Saturday, January 24, 2015

Should the state intervene in matters of teeth brushing and vaccinations?

Child years ago in classroom learning to brush teeth
Carol Forsloff---Various states often try to instill health habits or habits referencing personal behavior, including children's health and related issues.  At one time in Massachusetts it was debated whether the state can require children brush their teeth.  Now the issue is vaccination and measles.  What are the issues in state vs parental responsibilities regarding children's health?

The New York Times had an article about Massachusetts being the only state to require pre-school children to brush their teeth in school.  It reported the issues that led to discussion on the limits of the state's regulations over the welfare of children.  Some were said to be clear-cut, while others were considered ambiguous.

Child cruelty, killing, rape and endangerment are frequent news items.  There are often cases in the news where parents abuse their children, or do things that create harm, because of certain religious or political beliefs.  These raise questions about child safety.  People will sometimes indict the State for not stepping in soon enough to prevent a tragedy.  Sometimes individuals who work for the State are even sued for not intervening in preventing child abuse.

But can the State assume the parental role in something as simple as brushing one's teeth?  After all, dentists remind us that brushing one's teeth is basic healthy behavior and that lack of brushing can lead to health problems over one's lifetime.

Parental abuse is sometimes a debatable issue when it involves the rights of the legal guardians of a child vs the public responsibility when it comes to issues of neglect.  Does a teacher who is with a child all day in school have a responsibility to report signs of abuse.  The law says the teacher has that responsibility, but what if the teacher does not report abuse.  Is the person to be found complicit in that event?  How might that impact professional reporting if there is a law that references specifically a health measure like brushing one's teeth.


In schools children are with teachers all day.  Do they have a responsibility to see that children brush their teeth?  Tooth decay can lead to a multitude of health problems for children and can indicate parental neglect.  But should a teacher assume that tooth decay is part of his/her school responsibility and take responsibility if the child's teeth are not being brushed regularly at home?  Is tooth brushing at school a replacement for those parents who don't encourage children to brush their teeth.  Proponents of the directive declare it is part and parcel of all of these arguments.


Special needs children have been regarded more and more as part of school responsibility in terms of provisions of health care.  Child neglect by a school official,however, is one thing; but at what point does what the teacher thinks
might be a health problem caused by parental neglect become an issue?


These cases are often considered on a case-by-case basis, with the worst
case, the death or severe injury of a child, demonstrating what most
people would consider a reasonable concern.  But at what level is
neglect determined, and is tooth brushing a subjective determination in some ways,especially when the target for being neglectful is the parent?


And what about vaccination?  Some parents believe children who are not vaccinated should be barred from school to prevent the spread of disease.  Some defend the parental rights to make a decision about vaccination, especially if it is based on the fear that doing so might cause side effects that could harm the child.  Others believe the State has a right to protect the public to the extent that it restricts certain behaviors and promotes overall the welfare of the greater community.

Whether it is brushing one's teeth, and having a law that allows the state to monitor the behavior, or vaccinations the issue of the State authority vs the rights of the individual continue to be part of the debate in the United States that continues to spark discussions in the public square via the Internet.

While some take a religious position and side for or against State involvement in restricting personal affairs, such as on matters of abortion or gay marriage, the more subtle issues often create arguments as well about freedom and public rights.

And as parents seek to have unvaccinated children barred from school, a Federal judge upheld just such a law in New York that restricts children from the classroom who have not been vaccinated.

At which point does the public responsibility take over in cases of
medical neglect?  It continues to be an issue that is tested and discussed in numerous cases where the welfare of children is discussed, where some might limit controls and worry over the encroachment of their lives like a welfare state and others see the central issue as not the controls themselves but the ultimate goal:  the health and welfare of the child.  The conflict is on how to arrive at that goal



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