The word “conscience” might seem a little old-fashioned to people these days. Wasn’t that Jiminy Cricket’s job as Pinocchio’s pal? But in fact, conscience remains an important concept in all our doings—including in decisions about whether or not to vaccinate.
So then, what exactly does conscience mean? According to Dictionary.com, it is “the complex of ethical and moral principles that controls” a person’s thoughts or actions. Conscience is what makes us caring and unselfish toward others. The truly conscientious healthcare decision would be to get ourselves and our children vaccinated, not just for our own families, but for the health of the vulnerable people around us: babies who are too young for some vaccinations, medically fragile people who for cannot safely be immunized, elderly people for whom the flu can be deadly.
Yet in Texas, the wording is backwards. Parents who decide not to vaccinate because they have been misinformed by the pseudoscience circulating about vaccination, or because they figure other kids who are vaccinated will keep their children safe, can receive what the state calls an “exemption of conscience” that allows them to send their kids to school without the required vaccinations.
No matter how you look at it, the term is simply inaccurate. Deciding against vaccines has nothing to do with ethical or moral principles.
A new piece of state legislation would provide a simple fix for this accuracy problem. HB 120, authored by Rep. Sarah Davis, would change the wording to “non-medical exemptions.”
Here are a few important facts to keep mind about the change:
- Parents would have the same ability to decide against vaccination. All the bill would do is change the wording, not the process for filing an exemption.
- The term “non-medical exemption” is more accurate. There would still medical exemptions for children with compromised immune systems or those undergoing chemotherapy or taking immunosuppressive medications. “Non-medical” would cover everything else. It makes more sense.
- The term “exemption of conscience” makes it sound as though the vast majority of parents who do have their children vaccinated are somehow making a less-than-conscientious choice. The opposite is true: They are helping to keep the community free of preventable diseases that used to kill thousands of American children each year, and leave others permanently damaged. Want an example? The number of cases of meningococcal disease has fallen by 66 percent since Texas instituted its vaccine requirement for this potentially fatal illness.
- In contrast, the term “non-medical exemption” is neutral. It doesn’t disparage parents who decide against some or all vaccines, or those who choose immunization.
- The word “conscientious” also carries connotations of a carefully researched decision based on reason. But a vast and ongoing body of research, reviewed by an expert committee three times a year, continues to find that vaccines are safe and effective at preventing the scourge of many serious infectious diseases.
- The first year that Texas allowed parents to opt out of vaccinations for non-medical reasons, about 2,300 children were exempted. That number has since increased 19-fold, to 45,000 students, and public health officials fear the numbers continue to be on the upswing. Parents have the right to make decisions to go against science and what most pediatricians would tell them, but they should not have their decisions cloaked in wording that implies they are making a morally and ethically superior decision.
If wording matters—and it often does—that inaccurate phrase can only encourage parents to decide against vaccines. At minimum, it gives a kind of quiet approval to a decision that goes against the interests of public health.
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