Washington ? States should have the power to restrict the movement of patients with contagious diseases even before they have the chance to disobey doctors’ orders, says a top federal health official.

The need for such authority to order someone quarantined emerged as lesson No. 1 from the case of the Atlanta lawyer who went to Europe despite having a dangerous form of tuberculosis.

“If we believe the patient has a strong intent to put others at risk, we need to have confidence we can take action absent documentation of intent to cause harm,” Dr. Julie Gerberding, director of the Centers for Disease Control and Prevention, told lawmakers last week.

It was not clear whether she was calling for overriding federal legislation or for states to strengthen their existing individual quarantine powers.

Gerberding also mentioned outfitting a CDC plane so the government could fly patients long distances without fear of contaminating others on board and improving communications among government agencies.

Also cited by the Senate Appropriations subcommittee hearing was the lapse at the U.S.-Canadian border that allowed Andrew Speaker to enter the U.S. even though his name was on a watch list with instructions to detain him. Officials said a lone border agent made a bad decision.

The ability to require that someone be kept in isolation leads to legal and ethical questions about possible overreaching by the government.

“First of all, up front, before the patient left the United States, we believe that we could strengthen our states’ ability to restrict the movement of patients before they demonstrate noncompliance with the medical order,” Gerberding told lawmakers.