Louisville Medicine Volume 66, Issue 10 | Page 28

OPINION DOCTORS' Lounge (continued from page 25) 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