an important concept in deliberations on the response to infectious disease emergencies. Some infectious diseases—such as HIV/AIDS, Severe Acute Respiratory Syndrome, and pandemic strains of influenza—are hypothesised to pose a threat to security (in addition to the risk they pose to human health). Severe infectious disease epidemics could thus be instances of “supreme emergency”, where threats to security justify measures beyond those normally regarded as permissible (Walzer, 2000). If a particular epidemic threatens security, then coercive public health interventions—e.g., compulsory vaccination and/or restrictive social distancing measures such as isolation and quarantine—might be justifiable (Selgelid and Enemark, 2008). On the other hand, the “securitization” of disease might politically legitimise morally unjustified rights violations (Elbe, 2006). The status of severe epidemics as threats to security and the justifiability of treating health emergencies as security threats are unresolved questions.

But what does it mean to be secure? Why is security valuable? Answers to these questions are imperative before we can begin to assess whether the securitization of certain infectious disease emergencies is morally justified. Despite the centrality of security to political philosophy and many modern moral dilemmas, surprisingly little attention has been paid to the concept of security by philosophers (c.f. Waldron, 2006). While discussion abounds on the balance between security and liberty (Waldron, 2003), and the permissibility of infringing generally inviolable rights when faced with supreme emergencies (Walzer, 2000: 251-252), very rarely is the meaning of “security” interrogated. There is therefore a lacuna in our toolkit of moral concepts, one which should be filled if we hope to properly assess the permissibility of actions claimed to promote or maintain security.

This chapter provides a philosophical analysis of the different meanings of “security” and, by so doing, identifies some key features of the concept of security. I begin by establishing a number of qualities which this chapter’s conceptual analysis should ideally possess. I then make an important distinction between security as a practice and security as a state of being, and argue that more attention should be paid to the latter if our goal is to interrogate the justifiability of using security practices in the context of infectious disease emergencies. The latter half of the chapter investigates three common features of contemporary accounts of security: (1) the referent object, (2) the conditions that object must satisfy to be secure, and (3) the distinction between the objective and subjective realisation of those conditions. I argue that accounts of the meaning of “security” identify a referent object and a set of conditions which must be reliable for that referent. I conclude by suggesting that a deeper engagement by moral philosophers with the concept and value of security (as a state of being) is required if we are to get very far in evaluating the justifiability of treating infectious disease emergencies as security issues.

Security and Essential Contestability

The modern concept of security has a long and complex genealogy. Antecedents of “security” in Latin (securitas) and Ancient Greek (ataraksia) described a psychological quality—an individual’s calm acceptance of her predicament and place in the world—which was largely detached from the physical or political context (Arends, 2008). Early Christian use of the word “security” described an individual’s sinful sense that she commanded her own life: an unwarranted certitude in the face of God’s omnipotence. ¹ The more familiar notion of security as the physical safety of individuals arose with Enlightenment and Napoleonic scholars, whose belief that individual security could only be guaranteed by social institutions provided their chief justification for the modern State (Rothschild, 1995). The discipline of International Relations, where national security is a key concept, has built upon this Enlightenment heritage by associating the term almost exclusively with the territorial and political integrity of the State (Walt, 1991). In recent times, “critical security scholars” have challenged this understanding, suggesting that being secure is a property not of the State per se, but of individuals (see United Nations Development Program, 1994; Booth, 2007). This tumultuous genealogy has produced a diverse set of contemporary meanings of the word “security”; evident in the multitude of conceptualisations of national security (Wolfers, 1962; Ullman, 1983; Walt, 1991), human security (United Nations Development Program, 1994; Ogata and Sen, 2003), ontological security (Giddens, 1991; Mitzen, 2006), emancipatory security (Booth, 1991; Wyn Jones, 1999) and securitization theory (Wæver, 1995; Buzan, Wæver et al., 1998).

¹ See for instance the usage in Macbeth: “…security; Is mortals’ chiefest enemy”. (Shakespeare, 1988: Act 3, Scene 5, Line 31)

The greatest obstacle to clarifying the concept of security, then, is not that nobody knows what it means, but rather that “security” means many different things to many different people. The diversity of meanings is so great that security is typically labelled an “essentially contested concept” (Buzan, 1983: 6). In this sense it is claimed to be similar to other concepts—such as “health”, “justice”, “race” or “gender”—which have a multitude of competing definitions, none of which are accepted as correct by all. ² Each definition of a contested concept emphasises different aspects of that concept and, by so doing, makes different claims about what is important or valuable about security. As Gray (1978: 392) suggests:

² For a general overview of “essential contestability” see Gallie (1955) and Swanton (1985).

[T]he major source of a concept’s essential contestedness is the normative standard embodied by its criteria. This is to say that a concept is essentially contested if its rival uses express competing moral and political perspectives.

Thus, human security, national security, ontological security etc., could be seen as competing accounts of the concept of security which instantiate different claims about the value of states, individual wellbeing, psychological quietude etc. We cannot easily resolve the dispute between these definitions because we can reasonably disagree about the value of the goods which are emphasised by each definition.

The seemingly irresolvable contest between definitions of security has prompted some to contend that attempts to systematically analyse the concept of security are futile. Instead of conceptual analysis of security we should identify and critique the politics of its meaning (Huysmans, 1998: 232). This approach to essential contestability is, however, peculiar to discussions of the concept of security. The essential contestability of power, liberty and justice have not prevented philosophers from attempting to provide a structure that clarifies the value claims embodied within various definitions (see Lukes, 1974; Gray, 1977; Gray, 1978). Whilst it may not be possible to precisely define the content of an essentially contested concept through conceptual analysis alone, such analysis may identify what is at stake in the contest between definitions. Moreover, there may be a “common core” or structure to definitions, over which there appears to be broad agreement (Gallie, 1955). Finally, this common core might identify why we take security to be especially valuable and help elucidate the role that appeals to security play in justifying the use of extraordinary measures.

Legitimate Purposes

Bearing in mind that security appears to be an essentially contested concept, I begin by asking what goals an analysis of the concept of security should strive to fulfil. One way of giving structure to a conceptual analysis of a contested concept is to explicitly identify the purpose of the analysis. ³ A conceptual analysis of “security” might, for instance, seek to identify those features of the concept which make it useful to theorists of international politics, or it might seek to identify features which explain the word’s rhetorical power. This chapter is explicitly concerned with identifying those features of the concept of security which explain its role as a consideration in moral decision-making. This purpose suggests four qualities which this chapter’s conceptual analysis should ideally possess.

³ This approach to the analysis of concepts, and the notion of “legitimate purposes”, is borrowed from Haslanger (2005).

First, the conceptual analysis should integrate the concept of security with theorising about our ultimate moral and political goals. As noted above, security is typically viewed as an especially valuable good: perhaps as an end in itself. A conceptual analysis which integrates security with moral and political theorising might reveal why this is so, and how the invocation of security operates to justify certain actions and political practices. Others have recognised that analysis of the concept of security must be normatively-sensitive: critical theorists explicitly acknowledge this consideration and some post-structuralists have begun to investigate an “ethics of security” (see Wyn Jones, 1999; Booth, 2007: 109; Burke, 2007). However, the analytic (or Anglo-American) stream of moral and political philosophy has yet to fully engage with the concept of security, and this leaves much of contemporary ethical theory ill-equipped to engage with security’s role in moral decision-making. An analysis of the concept of security should thus attempt to explain the grounds for the special value of security in a way that is compatible with the language and theory of analytic moral and political philosophy.

Second, since security is a contested concept, an analysis of the concept should be ecumenical towards many different conceptions of the good. A panoply of different referents and goods constitute accounts of security, instantiating a variety of value judgements on top of a common structure. Any characterisation of this underlying structure should thus be able to accommodate a wide range of referents and goods.

Third, a conceptual analysis of security should attempt to identify what makes security a distinctive consideration in moral decision-making. If two policies are being considered, the concept of security should help distinguish between courses of action in ways which are not already served by other concepts such as utility, freedom, equity or justice. A conceptual analysis of security which failed to identify what differentiated security from these other concepts—because it was either overly vague or expansive—would not improve our ability to discuss the trade-offs which could be made between security and these other important goals. This is not to say that maintaining security will be simple; it may, to the contrary, require many different means which would simultaneously serve other goals. Ensuring health security may require us to increase access to primary health care, simultaneously promoting health equity. It is a mistake, however, to consider the various means by which we ensure security as synonymous with the state of being secure itself. Thus, while the complexities of ensuring or providing security should not be forgotten, the state of being secure should be conceptualised as specifically as possible.

Fourth, conceptual analysis should not be disconnected from ordinary language. Whilst a project of defining “security” could be purely stipulative, conceptual analysis should engage with the competing meanings actually held by individuals in the world. A broad engagement with accounts of the meaning of “security”—not just with academic definitions but also with the ways in which the word appears to be used in ordinary language—is wanted.

A complete argument for these four qualities would be extensive and is beyond the scope of this chapter. Suffice it to say that I believe these purposes are intuitively appealing, prima facie plausible and ultimately defensible. My goal in this chapter is therefore...

Table of contents

• Cover
• Halftitle Page
• Routledge Page
• Title Page
• Copyright Page
• Contents
• List of Figures
• List of Tables
• List of Abbreviations
• Notes on Contributors
• Dedication
• Introduction
• 1 The Concept of Security
• 2 The Value of Security: A Moderate Pluralist Perspective
• 3 HIV/AIDS, Security and Ethics
• 4 Filth and Failure: The Security Politics of Cholera
• 5 Securitizing Epidemics: Three Lessons from History
• 6 The Disappearing Act of Global Health Security
• 7 Extending Ethical Justification for Public Health Surveillance to Situation Awareness
• 8 Electronic Surveillance for Communicable Disease Prevention and Control: Health Protection or a Threat to Privacy and Autonomy?
• 9 Ethics of Research in Epidemic Response
• 10 Media Ethics and Infectious Disease
• 11 Ethics and Indigeneity in Responding to Pandemic Influenza: Mori Values in New Zealand’s Emergency Planning
• 12 Governance, Rights and Pandemics: Science, Public Health or Individual Rights?
• Index