Resolved:Public health concerns justify compulsory immunization.
According to the New York Times Today a New York State Supreme Court judge halted the enforement New York State Department of Heatlh regulation mandating, as a condition of employment, health care workers to get H1N1 flu vaccinations. In looking for some more information on that case, I came across a letter the New York Civil Liberties Union (NYCLU) wrote arguing against the mandatory vaccinations, and think it should be required reading for any debaters interested in debating this topic. The argument the NYCLU makes is nuanced. Though coming down against the vaccinations, it does not take an asbolutist position. Indeed, the authors of the letter state explicitlt that the may rare cases where the “circumstances where the danger to th public from the communicable disease is so grance that state action curtailing individual rights are warranted.”
The authors rely heavily on a supreme court decision, Cruzan v. Director, Missouri Department of Health, 497 U.S. 261 (1990), which upheld a competent adult’s constitutionally protected interest in refusing unwarranted medical treatmnent. To hear oral argument in that case, click here. As I mentioned in my last post, the established right of adults to refuse medical treatement is a very good starting point for a negative case and the Curzan case does directly address the question of balancing public health concerns and individual rights.
The authors also point to some of the same Center for Disease Control web pages that I posted links to yesterday, though they read the CDC as saying that individuals should determine for themselves whether to get vaccinated. I wasn’t able to find, however, where the CDC speifically advocates for that position. The CDC’s message is overwhelmingly in favor of vaccination, but it is worth noting that they don’t really address the issue of whether vaccinations ought to be mandatory.
The NYCLU also point to Jacobson v. Massachusetts, 197 U.S. 11 (1925), where the the Court upheld mandatory smallpox vaccinations. Rather than arguing that this case was wrongly decided, the NYCLU argued that H1N1 does not pose as serious a threat to public health as smallpox did. This is important affirmative ground, since while I suspect this topic was inspired by the swine flu outbreak, it’s not limited to it. The authors also point out that in the case of smallpox, vaccinations were part of a global effort to eradicate smallpox, which is not the case with H1N1 vaccines. It does help the affirmative that the efforts to eradiate smallpox were successful. Whether the negative can argue for rare exceptions to a general principle of not allowing compulsory vaccinations is going to be tough for judges to decide. My own sense is that negatives would be better off not allowing exceptions and arguing, instead, that the more serious the public health threat the more likely people are giong to be to voluntarily seek out immunization. How many people really would prefer to take the risk of getting smallpox to the risks involved in getting a shot. Also, given that people infected with smallpox pose no risk to those who have been vaccninated, negative could argue that letting people opt out of a vaccination program is not much of a public health concern. Of course, the more people who opt out the less effective a vaccination program will be, but how many people really would want to risk getting smallpox?
Another point that the NYCLU makes, which is interested but largely unwarranted in their letter, is that voluntary programs are preferable to compulsory ones since the former promote among the general public, the government, and health care workers. It is worth noting that the people objecting to the compulsory immunization program in New York were health workers. If there was any segment of the population likely to understand the benefits of univesral vaccination, it should be health professional. If they are resisting a program for compulsory vaccination, what is the general public to think.
This is amzing