"Simply put, it is not ethical to give a medicine that will kill and maim persons for no demonstrable benefit. Assuaging fears about vulnerability to a potential disease is not a benefit any physician should accept."

~ Dr. Jeffrey S. Sartin, MD

A controversy over vaccines, specifically the smallpox vaccine, is brewing in Washington. The administration is considering ordering mass inoculations for more than one million military personnel and civilian medical workers, ostensibly to thwart a smallpox outbreak before it occurs. Yet dangerous side-effects from the vaccine – ranging from mild flu symptoms to gangrene, encephalitis, and even death – cause many to question the wisdom and need for such inoculations.

As a medical doctor, I believe mandated smallpox vaccines are bad medicine. The available vaccine poses significant risks, even though the more serious complications affect only a statistically small number of people. As with any medical treatment, these risks must always be balanced against the perceived benefit. Remember, not a single case of smallpox has been reported, despite the near-hysteria that characterized recent news reports. Even if some individuals became infected, smallpox spreads only with very close contact. Those in the surrounding community could then decide to accept vaccines based on a much more tangible risk.

As a legislator, I believe mandated smallpox vaccines are very bad policy. The point is not that smallpox vaccines are necessarily a bad idea, but rather that intimately personal medical decisions should not be made by government. The real issue is individual medical choice. No single person, including the President of the United States, should ever be given the power to make a medical decision for potentially millions of Americans. Freedom over one’s physical person is the most basic freedom of all, and people in a free society should be sovereign over their own bodies. When we give government the power to make medical decisions for us, we in essence accept that the state owns our bodies.

The possibility that the federal government could order vaccines is real. Provisions buried in the 500-page homeland security bill give federal health bureaucrats virtually unchecked power to declare health emergencies. Specifically, it gives the Secretary of the Department of Health and Human Services – in my view one of the worst of all federal agencies – power to declare actual or potential bioterrorist emergencies; to administer forced "countermeasures," including vaccines, to individuals or whole groups; and to extend the emergency declaration indefinitely. These provisions mirror those found in the Model Emergency Health Powers Act, a troubling proposal that was rejected by most state legislatures last year. That Act would have given state governors broad powers to suspend civil liberties and declare health emergencies. Yet now we’re giving virtually the same power to the Secretary of HHS. Equally troubling is the immunity from civil suit granted to vaccine manufacturers in the homeland security bill, which potentially could leave individuals who get sick from a bad batch of vaccines without legal recourse.

Politics and medicine don’t mix. It is simply not the business of government at any level to decide whether you choose to accept a smallpox vaccine or any other medical treatment. Yet decades of federal intervention in health care, including the impact of third-party HMOs created by federal legislation, have weakened the doctor-patient relationship. A free market system would allow doctors and patients to make their own decisions about smallpox inoculations, without the federal government hoarding, mandating, nor prohibiting the vaccine. Instead, we’re moving quickly toward the day when government controls not only what vaccines patients receive, but what kind of health care they receive at all.

December 10, 2002