Measles: when Medicine meets Law

I was fascinated by a recent blog written on the subject of measles by my cousin, Sheila Kennedy, who is a law professor at Indiana University, former congressional candidate, author of several books, and former executive director of the Indiana ACLU. She regularly posts very incisive observations on matters of political importance..

I quote her comments below:

     Whatever one’s views of the anti-vaccination “movement”, its growth, and the current epidemic of measles that has resulted, offers a vivid metaphor for the basic tension that underlies liberal democratic governance.

     Our system, as I tell my students, restrains and limits government, especially when laws threaten to infringe on fundamental human rights–religious or political beliefs, free speech and the like. Government is absolutely prohibited from interfering with an individual’s beliefs, and must demonstrate a compelling purpose before interfering with conduct based upon those beliefs.

      One of the enduring debates in a liberal democracy concerns where we draw that line–under what circumstances do we allow government to require or prohibit behavior that is based upon an individual’s deeply held belief?

      Another way of asking that is: how much danger must the behavior pose to others before government interference is permissible?

     With respect to vaccination, many states have historically accommodated religious objections because relatively few people have harbored those objections, allowing the rest of us to develop what doctors refer to as “herd immunity.” A few non-immunized people in a population that is 95% vaccinated pose little threat to the rest of us, and it thus costs us little or nothing to accommodate their beliefs.

     Legal scholars have suggested a similar calculus was at play when the Supreme Court, in Yoder, exempted the Amish from laws requiring that children attend school until age 16; whatever one’s opinion of that decision, it affected very few people. Had the impact been wider, the decision would probably have been different.

      The current effort to exempt “bible-believing Christians” from compliance with otherwise applicable civil rights laws raises the same issue. Religious folks have absolute liberty to believe whatever they want about gay people or black people or Jewish people or whoever. But do those beliefs entitle them to engage in discriminatory behavior that is contrary to America’s cultural and legal commitment to civic equality? Can they claim a religious privilege to behave in ways that we collectively deem destructive to our social health?

     If my “sincere” beliefs required me to blow up your headquarters building, or sacrifice my newborn, few people would argue that I should be allowed to act upon those beliefs.

     If your religious (or just uninformed) decision to forego vaccinating your child is shared by enough people to pose a health risk to other children in a classroom, shouldn’t government be able to exclude your child from that classroom?

     If your demand for “religious liberty” includes your right to breach the social contract and refuse to do business with certain of your fellow-citizens, shouldn’t government be able to rule such behavior out of order?

    It’s all about where we draw the line.

From my standpoint, I have no difficulty in drawing a line: No group of any size—no matter what their beliefs—may be allowed to jeopardize the health of our population by exposing them to measles or any other similarly preventable infectious diseases. Our governing officials must be aware of this fact and act accordingly!