The enduring conflict between medical compulsion and individual liberty

“ THE spirit of the laws by which matters of public health are administered rests upon the theory which underlies all forms of government, that is, that the state has the power to compel the ignorant, the selfish, the careless and the vicious to so regulate their lives and property that they shall not be a source of danger to others. ”

“ The object of this Essay is to assert one very simple principle, as entitled to govern absolutely the dealings of society with the individual in the way of compulsion and control, whether the means used be physical force in the form of legal penalties, or the moral coercion of public opinion. That principle is, that the sole end for which mankind are warranted, individually or collectively, in interfering with the liberty of action of any of their number, is self-protection. ”

“ VACCINATION AND SMALL-POX
Among the greatest self-created scourges of civilized humanity are the group of zymotic diseases, or those which arise from infection, and are believed to be due to the agency of minute organisms which rapidly increase in bodies offering favourable conditions, and often cause death. Such diseases are: plague, small-pox, measles, whooping-cough, yellow fever, typhus and enteric fevers, scarlet fever and diphtheria, and cholera. ”

“ It appears that fever, after its ravages amongst the infant population, falls with the greatest intensity on the adult population in the vigour of life. The periods at which the ravages of the other diseases, consumption, small-pox, and measles take place, are sufficiently well known. ”

“ This Nation has always been committed to fostering the health of its people, and particularly of its children. Immunization against disease has been an exciting chapter in that effort. The United States can take pride in the dedicated research which has produced safe and effective vaccines against polio, measles, rubella, and other childhood diseases. ”

“ CONCLUSION As soon, therefore, as this crushing fact of the great danger of vaccination to human health and life enters the mind and conscience of the mass of the people, and is fully grasped by the legislative, the judicial and the executive minds of the country—from whom it has been so long concealed by medical falsehood in high places—this enlightenment will, I firmly believe, result in the permanent abolishment of all compulsory vaccination, if not in the penal prohibition of general vaccination, as being now more dangerous than natural smallpox ”

“ The liberty of contract and the right of private property which are protected by the limitations of the constitution are held subject to the police power of government to pass and enforce laws for the protection of the public health, public morals, and public safety. ”

“ The problem which the advocates of political reform had to solve was how to secure the largest measure of individual liberty compatible with an irresponsible government. They were right in believing that this could be accomplished only by building up an elaborate system of constitutional restraints which would narrowly limit the exercise of irresponsible authority. Individual liberty as they understood the term was immunity from unjust interference at the hands of a minority. ”

“ All laws, therefore, which impair or trammel these rights, which limit one in his choice of a trade or profession, or confine him to work or live in a specified locality, or exclude him from his own house, or restrain his otherwise lawful movements, except where the public health or safety intervenes, are infringements upon his fundamental rights of liberty, which are under constitutional protection. ”

“ The principles of the science of health are every day becoming concrete in laws, and habits of thought and living. It is the conviction of the progressive minority that a Nation’s first duty is to conserve and protect its citizens, to develop a community of efficient men and to minimize natural disadvantages. Further, that collective intelligence must plan for the preservation of the people and the perpetuity of the State, and in so doing must recognize public health as fundamental, both in the simple phases and in its comprehensive aspect. ”

“ The public health, or the health of people en masse, in groups or communities, is more than an adding together of the conditions of health in which each person in the group finds himself. Just as the mob-sense, the group consciousness, or the dominant spirit of the mass, as one chooses to call it, differs from the individual personalities which compose it, so the public health differs from the individual health of each single person. The public health is intangible, though none the less real. ”

“ And of the two it is obvious that the right to medical freedom is even more important than the right to religious freedom, and that medical compulsion is to-day a far more dangerous evil than religious compulsion ever was. ”

“ On the other hand, where medical practice is perfectly free and voluntary, the practitioner has no bias or interest whatever to make false claims of alleged efficiency or to conceal facts as to failures, dangers and fatalities, so that it is therefore obvious that for both medical truth and progress and human right and safety, Medical Freedom is an absolute public necessity, and that, per contra, Medical Compulsion is a most dangerous public evil which must be abolished as completely as the less dangerous evil of religious compulsion has been abolished. ”

“ Our voice may be as that of one crying in the wilderness, but we cry with conviction when we call for more individual liberty, with its correlative individual responsibility. There is something wrong, something vicious, in the application of compulsion where freedom of choice is indicated by all the natural conditions of the case. Force should be reserved for cases in which force is required, where nothing else will serve the purpose, and where the purpose is vital to the life of the society. ”

“ The second main branch of public health work is the suppression of communicable diseases. Suppressive measures include the establishment of quarantine, the isolation of patients, disinfection, vaccination and the management of epidemics. Contrary to the custom of twenty years ago, all the best work in these directions to-day is based upon a scientific knowledge of what we may call the natural history of disease. In all these matters of control the dictum of the health authority is supreme. It can be resisted only through intervention by the courts. ”

“ As a single example, the transmission of disease at school may be cited. Measles, scarlet fever, whooping cough, and diphtheria are all children's diseases, easily carried and transmitted, and held in check only by preventing a sick child from coming in contact with children not sick. No law is sufficient. The matter must be left to the mother, who will retain children at home at the least suspicion of sickness and keep them there until after all traces of the disease have passed away. ”

“ It is unfortunate that the attendance at school of children under six years of age is encouraged. Such children have more severe and more323 frequently fatal attacks of diphtheria, scarlet fever, measles, and whooping-cough; and these are frequently acquired at school.
International Quarantine was originally enforced against plague; but in many countries has been extended to other diseases, as cholera, yellow fever, typhus fever, small-pox and leprosy. In England cholera is the only disease in connection with which it has been in the past enforced. ”

“ Infections accompany crowds, and baby is far better off at home, in the quiet of his natural surroundings, than he is in the dust, closeness, and bustle of illy ventilated cars, streets, shops, movies, or even at church. Many an infant has been sacrificed by a train journey to "show him off" to the fond grandparents; scores of babies acquire whooping cough at the movies; and many a baby has nearly lost his life by catching measles, scarlet fever, or diphtheria at church ”

“ The cost and danger to society from preventable diseases, such as typhoid, diphtheria, scarlet fever, measles, are imperfectly represented by the number of deaths. Medical skill could gradually reduce death rates in the face of [132] increasing prevalence of infectious disease. With few exceptions, only those patients who refuse to follow instructions will die of measles, diphtheria, or smallpox. The scarlet-fever patient who recovers and goes to church or school while "peeling" can cause vastly more sickness from scarlet fever than a patient who dies. ”

“ Arm’s length is the striking distance of a contagious disease. There’s a truth for all of us to remember all the time.”
“If it is a truth,” challenged Mrs. Sharpless. “One of the surest and one of the most important,” averred the Health Master. “The only substance that carries the contagion of diphtheria or measles is the mucus from the nose or throat of an infected person. As far as that can be coughed or sneezed is the danger area. Of course, any article contaminated with it is dangerous also. But a hygienically conducted schoolroom is as safe a place as could be found. ”

“ If a child comes to school heavy-eyed, hoarse, and snuffling, the teacher should send him home at once. He will only waste his time attempting to study in that trim, and may infect a score of others. Moreover, it may be remarked, parenthetically, that these are also symptoms of the beginning of measles, scarlet fever, and diphtheria, and two-thirds of all cases of these would be sent home before they could infect any one else if this procedure were the rule. ”

“ The prevention of pollution of water supplies, the compelling of reasonable cleanliness in public vehicles for human transportation by land and by sea, the enforcement of precautions against the spread of disease in public hostelries and places of assembly, the organization of a national health bureau—these are all tasks which must speedily be undertaken, and they may be led to rich accomplishment if the physician will but hold more clearly in his consciousness his primal duty as a citizen. ”

“ Thus, in records of death, it is very common to see reported pneumonia as the cause underlying and fundamental, when the cause was really typhoid fever, the patient yielding to the former disease because of the enfeebled condition due to the latter. Again, many children contract diseases like measles or whooping cough because of reduced vitality due to insufficient nourishment, lack of clothing, and neglect, and their illness is said to be due to measles or whooping cough when under [Pg 296] proper conditions of care and attention they would not have the disease at all. ”

“ They are, first, natural, that is, some pervasive natural changes in conditions of human life, which are more or less unknown or not yet fully understood in their exact nature, but which have surely brought about a great reduction in the general death-rate and also in specific death-rates from several deadly diseases, in which no remedy such as vaccination has ever been used, and yet the general death-rate and the death-rates of these particular diseases have been reduced in modern times even more than smallpox has been reduced since the use of vaccination. ”

“ The fact that much of the dissipation and the disregard of health laws is due to ignorance rather than to want of thought is sufficient reason for the study of health laws. But, as the health of individuals is closely related to the health of the village, town, or city in which they live, and as "public health is public wealth," another reason is apparent for the popular study of hygiene. ”

“ So extensive and so numerous are the conditions of modern civilization which certainly affect health, that boards of health generally do not pretend to cover them all. For example, the construction and maintenance of public water supplies and sewerage systems, although undertaken by the public at the public expense, are not conducted by health authorities but by private corporations or special municipal departments. Likewise the collection and disposal of garbage, and even the cleaning of privies, is often done by other than public health authorities. ”

“ The most strange, assuredly, is that which has been from all time established with a great number of these diseases, that they are non-recurrent. As a general rule, notwithstanding some rare exceptions, man can only have measles, scarlet fever, plague, yellow fever once. What explanation, even hypothetically, can be given of such a fact? Still more difficult is it to explain how vaccination, which is itself a virulent though benign disease, preserves from a more serious malady, the small-pox? ”

“ When once the body has learned the wrestling trick of throwing and vanquishing a particu [Pg 219] lar germ or bacillus, it no longer has much to dread from that germ. This is why the same individual is seldom attacked the second time by scarlet fever, measles, typhoid, and smallpox.
While, however, the individual may be entirely immune to the germs of a given disease, he may carry them in his body in enormous numbers, and infect others while escaping himself. ”

“ Yes, and so does small-pox prevent itself from ever happening again, and we know just as much of the principle involved in the one case as in the other. For this is only one of a series of facts which we are wholly unable to explain. Small-pox, measles, scarlet-fever, hooping-cough, protect those who have them once from future attacks; but nettle-rash and catarrh and lung fever, each of which is just as Homoeopathic to itself as any one of the others, have no such preservative power. We are obliged to accept the fact, unexplained, and we can do no more for vaccination than for the rest. ”

“ But it is tragic for a child to die or endure lifelong handicaps from conditions we can prevent. Although such diseases as polio, measles, rubella, diphtheria and whooping cough have been subdued for the time being, they are not beaten. It is in our power to protect all our children, but nearly 40 per cent of those under the age of 15 are inadequately immunized. ”

“ The Commissioners repeatedly call attention to the fact that the mortality from measles has not at all declined and that other zymotics have not declined in the same proportion as small-pox, and they argue: “If improved sanitary conditions were the cause of small-pox becoming less, we should expect to see that they had exercised a similar influence over almost all other diseases. Why should they not produce the same effect in the case of measles, scarlet fever, whooping-cough, and indeed any disease spread by contagion or infection and from which recovery was possible?” ”

“ These figures, considering the vaccinal conditions existing in Japan, under most rigid compulsory laws, are surely terribly significant, to say the least, and fully shatter the fallacious vaccine doctrine that vaccination is the only effective remedy against smallpox and that it always lowers the mortality in epidemics! Per contra, here we see from these official U. S. Health Reports that in this much-vaccinated population there was not only a series of severe epidemics with a very high mortality, but a constantly ascending mortality from 271⁄2 per cent. ”

“ Should we logically expect anything else but that epidemics of smallpox and cow disease should break out in due time in such a generally vaccinated and infected population, and that vaccine or cow disease should be extended to other populations wherever the virus made from human and cow diseases should be carried and used? ”

“ There has been a strong conviction growing for some years past among close [Pg 91] students of vaccination, both within and without the medical profession, that the practice of wide-spread inoculation of the population with known and unknown ulcerative diseases or pus infections such as found in vaccine virus is probably responsible for the great increase in two of the worst and most fatal ulcerative diseases of modern times, viz., Tuberculosis and Cancer. ”

“ That some people die of other diseases since the introduction of vaccination, is undoubtedly true, for many of those who would have died in early infancy of small-pox are cut off later by measles or bronchitis, or die during teething; since it is obvious that vaccination does not protect against any other disease than small-pox. ”

“ Who should not be Vaccinated.—Unless exposure to smallpox is believed to have taken place or likely to take place, teething children, pregnant women, persons suffering from measles, scarlet fever, erysipelas, or susceptible to and recently exposed to one of these diseases, persons suffering with skin diseases or eruption, and in general feeble persons not in good health, should not be vaccinated. ”

“ And if it can be shown in such a large and free test that the unvaccinated part of the population or the unvaccinated part of the Army and Navy is no more liable, on the average, to catch smallpox or typhoid fever than the vaccinated part, and is entirely free from the grave dangers of vaccination itself, surely a great lesson in medical sanity and progress will be learned. As a matter of fact, this test has already proved in the case of the U. S. Army in France that typhoid vaccination is useless as a preventive where sanitation is grossly neglected. ”

“ Nevertheless it is a fact that the medical profession, as now organized and possessed of political and official power, and in control of some of our most important departments of government, such as Public Health, Vital Statistics and Medical Legislation, has already a most dangerous power over the people, perhaps more dangerous and unlimited than any other class of men, and this dangerous power must be curbed as soon and as much as possible in the interest of true Medical Freedom and Progress and public right and safety. ”

“ COMPARED WITH THE MODERN VACCINATION FANATICISM, “LET US FORCE AND SPREAD DISEASE UPON THE PEOPLE SO THAT HEALTH MAY ABOUND!” In the past centuries, before our great American Institutions of Civil and Religious Liberty were established, it was the Doctors of Divinity who were wholly responsible for inventing and maintaining that great evil of Compulsory Religion, where one type of religion or one conception of Deity was forced on the whole population under penalty of torture, disfigurement, mutilation, or death ”

“ But as soon as mankind have attained the capacity of being guided to their own improvement by conviction or persuasion (a period long since reached in all nations with whom we need here concern ourselves) , compulsion, either in the direct form or in that of pains and penalties for non-compliance, is no longer admissible as a means to their own good, and justifiable only for the security of others. ”

“ The ability to exercise the faculties, the total denial of which causes death—that liberty to pursue the objects of desire, without which there can not be complete life—that freedom of action which his nature prompts every individual to claim, and on which equity puts no limit save the like freedom of action of other individuals, involves, among other corollaries, freedom of exchange. ”

“ What do you now think of any medical scheme for the alleged benefit of “public health” which is capable of causing such disasters to animal and human life as this peculiar and extraordinary scheme of bovine vaccination? Do you think, Mr. President, that any medical device capable of causing such disasters should be made compulsory by law, in our Army or Navy, on our public school children or on any one else in any shape or form? And do you not think that all compulsion should be now abolished and Medical Freedom from inflicted disease established as an absolute American and Hygienic Right? ”

“ They are at liberty, indeed, are under a solemn duty, to look at the substance of things, whenever they enter upon the inquiry whether the legislature has transcended the limits of its authority. If, therefore, a statute purporting to have been enacted to protect the public health, the public morals, or the public safety, has no real or substantial relation to those objects, or is a palpable invasion of rights secured by the fundamental law, it is the duty of the courts to so adjudge, and thereby give effect to the constitution. ”

“ If a man's personal health is a public concern, his most private acts are more public than his most public acts. The official must deal more directly with his cleaning his teeth in the morning than with his using his tongue in the market-place. ”

“ If he is to control the health of the community, he must necessarily control all the habits of all the citizens, and among the rest their habits in the matter of sex.
But there is more than this. It is not only true that it is the last liberties of man that are being taken [153] away; and not merely his first or most superficial liberties. It is also inevitable that the last liberties should be taken first. It is inevitable that the most private matters should be most under public coercion. ”

“ In other words, the rights of man must be articulated with the duties of man. Freedom cannot exist without order. They are concentric. Without the recognition of the sanctity of obligation to others, the age-long aspiration of the race for liberty is an impotent endeavor. It would have plunged eyeless through the cycles in which it has worked its way into civilization, had it not been that reciprocity, mutual help, is a basis of its being. Mankind can never be absolved from this eternal law. ”

“ But I deny the right of the people to exercise such coercion, either by themselves or by their government. The power itself is illegitimate. The best [Pg 30] government has no more title to it than the worst. It is as noxious, or more noxious, when exerted in accordance with public opinion, than when in or opposition to it. If all mankind minus one, were of one opinion, and only one person were of the contrary opinion, mankind would be no more justified in silencing that one person, than he, if he had the power, would be justified in silencing mankind. ”

“ The same thing is true with regard to the spread of the acute contagia, the burden of venereal disease, the obscure ill effects of defective eyes and ears and teeth, and a dozen other problems which in greater or less degree concern the public health. In every one of these cases the results we are striving for can only be reached by spreading a clear knowledge of the ways in which disease spreads, and the ways in which it is prevented, among the mothers who bring up babies and the men who pay rent in the tenement and work in the stores and factories. ”

“ Comprehension must be the soil in which shall grow all the fruits of friendship, and there is a reason and a compulsion lying behind all this which is dearer than anything else to the thoughtful men of America. I mean the development of constitutional liberty in the world. Human rights, national integrity, and opportunity as against material interests—that, ladies and gentlemen, is the issue which we now have to face. I want to take this occasion to say that the United States will never again seek one additional foot of territory by conquest. ”