The Legacy of Jacobson V. Massachusetts on Public Health

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American Military University
The Legacy of Jacobson v. Massachusetts on Public Health
PBHE426
Professor Lucas
February 19, 2012

Abstract
In the 1905 Supreme Court case of Jacobson v. Massachusetts, the court ruled that the state had the right to compromise a person’s right to due process in the name of the common good of society. This case was controversial because it brings up a question of whether or not the ruling was ethical. More than one hundred years later, the ruling still plays a role in the authority of public health officials and has been stated as the most influential case for public health thus far. In today’s law the Jacobson ruling can be seen in smoking bans across the nation, as well as seatbelt and helmet laws. The most influential result of the case is the power of the government to isolate or quarantine a person so as not to further spread a communicable disease.

The Legacy of Jacobson v. Massachusetts on Public Health
Reverend Henning Jacobson was living in a Boston suburb in the early twentieth century. When a smallpox outbreak occurred, the board of health of the city of Cambridge, Massachusetts imposed a mandate that all persons must become vaccinated. When Jacobson failed to comply, he was ordered to pay a fine. He, and three other men, decided the mandate was in violation of their 14th amendment rights and decided to take the matter to court. After failing to win the case in three lower courts, Jacobson took his case to the Federal Supreme Court. The verdict of Jacobson was a 7-2 vote in favor of the state. This set a precedent that would be used for over one hundred years after the initial case. Jacobson v. Massachusetts, although controversial, has proven to be beneficial to public health authority over the last century.

In and around the early 1900s, smallpox was endemic in the United States. There were periods of epidemic that took the lives of many people. If people were lucky enough to survive the disease, getting well again was a long road. In response to the continuous disease presence, the board of health in Cambridge, Massachusetts made it mandatory for all citizens to be vaccinated against smallpox (Centers for Disease Control and Prevention, n.d.). If anyone refused vaccination, the city would impose a $5 fee, what would be around $100 today (Toward a twenty-first-century Jacobson v. Massachusetts, 2008).

In 1721, Dr. Zabdiel Boylston was the first doctor to administer a form of the smallpox vaccination. The early version had many flaws and was often dangerous to both the recipient and people within close proximity (Centers for Disease Control and Prevention, n.d.). When a newer, more effective, and safer option was presented as a means of controlling the disease, many people were apprehensive because of its predecessor. Besides being scared, some people also cited religious reasons as why they did want to become vaccinated. The Centers for Disease Control and Prevention (CDC) states that “in 1850, Massachusetts became the first state to require smallpox vaccination as a condition of admission to school” (n.d.). This new rule was not widely accepted at first, but eventually there were more supporters than opponents.

The early 1900s was the beginning of the industrial revolution. As a result of the new technology, immigration began to increase as new jobs became available. Great periods of immigration in the early years of the United States often brought an influx of disease, as well as people. This period was no exception, as small pox was, once again, on the rise. The CDC reports that by this point, smallpox had already claimed millions of people across the world (n.d.). This new epidemic forced public health officials in Cambridge to find a means of controlling the awful disease. The result was a mandate that all persons become vaccinated or face the $5 fine.

This did not sit well with everyone in Cambridge and four men spoke out...
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