Posted by Eugene Volokh:
HPV Immunization and Risky Personal Choices:
http://volokh.com/archives/archive_2007_02_04-2007_02_10.shtml#1170719113


   I've heard some argue that HPV is different, and a less proper
   candidate for a government-mandated (or even
   government-strongly-pressured) immunization, because HPV is acquired
   through risky, and usually personally chosen, behavior. This, though,
   strikes me as mistaken.

   Though having multiple sexual partners increases one's risk of getting
   HPV, all it takes is one sexual partner. Nearly every woman will have
   sex at some point in her life. Even if she is a virgin bride, she can
   get HPV from her husband on her wedding night. True, if she marries a
   virgin, and her husband never cheats on her, then she's not at risk
   (setting aside the possibility of rape). But even the most moral
   behavior on her part, under any definition of morality short of
   lifelong abstinence from sex (including marital sex), won't protect
   her. The vaccine, on the other hand, likely will protect her.

   There's also a very different kind of risky behavior argument: I'm
   told that regular pap smears, and the medical procedures used when the
   pap smears show a dangerous result, are very reliable in preventing
   even HPV-infected women (about 50% of the population, I have read)
   from developing cervical cancer. In a sense, then, actually getting
   cervical cancer may be said to be the woman's "fault" not because of
   her sexual behavior but because of her medical laxness. (That sounds
   harsh, but I take it that we do say that in some measure, though not
   without sympathy, in other contexts: If someone dies of untreated
   pneumonia -- consider, for instance, Jim Henson -- we might think that
   this death was in some measure his fault.)

   Yet that seems to me to be a not very good argument against
   immunization. Many women don't get pap smears because they're fairly
   poor. Even those that could easily get them but don't seem to deserve
   some protection. And even for those who get them and thus don't get
   cervical cancer, the treatment used to avoid death from cervical
   cancer is expensive, unpleasant, and emotionally distressing -- and it
   can lead to infertility.

   Of course, all this then raises the broader libertarian objection: Why
   should some people be forced to be immunized (assuming the Texas law
   mandated immunization, which this one seems not to, given its broad
   exemption for parents with conscientious or religious objections) in
   order to protect others? I'll turn to that in the next post.

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