On 27 June 2017, in a Florida vaccine laws case, a Florida Court of Appeals – The District Court of Appeal of the First District – rejected Patrick Flynn’s appeal against a lower court decision that found that a Catholic diocese had a constitutional right to exclude unvaccinated children if its interpretation of religious law supports doing so. The Court affirmed that the church autonomy doctrine, under which the state will not interfere in a church’s interpretation of religious law, prevents application of state vaccination law to this case.
From a public health perspective, this is a good news/bad news case. On one hand, the case made it clear there is no constitutional right to a religious exemption, and allowed religious private schools to reject non-vaccinated students when that rejection is religiously motivated. On the other hand, it also made it clear that other private schools cannot, under Florida law, reject unvaccinated students if their parents file a religious exemption, and neither can religious schools when their policy is based on secular reasons.
Florida vaccine laws – the case
Patrick Flynn is a Catholic father of eight. All his children were educated in Catholic schools in the Catholic Diocese of St. Augustine, Florida (“The Diocese”). At some point of his life he decided that vaccinating was against his religious beliefs, and began providing a letter expressing his religious objection to vaccine, to fulfill the requirements of Florida’s religious exemption.
After accepting religious exemptions for years, the Diocese, through its leader, Bishop Felipe de Jesús Estévez, decided not to accept them anymore, starting with the 2015-2016 school year. The court decision (pdf) explained that
Bishop Estevez’s legal position as Bishop is that immunizations of children attending Catholic schools is an issue of faith, discipline, and Catholicism which can only properly be determined by the church and not by the civil courts.
The Diocese did not point to any specific tenet that supported its position on immunization – in fact, it did not provide any materials that explained its previous position that allowed exempt children in or its current position that refused them. It did state the basis of its opposition was religious.
Mr. Flynn’s youngest son has just finished Kindergarten in 2015. Mr. Flynn submitted a letter of religious exemption, but under the new policy was refused admission to the school unless his parents vaccinate him.
Naturally, his family was unhappy. The father opened a GoFundMe campaign, and sued the Diocese, first in the trial court and after losing the case there, appealed.
The basis for his appeal was the claim that under Florida’s statute about religious exemptions, that says:
“that immunization requirements do not apply if “[t]he parent of the child objects in writing that the administration of immunizing agents conflicts with his or her religious tenets or practices.” § 1003.22(5), Fla. Stat.” (opinion, p. 4)
Private schools have to accept religious exemptions, and cannot reject unimmunized children exempt under them.
The court of appeals affirmed the trial court’s ruling, which basically held that when the church’s constitutional right conflicts with a parent’s legal right to an exemption, the constitutional right trumps. There were three slightly different decisions in the appeal court (pdf).
Judge Makar wrote the main opinion. It basically said:
- The church autonomy doctrine prevents civil courts from deciding matters that involve those courts in theological controversy, church discipline, ecclesiastical governance, or conformity with moral standards set by the church – on those issues, the courts will defer to the highest ecclestial authority. The doctrine is ground in Article I of the United States constitution – both the free exercise clause (it protects churches’ freedom of religion) and the establishment clause (by preventing excessive government entanglement with religion). It gives churches a constitutional right to autonomy.
- In Florida, it’s a jurisdictional bar. That means that when a matter that involves one of the issues above – for example, here, stepping into a theological controversy – comes before a court, a court does not have jurisdiction over the issue and may not hear it.
- There are limits on the application of the doctrine when it comes to clearly neutral laws that do not require deciding secular matter, but they do not apply here (said with caution by the main opinion, less carefully by the other opinions).
- Neutral state laws requiring immunization are constitutionally valid even without a religious exemption. This means that the right to a religious exemption here is created by statute – Mr. Flynn does not have a constitutional right to a religious exemption from the school mandate.
- Here, we have a religious debate on immunization. Mr. Flynn is asking the courts to prefer his religious exemption over the Diocese’s – directly to step into a religious disagreement. In the Court’s words:
“The Diocese has a religiously-based immunization policy with which one of its members disagrees; Mr. Flynn seeks the power of the State to compel the Diocese to depart from its point-of-view and admit his non-immunized son. But doing so would further his own religious views at the expense of the Diocese’s on the topic of immunizations. We are convinced that a secular court should not be making the judgment as to which side’s religious view of immunization is to be respected.”
- Immunization is a basis for religious debates as well as secular ones, which is why most jurisdictions offer a religious exemptions. So this can fairly be seen as a religious debate between the parties, and courts should not step in. That is even more clearly the case here. This is a case where the church autonomy doctrine is in full force.
- Mr. Flynn complains that the Diocese did not provide an explanation – but under the jurisprudence of Florida’s courts, private people do not have to explain their religious objections, just state that they have one, and it’s unfair for Mr. Flynn to demand more from the Diocese than a private person would have to give.
In the Court’s words:
Courts are in no more of a position to compel the Diocese to provide a sufficient quantum of passable proof that its view of immunization is consistent with the Catholic faith than to do so as to Mr. Flynn’s personal views of Catholic doctrine on the very same subject. … Mr. Flynn points out that he has no duty to prove that his objection is religious, citing Curry, yet he insists that the Diocese must provide adequate proof that sufficiently grounds its religious viewpoint in specific church tenets. We can’t help but note the incongruity of giving primacy to a parishioner’s religious viewpoint that is contrary to that of his mother-church on the same topic; respectfully, it would be an odd role reversal—a devotee’s tail wagging the corpus of church leadership—to do so.
- Even more generally, “the Catholic Church’s governance of its parochial schools is inherently religious, its obvious mission being the transmission of its religious values,” so courts are careful not to interfere in such religious governance.
In short, the statutory right to send a child unvaccinated to any school the parent wants has to give way before the constitutional right of a church to autonomy.
Judge Bilbrey joined the opinion, making it the majority opinion, but added a concurrence – an opinion in agreement that makes additional point – of his own. He wanted to make it clear that the focus here isn’t that it was a dispute between a Catholic member of the Diocese and the Diocese itself. He explained:
All that is required for application of the doctrine is for a church or ecclesiastical body to take a position on religious grounds; it matters not that the opponent of the church have a religious basis in opposition. As Judge Makar observes, “the Catholic’s Church governance of its parochial schools is inherently religious, its obvious mission being the transmission of religious values. . . .” (Maj. Op. at 21). In my view, that is all that is needed in order to invoke the “church autonomy doctrine.””
Judge Kelsey agreed with the result, but offered a different reasoning. Since his reasoning is not the majority, I’ll just say shortly that he analyzed the theology and found that the church’s position was based in valid religious principles, and courts should not get caught in the religious debate between the Diocese and its believer, under the church autonomy doctrine.
Florida vaccine laws conclusion
This decision means that religious private schools in Florida that refuse to accept unimmunized children on religious grounds are constitutionally protected from having to accept religious exemptions. In that, it protects the right of these schools to require immunization (and protect their pupils – and the community – from outbreaks).
Note the limits, though. This applies only to religious schools; the court made it clear that the law requires private schools, generally, to accept religious exemptions. Private schools that are not religious cannot refuse unimmunized children if their parents file a religious exemption – and the parents don’t even have to explain their religious objections, making it very easy for parents whose opposition is not religious to use this exemption.
Religious schools, too, cannot refuse unvaccinated children unless their reasons are religious. A question arises whether that could incentivize such a school concerned about outbreaks to cloak a secular reason to refuse unvaccinated children in religious language – and whether incentivizing people and religious schools to present secular objections as religious is good public policy.
Nonetheless, upholding the fact that the constitution does not require a religious exemption from immunization requirements, and allowing Catholic schools to keep their schools safe by refusing unimmunized children, do help protect the public from disease.
If you cruise around the internet, engaging with the antivaccination cult (not recommended), you will pick up on their standard tropes, lies, and other anti-science commentary. One that has always bothered me, not because that it was a lie, but because I had enough evidence floating in my brain that I was wondering if it were true–that vaccines cause diabetes, especially the Type 1 version.
A lot of the vaccine deniers believe that vaccines cause a lot of everything, and several claim that vaccines cause Type 1 diabetes (or here), based on little evidence. As far as I can tell, this myth is based on the “research” from J. Barthelow Classen, M.D., who has pushed the idea that vaccines causes type 1 diabetes, through some magical process that has never been supported by other independent evidence.
In another example of the antivaccination world’s cherry picking evidence to support their a priori conclusions, they ignore the utter lack of plausibility supporting any link between vaccines and Type 1 diabetes.
Moreover, Classen seems to come to his beliefs based on population-wide correlations that rely on post hoc fallacies, rather than actually showing causality between vaccines and diabetes. It’s like finding that a 5% increase in consumption of Big Macs is correlated with Republican wins in elections. They may happen at the same time, but it would take a laughable series events to show any relationship.
Continue reading “Vaccines cause diabetes – another myth refuted and debunked”
Apparently, the “polio vaccine causes cancer” zombie meme has been reanimated by the antivaccination cult. Lacking evidence for their beliefs, retreading old debunked memes is their standard operating procedure.
The interesting thing about social media (Facebook, Twitter, blogs, Google, reddit) is that it’s fairly easy to push pseudoscientific beliefs. The first problem is that many people read the headlines, and never the underlying discussion. If it can be said in 140 characters, or a misleading infographic, many individuals will share that across the internet as a “fact”. So, if you see an claim that “Polio vaccines infected 98 million Americans with a cancer virus,” many people will immediately see that an accept it without much criticism.
Of course, this leads to a second problem. To refute this claim takes a lot more than 140 characters. The refutation is often complex, nuanced and highly scientific, and may take 2000 words or more to blast the claim into orbit. It’s highly emotional to claim a vaccine can cause cancer. On the other hand, to say it is not isn’t emotional–it’s coldly logical. And takes a lot of words.
And the third problem is that is that social media fallacies have multiple lives, so when someone reads one of these memes a year from now, they think “yeah, this is great information”, and pass it along as if it’s the Truth. Killing zombie memes are just as difficult as killing zombies in real life, or at least, on a TV show. Debunking these zombie memes is a full-time job. And, once it’s been debunked, we move back to the first problem again, again, and again.
Continue reading “Polio vaccine causes cancer – just a myth”
The public’s concern about adverse events, especially death, immediately or soon after vaccinations is very disruptive to vaccine uptake, leading to increased morbidity and mortality of vaccine-preventable diseases. For example, a 2009 Japanese study that showed 107 deaths following H1N1 influenza A vaccination, assumed a causality between the vaccine and the deaths without any evaluation of background rates of of deaths, which would help indicate whether there was any significance to the death rate or even if its related to the vaccination. Vaccine mortality is one of the most abused terms in discussions about vaccines.
It has been demonstrated that passively reported data, that is, data that isn’t actively investigated by trained researchers, cannot be used to assess causality. In an active investigation, it was found that only 2 of the 107 deaths had an autopsy performed, and most of the others had other underlying diseases and conditions that were causally related to the mortality events. Furthermore, 15 million people were vaccinated with the H1N1 seasonal vaccine, and it would be expected that there would be >8000 deaths during the 20 days after vaccination using a crude mortality rate in Japan. Though it would still be a misuse of statistics, there really is more evidence that the H1N1 vaccination lowered the background death rate from 8000 to 107 post vaccination. Continue reading “Properly evaluating vaccine mortality – let’s not abuse VAERS”
I have railed against charlatans who claim that they have the easy way to prevent or cure cancer. Generally, these snake oil salesmen try to convince you that they have some miraculous food, supplement, spiritual energy, and on and on, that can either kill cancer in its tracks. Or keep them from even growing in your body. But their claims are nearly always absent real compelling scientific evidence.
Like the trope supplements preventing cancer. They don’t. And that’s been shown in study after study after study after study (yeah, I could go on for awhile).
Or like avoiding GMO containing foods prevents cancer. Again, studies show that GMO foods have no effect on cancers. Oh, one more thing–bananas don’t have tumor necrosis factor, and the yellow fruit can’t prevent or cure cancer (but that doesn’t mean that they aren’t delicious).
Despite the absolute lack of evidence that supplements, kale, bananas, or drinking the pure waters of a glacial fed stream (which may not be an option with climate change), there are some things that can be done to reduce your risk (see what I did there–no absolutes, just management of risks) of cancer.
How to prevent cancer has been codified byThe World Health Organization (WHO) into 12 steps (no, not that debunked one) that is called the European Code Against Cancer.
Let’s take a look at cancer and the evidence-based ideas about cancer prevention.
Continue reading “How to prevent cancer in 12 easy steps–OK, not that easy”
Immune system myths are one of the common claims of the junk medicine medicine crowd, especially the anti-vaccine activists. The pseudoscience of the immune system is pernicious and possibly dangerous.
It’s frustrating that the pseudoscience from the junk medicine crowd claims that this supplement or that food is critical to boosting the immune system – hang out for a day on Facebook, and you’ll probably see way too many memes saying that all you have to do to boost your immune system is eat a blueberry kale smoothie. I still see that dumb banana claim that it cures cancer.
The problem with these immune system myths is that they overlook or ignore a basic physiological fact – the immune system is a complex interconnected network of organs, cells, and molecules that prevents invasion of the body by hundreds of thousands, if not millions of pathogens and other antigens every single day.
And no matter how much individuals try to trivialize the complexity of the immune system, it does not make it so. One can claim all day long that downing a few tablets of echinacea will boost the immune system to prevent colds (it doesn’t), it doesn’t make it scientifically accurate. Nor does it create an accurate description of the immune system.
Continue reading “Immune system myths – can we really boost it?”
Two of the most disreputable public personas today are Andrew Wakefield, fraudulent anti-vaccine “scientist” and liar, and Donald J Trump, fraudulent anti-vaccine presidential candidate and liar. The Trump Wakefield bromance developed over their mutual belief that vaccines cause autism. In case you’re wandering to this blog from another planet, there is absolutely no evidence that vaccines are related to autism.
If you follow this, or honestly any skeptic’s, website, you’d know that Andrew Wakefield is one of the greatest conmen in medicine and science. And to be honest, that’s a tough list. His delusion that vaccines are related to autism has lead to actual harm to children throughout the world, as parents listen to his junk medicine and refuse to protect their children from vaccine preventable diseases.
Of course, most rational people understand Donald Trump’s misogyny, racism, and alt-right beliefs. I’ll let political writers elsewhere continue to point that out leading up to the election. For me, there are so many reasons to dislike Trump, with his anti-vaccine ignorance being near the top.
Lovely, aren’t they? Many skeptics have pointed out Trump’s dishonesty for years. The mysterious Orac has been pointing out Trump’s ignorance on vaccines for years.
Let’s take a look at the budding Trump Wakefield bromance. I promise, it will make you ill.
Continue reading “The Trump Wakefield anti-vaccine bromance – yes, it’s a thing”
Polio is a crippling and potentially deadly infectious disease caused by the poliovirus, a human enterovirus, that spreads from person to person invading the brain and spinal cord and causing paralysis. Because polio has no cure, the polio vaccine is the best way to protect yourself and the only way to stop the disease from spreading. In a case study that will be presented at the 2014 American Academy of Neurology meeting, researchers report the discovery of a polio-like illness that has been found in a cluster of children from California over a one-year period.
This outbreak isn’t a result of anyone’s refusal to be vaccinated against polio, since all of the children in this study had been previously vaccinated against the poliovirus.
The United States last experienced a polio epidemic in the 1950s, prior to the introduction of the polio vaccine 60 years ago. Today, polio has been eradicated from most of the planet, as the number of worldwide polio cases has fallen from an estimated 350,000 in 1988 to fewer than 223 in 2012—a decline of more than 99% in reported cases.
Continue reading “Polio-like illness emerging in California – not vaccine related”
We’re nearing the commencement of the 2016-2017 flu season in the Northern Hemisphere. And every flu season, for the past 5 years, I reprint Dr. Mark Crislip‘s epic rant about Dumb Ass healthcare workers who refuse to get the influenza vaccination.
Dr. Crislip’s impassioned characterizations, which was originally published in A Budget of Dumb Asses, are a list of the different types of flu vaccine refusing Dumb Asses. It is important that I resurrect this list in advance of the flu season – there is nothing more frustrating than healthcare workers who refuse to get the influenza vaccination.
Even though this broadside is about flu vaccine refusing Dumb Asses, it’s all right to search and replace flu with say meningitis, pertussis, measles, HPV or any other vaccine. And just because this rant is really about healthcare workers, it’s all right to replace that with your neighbor, co-worker, or some other antivaccination Dumb Ass. There are just so many.
The upcoming 2016-2017 flu season is just starting, and many physicians and clinics (along with many pharmacies, government flu clinics, and other places) already have this season’s flu vaccine. One of the best ways, if not the only real way, to boost your immune system against the flu is with this vaccine. No, drinking copious quantities of bone broth (yes, it’s a thing) is not going to boost your immune system, kill flu virus, or create a force field against the flu.
And it’s time for intelligent, reasonable, and rational people to get their flu shots. We’ve dispensed with many of the myths that are cherished by vaccine refusers, and many reseachers have shown that getting the flu vaccine can improve health outcomes.
Continue reading “Influenza vaccination – epic rant about anti-vaccine Dumb Asses”
Editor’s note: This article was originally published in December 2014. It has been revised and updated to include more comprehensive information, to improve readability, or to add current research.
The name of this blog, of course, is the Skeptical Raptor. I’m not sure how I invented that name, but I like raptors, either the fossil dinosaur version, or the living dinosaur versions, birds of prey. They both actually work as a metaphor of what I try to do–provide scientific and knowledgeable analyses of the scientific consensus or critiques of beliefs and pseudoscience. Usually one leads to another.
Of course, I don’t pretend to be very nice about my critiques, probably another reason why I chose to put “Raptor” in the blog’s name.
So, you know I’d get super annoyed by those who reject science, then misappropriate the word “skeptic” (or for those of you who prefer the Queen’s English, sceptic). A denier is not a skeptic – the former actually reject the rationality and open-mindedness of real skepticism (and science), but they pretend they are the real skeptics. Oh really? Continue reading “I call it as I see it–a denier is not a skeptic”