In January of 2015 over 100 people in the US contracted measles, mostly from an outbreak of the disease at California’s Disneyland theme park. 16 The outbreak was spread in part by people who had refused to accept vaccinations for themselves or their children. In July of 2015, the Washington State Department of Health confirmed the first death from measles in the United States in 12 years. 17
Vaccinations for diseases like measles, mumps, and rubella have kept these diseases in check in the Western world for more than 50 years. While these diseases used to run rampant and threaten adults and children alike, they had all but been defeated up until the early 2000s. 18 Guided by a pop-culture movement that cited, among other things, a (now retracted) scientific paper linking autism with the vaccine for measles, mumps, and rubella (MMR), 19 people began delaying vaccinations for their children or refusing them outright. While numerous studies have shown that childhood vaccinations are safe and reliable bulwarks against disease, 20 the number of parents refusing vaccines has continued to climb.
Anti-vaccination groups also cite a worrisomely close partnership between the pharmaceutical companies making the vaccines and the Federal Drug Administration (FDA) which oversees the safety of vaccines. They maintain that the FDA does not sufficiently supervise the implementation of precautions after the drugs are on the market for human use. 21 They also cite the existence of the National Vaccine Injury Compensation Program (NVICP) as evidence that vaccines are legally recognized as possibly causing suffering that requires compensation by the government. 22 (They also suggest that the NVICP incorrectly shields pharmaceutical companies from justified lawsuits.)
As the number of unvaccinated people grew, so did the risk that a carrier of one of these diseases could spread the disease more rapidly. If the human “herd” lost its increased immunity to the disease, even those who were vaccinated could be at risk. And with an increased number of life- threatening illnesses comes increased healthcare costs. For instance, the cost of the measles outbreak is high, potentially costing up to $10,000 per case. In a healthcare system like the one in the United States, these costs are absorbed not only by the families of the sick children, but may also be “shared” by all those paying for health insurance in the form of increased premiums. 23
Citing the unfairness of saddling those who vaccinate their children with the increased health insurance costs from those who do not, a team of doctors and lawyers are now proposing a tax on those who refuse vaccinations. 24 Since vaccinations have been established to be safe for most children and vaccination costs are covered by all health insurance plans, they argue that the choice not to vaccinate one’s children should be discouraged by creating a tangible disincentive to opt out of vaccination, regardless of whether any members of the family actually contract a vaccine-preventable disease. Furthermore, such a tax would allow the healthcare system to recoup the costs directly from those whose choices potentially increase the costs. In this way, the proposed tax would work much like a tax on cigarettes that would fund lung cancer treatment. Anti-vaccination advocates and other libertarian thinkers, however, argue that such a tax interferes with important principles of liberty.
Indeed, people generally have the right to refuse medical treatment for themselves as well as their children — some advocates believe that they should have the right to refuse vaccines as well. They argue that the state should not take a position on treatments where some people have serious doubts about the scientific data, and that the tax amounts to economic coercion. There is no such tax, for instance, on foods that may increase the risk of diabetes or heart disease (which are far more costly diseases). And there are no societal sanctions on those who refuse to cover their mouths when they cough or come to work when they are sick with the flu, even though the flu is a communicable disease with a much higher risk of transmission than measles, mumps, or rubella.
16 Stephen Reinberg, Low Vaccination Rates and Disney Measles Outbreak, HealthDay Reporter, March 16, 2015, http://www.webmd.com/children/vaccines/news/20150316/low-vaccination-ra…
17 Maggie Fox, Washington Woman is First US Measles Death in 12 Years, NBC News, July 3, 2015, http://www.nbcnews.com/health/health-news/woman-dies-measles-first-us-d…
18 National Center for Immunization and Respiratory Diseases (Division of Viral Diseases), Measles History, Centers for Disease Control and Prevention, November 3, 2014, http://www.cdc.gov/measles/about/history.html
19 Fiona Godlee, Jane Smith, and Harvey Marcovitch, Wakefield’s article linking MMR vaccine and autism was fraudulent. BMJ 2011;342:c7452, January 6, 2011, http://www.bmj.com/content/342/bmj.c7452
20 Centers for Disease Control and Prevention, Vaccine Safety, March 27, 2015, http://www.cdc.gov/vaccinesafety/index.html
21 Shannon Barber, No, I Am Not an Anti-Vaxxer, But I Do Understand Their Stance, Addictinginfo.com, February 3, 2015, http://www.addictinginfo.org/2015/02/03/no-i-am-not-an-anti-vaxxer-but-…
22 Barbara Loe Fisher, Why Vaccine-Injured Kids Are So Rarely Compensated, Mercola.com Health News, December 13, 2008, http://articles.mercola.com/sites/articles/archive/2008/12/13/why-vacci…
23 Charlotte Moser, Dorit Rubinstein Reiss, and Robert Schwartz, Funding the Costs of Disease Outbreaks Caused by Non Vaccinations, June 3, 2014, Journal of Law, Medicine, and Ethics, http://papers.ssrn.com/sol3/papers.cfm?abstract_id=2445610##
REGIONAL ETHICS BOWL CASES FALL 2015
Gretchen Adel Myers, Chair
Susanna Flavia Boxall
Rhiannon Dodds Funke
© Association for Practical and Professional Ethics 2015