Silverman Ross D
Department of Medical Humanities, Southern Illinois University School of Medicine, Springfield, IL, USA.
Ann Health Law. 2003 Summer;12(2):277-94, table of contents.
Professor Silverman's article examines the complex challenges faced by U.S. policymakers attempting to balance the public health protections of mandatory childhood immunization programs with the legal, religious, philosophical, and practical concerns raised by permitting non-medical exemptions under the programs. The article begins with a discussion of the history of childhood immunization programs, and continues by describing the inconsistency of enforcement of state immunization laws and exemptions. The author analyzes recent cases from New York, Wyoming, and Arkansas, and discusses how these decisions both pose threats to these programs' public health protections, while also offering insight into potential problems for other state vaccination programs. Professor Silverman concludes by advocating that states adopt an "informed refusal" approach to vaccination exemption as a way of improving immunity protections, while respecting the autonomy rights of those who wish to opt out of the program.
西尔弗曼教授的文章探讨了美国政策制定者所面临的复杂挑战，他们试图在强制性儿童免疫计划的公共卫生保护与因允许该计划下的非医疗豁免而引发的法律、宗教、哲学及实际问题之间取得平衡。文章开篇讨论了儿童免疫计划的历史，接着描述了各州免疫法及豁免执行情况的不一致。作者分析了纽约、怀俄明和阿肯色州最近的案例，并探讨了这些判决如何既对这些计划的公共卫生保护构成威胁，同时又为其他州的疫苗接种计划揭示潜在问题。西尔弗曼教授在结论中主张，各州应采取“知情拒绝”的疫苗豁免方式，以增强免疫保护，同时尊重那些希望退出该计划者的自主权利。
