HumanistNetworkNews.org
June 21, 2006
In a recent article Art Caplan, the Emmanuel and Robert Hart Professor of Bioethics at the University of Pennsylvania, suggests that tough moral choices accompany the announcement of a new vaccine that can prevent cervical cancer. Who will be vaccinated? When? And who will pay?
Cervical cancer is caused by the human papilloma virus (HPV), which is transmitted sexually. Men can carry this virus, but only women get cervical cancer, of which 3,700 women in the United States die every year. The new vaccine is estimated to protect women for five years, and so the best time to vaccinate women is right before they become sexually active.
This is why the vaccine is considered a moral issue. There are some conservative religious groups that do not want the HPV vaccine offered to young women because they believe that it condones promiscuity by making women believe they are "safe." They believe that the best way to prevent HPV and all other sexually-transmitted diseases is to teach abstinence until marriage. But what if a young woman decides to abide by these rules and then marries someone who did not? She would still be at risk for an HPV infection that the vaccine could have prevented.
The question of who decides whether a young woman gets vaccinated is another ethical dilemma. Should young women be able to choose for themselves whether or not they want the vaccine, or should their parents make that decision? In most states doctors are legally permitted to treat sexually-transmitted infections in teenagers and prescribe contraceptives without parental notification or consent. The reasoning is that many teenagers would not seek medical care if parental consent were required, leading to untreated infections and unwanted pregnancies.
Should the HPV vaccine be treated the same way? Today doctors cannot administer a vaccine without parental consent. What should a doctor do when a 14-year-old patient comes in and says that she has become sexually active? Legally the doctor cannot administer the vaccine even though it is in the girl’s best interest that she receives it.
Even if it could be agreed upon that every young woman should be vaccinated no matter whether parental consent is required, who will pay for it? Many health insurers do not pay for vaccines, and almost every city and state health department cannot afford to vaccinate every young woman at the age of 12.
So will only the rich have access to this vaccine? They are the group that needs the vaccine the least since they are already getting their daughters good medical care.
HPV is not restricted to the US; cervical cancer is the leading cause of death for women in sub-Saharan Africa, South Asia and Latin America. Who will pay to vaccinate them?
Despite the difficulties in doing so, the right thing to do is to ensure that all young women are vaccinated. The issues surrounding cervical cancer will soon find you at your school, church, synagogue, mosque or doctor’s office. We need to push politicians now to make sure that the money for these vaccines is available. If insurance companies do not have to pay, and public health departments cannot afford to, then all other moral issues surrounding the vaccine will become insignificant.
Ana Lita, Ph.D., is director of the IHEU-Appignani Center for Bioethics, an affiliate of the International Humanist and Ethical Union.
prev story