Medical ethicist joined Boston Public Radio on Wednesday for his regular "Ask the Ethicist" segment. Caplan talked about a new California vaccination law, the few abortion clinics in Texas, and the Supreme Court upholding the use of a particular drug for lethal injections.
Art Caplan is head of the division of medical ethics at New York University's Langone Medical Center, and he's cohost of the Everyday Ethics podcast. Caplan's responses (below) are edited where noted [...], and questions are paraphrased.
California Gov. Jerry Brown just signed a tough new vaccination bill into law. Now there won't be philosophical or religious exemptions for vaccinations. Is it tough enough?
I like the law. I think a lot of people won't, but I think it's a good shift. [...] The California law now says no more philosophical exemption, no more religious exemption. You can still exempt out on health grounds, but it's not the parents who do that, it's got to be a doctor [who decides]. Having the doctor do it gets rid of chiropractors and homepaths who were exempting kids, too. So, on the whole, the [Disneyland] measles outbreak scared people in California, and we got the law.
How do you justify exempting anyone?
It's hard to justify, because if your child goes to the supermarket, or the bus station or the airport — even if they're home-schooled — and exposes people to some disease they picked up, it's still a problem. [...] If your kid makes my kid sick, I think you should be held liable! I think you should be sued. [...] I think there ought to be some serious financial penalties there.
How serious can it be if you get measles when you're older?
Measles is a serious disease. We tend to think of it as, you know, something you get and you get over it. No big deal. But you are sick, and some of the worst cases are really awful.
There are very few abortion clinics still open in Texas. The Texas legislature has passed strict requirements for clinics, and many have shuttered instead of complying. What does organized medicine have to say about this?
Really, legislators? When did they become experts on the safety standards of any clinic? And, where's organized medicine in saying, 'would you keep the legislature out of my conversations with my patient?' [...] It's the legislature practicing medicine, and I can't believe that organized medicine isn't crying holy hell about this.
Some major medical organizations — like in Boston —have the opportunity to conduct the kind of business that Planned Parenthood does in their clinics behind hospital walls, but they've elected not to.
They don't want the hassle, and these mighty organizations, I think, have turned tail and run away, and let Planned Parenthood set up these little clinics and so forth. They don't want the demonstrators at the front door, and they don't want the board of trustees saying, 'Why are you giving us this bad publicity?' [...] However, I still think things are going to change because I think we're going to see abortion move more toward a pill and less toward a surgery. [...] I'm actually conservative about abortion. I think there a lot of bad reasons to have abortions. I condemn some of them. But, I'm not going to outlaw it. I'm gonna let women make their choice.
The Supreme Court ruled 5-4 to uphold the use of the lethal injection drug midazolam, despite misgivings it could cause a long and excruciating death. What do you make of that decision?
I just disagree with them on this one. I don't think people know what they're doing. They're botching these executions. It's gotten so bad that a couple states have just pulled out of it entirely. Until you show — probably using animals — that you can effectively come up with some formula to safely kill people, it's hard for me to say that that ought to proceed.
So, to you it seems like they're 'experimenting' on death-row prisoners, trying to find a combination of drugs that will work to kill people?
In my line of thinking, trying out new combos of drugs when you can't get the ones that you've traditionally used, or doing new techniques, that's experimentation. [...] You have to try it on animals, and you can euthanize the mice, and if they seem to go painlessly from this earth [it's okay]. I don't think they got it straight.
