Calling the Shots
Rights, Responsibilites, and Public Health
Jacobson v. Massachusetts /
Individual Rights vs. Public Health
Number of cases in the Massachusetts epidemic,2001. Courtesy of nejm.org.
SMALLPOX OUTBREAK IN MASSACHUSETTS
In 1901, there was a smallpox outbreak in Massachusetts. The Massachusetts government enacted a compulsory vaccination law to stop the epidemic. The state government believed that a mandatory vaccination law would increase vaccination rates. This law required all citizens to vaccinate or pay a $5 fine, about $185 today.
"Whereas, smallpox has been prevalent to some extent in the city of Cambridge and still continues to increase; and whereas, it is necessary for the speedy extermination of the disease, that all persons not protected by vaccination should be vaccinated."
- Text from the Massachusetts law, 1906
THE COURT CASE
On July 17, 1902, Henning Jacobson refused to vaccinate or pay the fine. He argued that the compulsory vaccination law was a violation of the 14th Amendment. He believed that the law abridged his personal privileges and immunities given to him. He took his case to the state court and lost.
Henning Jacobson, 1878. Courtesy of the New England Historical Society.
"No State shall make or enforce any law which shall abridge the privileges or immunities of citizens of the United States; nor shall any State deprive any person of life, liberty, or property, without due process of law; nor deny to any person within its jurisdiction the equal protection of the laws."
- 14th Amendment
14th Amendment,1866. Courtesy of monticello.org.
A prediction for the outcome of Jacobson v. Massachusetts. The Hawaiian Star, Jan 27, 1905. Courtesy of Chronicling America.
"The word that shall come from the august bench will be momentous for the whole country. It will say whether or not a state has the right to scratch the arm of any of its citizens for the prevention of pestilence."
- An article in the Hawaiian Star, describing the potential impact of Jacobson v. Massachusetts.
JACOBSON v. MASSACHUSETTS
After this, Jacobson appealed to the Supreme Court. In 1905, the Supreme Court ruled 7-2 in favor of Massachusetts. The court believed the compulsory vaccination law was valid because the epidemic was a crisis. This decision allowed the government to make healthcare decisions for the safety of the people.
Chief Justice Harlan,circa 1980. Courtesy of the Library of Congress.
Summary of the Jacobson v. Massachusetts decision, and arguments, as written by the Supreme Court in 1905. Courtesy of the Library of Congress.
Excerpt from an article by Harry Weinberger in the Bridgeport Evening Farmer, 1913. Courtesy of Library of Congress.
"But the liberty secured by the Constitution of the United States to every person within its jurisdiction does not import an absolute right in each person to be, at all times and in all circumstances, wholly freed from restraint."
- Chief Justice Harlan, in majority opinion of Jacobson v. Massachusetts
Judge Harlan set four standards for imposing mandatory vaccinations: necessity, reasonable means, proportionality, and harm avoidance.
" ...in every well-ordered society charged with the duty of conserving the safety of its members the rights of the individual in respect of his liberty may at times, under the pressure of great dangers, be subjected to such restraint, to be enforced by reasonable regulations, as the safety of the general public may demand."
- Chief Justice Harlan, in majority opinion of Jacobson v. Massachusetts
This case is a prime example of the tradeoff between government responsibility and individual rights. The state is responsible for protecting public health. In this case, the state prioritized the public's safety over individuals' rights. Because of this, the Jacobson v. Massachusetts decision sparked much controversy. Supporters of individual rights maintained that the Jacobson decision did not justify mandatory vaccinations outside of an epidemic.
"Furthermore, the decision is not final, because it is not decided according to principle."
- Harry Weinberger,a civil liberties activist, in an article in the Bridgeport Evening Farmer, 1913.
Clip from a personal interview with Ms. Aromatorio about the impact of Jacobson on modern law.
"Because the scope of Jacobson was so small, but it has been used as the reasoning behind much broader restrictions for larger groups of people, I think that's kind of dangerous as far as a bioethics or a legal question would go."
- Julia Aromatorio, lawyer and professor of health and bioethics at Case Western Reserve University
PUBLIC OPINIONS
Because of the importance of the issues in Jacobson v. Massachusetts, there was a lot of discussion on the case. Many people shared their points of view through their local newspapers, letting others know their opinions, whether positive, negative, or neutral.
A newspaper article featuring a question and answer segment on the topic of compulsory vaccination. Courtesy of Chronicling America.
A newspaper article detailing the defending arguments and results of Jacobson v. Massachusetts. Courtesy of Chronicling America.