OPINION
DOCTORS' Lounge
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Hastings, is a pro-vaccination advocate.
She has called for considering legal liabili-
ty for parents who refuse to vaccinate their
children. She was instrumental in getting
California SB 277 signed into law in 2015,
a bill that eliminated the “personal belief ”
exemption in the state of California. She was
roundly criticized by anti-vaccine groups
who demonstrated furiously, as I recall from
news clips, in huge anti-vaccine rallies all
over California.
Professor Reiss has written a treatise on
the subject, published in the Cornell Journal
of Law and Public Policy, Vol. 23-595. The
question is, should deliberate choice by a
parent to not vaccinate their child, with con-
sequent harm to another person, be subject
to civil liability as governed by Tort law?
The Legal Information Institute defines
a tort as, “An act or omission that gives rise
to injury or harm to another and amounts
to a civil wrong for which courts impose
liability.” The common law explanation is “a
civil wrong that causes a claimant to suffer.”
Professor Reiss argues, “Negligence holds
people to a community standard, and if
people deviate from that standard, they are
liable for the harm they caused another and
are required to compensate the injured.”
She adds, “Sincere belief that the conduct
is reasonable is immaterial. The applicable
standard is objective: what would a reason-
able member of the community do?”
Her discussion of whether this is an
act versus an omission is illuminating. She
argues that the parent who makes this de-
cision is making an active choice, despite
education to the contrary. She argues that
such parents have the opportunity to make
that choice over and over as the child grows
through the normal schedules of vaccina-
tion, rejecting sound medical advice at ev-
ery turn. She points out that even though
parents, who potentially are found liable,
are not likely to have pockets deep enough
to fund millions of dollars of medical and
personal care, perhaps the anti-vaccine
groups could step in to help. She argues
that finding parents liable could potentially
serve as a deterrent to parents considering
the rejection of vaccination.
Professor Reiss argues that there is prec-
edent in establishing liability for failure to
acknowledge and accept medical risk, giv-
ing the example of someone who, despite
poor control of seizures, knowingly drives
and injures someone else. She cites a 1956
case ruling regarding the use of religious
freedom as a principle here: “To adopt an
absolute rule which required one citizen
to pay damages for the consequences of
another’s exercising her religious freedom
would favor an establishment of religion
in a way which seems constitutionally un-
supportable.”
Professor Reiss noted, in the 1944 case
Prince v. Massachusetts, the Supreme Court
addressed the issue of vaccination directly.
“Thus he cannot claim freedom from com-
pulsory vaccination for the child, more than
for himself, on religious grounds. The right
to practice religion freely does not include
liberty to expose the community or the child
to communicable disease, or the latter to ill
health or death.”
Our task remains clear: use the current
outbreaks as proof to disbelieving parents
and adults that childhood illnesses can be
lethal or cause permanent severe disability.
The overwhelming response of parents pre-
viously in denial, who are now rushing to
vaccinate their children, is a sign of hope.
I would like to see pictures of children suf-
fering from these diseases on every major
news channel. I would like to see accom-
panying graphics that say, “90 percent of
non-vaccinated people on an airplane with
someone with measles will get measles.”
Next slide: “Call this number to get your
child vaccinated now.”
Out of mercy, I would not have the next
slide say, “You Idiots Know Who You Are.”
But I am thinking it.
Dr. Barry practices Internal Medicine with
Norton Community Medical Associates-Bar-
ret. She is a clinical associate professor at the
University of Louisville School of Medicine,
Department of Medicine.
MEDICAL STUDENT STIMULANT USE IS BEING IGNORED
By Concerned Bystander Student
(In this article, methylphenidate and amphet-
amine salts will be referred to as “stimulants.”)
M
edical students are general-
ly a well-supported set. In
2016, 27 percent of medical
students graduated with no
student loan debt, despite a
decline in scholarship offerings from pre-
vious years. It’s safe to assume that some
medical school tuition is being paid for by
able relatives, many of whom are graduate
degree-holders or physicians themselves. (In
26
LOUISVILLE MEDICINE
the University of Louisville Medical School
class of 2019 for example, the parents of all
but three students have college degrees.) We
are selected to join medical school and guid-
ed through it by physicians and scientists.
With such a professional pedigree and phy-
sician presence surrounding and supporting
medical students, it might surprise you to
hear that I believe the medical student pop-
ulation is suffering from a neglect that risks
its medical and psychological well-being.
This risk is due to the high prevalence
of stimulant use among medical students.
At this point in our academic careers, if we
haven’t heard stories of other students using
stimulants to stay up for five days at a time
during finals week, then we’ve personally
seen them crush and snort Vyvanse at par-
ties. Stimulants are so common that I would
conservatively estimate that around 15-20
percent of the medical student body has
a prescription for, or regularly uses them,
to optimize their studies. The pressures of
performance in medical school, the ease of
stimulant prescription acquisition, dearth