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May 11, 2005


JAMA. 2005;293(18):2281-2285. doi:10.1001/jama.293.18.2282

The police powers wielded by public health authorities in times of crisis have often produced unforeseen and devastating consequences: individuals needlessly deprived of their liberty, families and communities disrupted, property destroyed. Faced with scientific uncertainty and political pressure, even cautious and well-intentioned health officials have implemented policies that have led to widespread and unnecessary suffering.

James C. Mohr’s Plague and Fire offers an object lesson in such dangers. In January of 1900, the Chinatown district of Honolulu burned to the ground when a fire that health officials had deliberately set to destroy a plague-infested building blazed out of control and, fanned by sudden winds, spread to neighboring structures. Thousands of people fled in terror and were subsequently quarantined in detention camps to prevent further spread of the disease. How was it, Mohr asks in his account of the events surrounding the burning, that the exigencies of protecting the public health resulted in such a calamity?

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