I have never actually wondered about how governments enforce public health laws. On the surface it seems quite obvious that government should enforce these public health initiatives in public interest, however you could surely argue that your religious beliefs, cultural customs prohibit you from following these directives. For example, say tomorrow a large community in the US decided against flu vaccines it would lead to a catastrophe. (Although keeping the present flu vaccine shortage in mind, I dont think the government would be too unhappy). You can just imagine the epidemic that might cause. So how does government force us to obey certain public health initiatives, eg. seat belts? Surely, you could argue on a personal basis that you dont want to wear it.
The law that enforces public health initiatives is based on a judgement passed in a case Jacobson vs Massachusetts in 1902. Basically Jacobson refused to take the smallpox vaccine during an epidemic and the court fined him $5. The argument was that if the state believed that the restriction of individual liberty was justified when there was a threat to a community, as the community has the paramount right to protect itself. The court however, did mention that these restrictions must be limited and cannot be used in an oppressive and arbitary manner.
There are important points to note in the case : Smallpox vaccination was well established by then and scientifically approved in the medical community. Smallpox was a deadly disease and mortality was high due to the disease. Lastly, jacobson argued that the state was acting in an dictatorial and socialistic manner, which weren't good enough grounds for dismissal.
Interestingly, I am unsure of what the situation back home is. There is the region in bengal which refuses to be vaccinated with polio in the belief that it causes sterility. What laws exist in India?
The article which lead me to even think about this was published in NEJM.
3 comments:
There's Sec. 336 of the IPC which talks abt an act endangering the life or safety of others. I think there's a 6 month imprisonment.
Also, there's a section re: volutarily spreading a disease or somehting of the like - with graver consequences. All you need to do is try and satisfy the requirements of each of them in court and the patient will be jailed if he doesnt take the vaccine. Simple!
yeah, this might be ok in cases of quarantine or even vaccination. However, I cant imagine a judge sentencing people to jail following an argument that not wearing a helmet endangers the lives of others or causes disease. No, what I am looking at is statues or laws that have a much broader gambit. How can we restrict the individual choice of an individual in the interests of better health and safety of a community
The idea remains rooted in a concept called 'Legal Paternalism', appropriately named, of course.
Sometimes, the law (or the legislature) decides what is best for an individual as also society as a whole.
And if that means you fine ppl not wearing helmets or jail ppl spreading disease, then so be it.
Mill in 'On Liberty' laid down some ground rules re: the freedoms of individuals - he is free to do what he wants as long as it does not affect the community.
Helmet wearing may not quite fit in that, but at some level the govt. or the 'sovereign' has to take charge of its subjects and look after their interests, cos he feels that they can't. Therefore...
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