Expert Decision Makers
Public health jurisprudence is based on a deference to scientific decision
making. This deference may be expressed by incorporating scientific standards
into legislation or by delegating the right to make public health decisions to
boards of health or individual health officers who are skilled in the science
of public health. This deference is illustrated in the best known of the
traditional public health cases, Jacobson v.
Massachusetts,113 in which the scientific basis of a
Massachusetts law requiring vaccination for smallpox was challenged.
Mr. Jacobson believed that the scientific basis for vaccination was unsound and
that he would suffer if he was vaccinated. The Massachusetts Supreme Court
found the statute consistent with the Massachusetts state constitution, and
Jacobson appealed to the U.S. Supreme Court. The Court first ruled that being
subject to vaccination was the price for living in society. (See Chapter 28.)
The Court then considered Jacobson's right to contest the scientific basis of
the Massachusetts vaccination requirement. Accepting that some reasonable
people still questioned the efficacy of vaccination, the Court nonetheless
found that it was within the legislature's prerogative to adopt one from many
conflicting views on a scientific issue:
- It is no part of the function of a court or a jury to determine which
of two modes was likely to be most effective for the protection of the public
against disease. That was for the legislative department to determine in the
light of all the information it had or could obtain.
In a recent case upholding the closing of a bathhouse as a disease control
measure, the court showed the same deference to discretionary orders by public
113Jacobson v. Massachusetts. 197 US 11 (1905).
City of New York v. New Saint Mark's
Baths. 497 NYS2d 979, 983 (1986).
- It is not for the courts to determine which scientific view is correct
in ruling upon whether the police power has been properly exercised. The
judicial function is exhausted with the discovery that the relation between
means and ends is not wholly vain and fanciful, an illusory pretense.