Brig. Gen. Daniel Ziankhan, left, chief of staff for the Armed Forces of Liberia, and American Maj. Gen. Darryl Williams, commander of U.S. Army Africa, cheer at the construction site of an Ebola treatment facility. (John Moore, Getty Images)
JOHANNESBURG — Some doctors in countries hit hardest by the deadly Ebola disease decline to operate on pregnant women for fear the virus could spread.
Governments face calls from frightened citizens to bar travel to and from afflicted nations. Meanwhile, the stakes get higher as more people get sick, highlighting a tricky balance between protecting people and preserving their rights in a global crisis.
The world could impose more restrictions to ward off a disease that has overwhelmed several West African countries, and exposed shortcomings in medical procedures in Texas and also Spain, where Ebola cases have been diagnosed. Such measures can be legal, lawyers say, but the challenge is to ensure that quarantines, curbs on movement and other steps do not intrude too heavily on civil liberties.
Health-care workers prepare medicine at an Ebola treatment center in Sierra Leone. (Michael Duff, The Associated Press)
"People would rather do more than less, and the problem is that it becomes a slippery slope in terms of rights," said Paul Millus, a New York lawyer who handles civil rights and employment issues.
Sierra Leone, Guinea and Liberia, where the Ebola outbreak has killed thousands, are trying to implement severe controls.
Authorities have imposed curfews, lockdowns and roadblocks. They have ordered a stop to traditional funeral rites that involve touching relatives' bodies. An entire battalion of troops in Sierra Leone is in quarantine, waiting to deploy on a regional mission to conflict-torn Somalia.
In the United States, Gov. Dannel P. Malloy of Connecticut signed an order last week giving the state's public health commissioner the ability to quarantine anyone thought to have been exposed to the Ebola virus.
John Thomas, a professor at the Quinnipiac University School of Law in Connecticut, said the world will be dealing "more and more" with the possible conflict between health policies and civil liberties.
"The tension here is how broadly to cast this protective net," he said. Thomas cited "the positive model" of relatively effective quarantines during the flu pandemic that killed millions in the early 20th century, and, on the other hand, quarantines imposed "for no reason whatsoever" on people in the early days of the AIDS crisis.
The World Health Organization says West Africa could see up to 10,000 new Ebola cases a week within two months, dramatically up from the 9,000 cases reported so far, about half of whom have died.
Doctors there are confronting ethical dilemmas on a daily basis.
Juli Switala, a South African pediatrician with Doctors Without Borders, said her team chose not to help some sick babies who were not newborn out of fear that staff might be infected by bodily fluids. The group's clinic in the town of Bo in Sierra Leone similarly decided to turn away pregnant women because childbirth poses a greater threat of infection.
Congo, where the disease was first discovered in 1976, is accustomed to periodic outbreaks. Through hard experience, the government knows how to reach out to affected villages and take over their burial ceremonies, according to health professionals.
"People don't fight and feel deprived because they understand it's necessary," said South Africa's health minister, Aaron Motsoaledi, while announcing health precautions.