Proposed ballot measure on medical mandates is a threat to Arizona public health, expert says

Arizona voters may be asked in November to decide whether to amend the state constitution to establish the right for residents to refuse medical mandates.

The proposal recently cleared the state House on a party-line vote. If the Senate OKs it, the measure will appear on November’s ballot.

Among other provisions, the proposal would prohibit government entities from requiring Arizonans to receive, accept or administer a medical treatment or product as a condition of work, school, access to facilities or taking part in services. It does say that parents would still have the right to make medical decisions for their kids who are younger than 18.

James Hodge, director of the Center for Public Health Law and Policy at ASU’s Sandra Day O’Connor College of Law, joined The Show to talk more about it.

Amber Victoria Singer/KJZZ

Full conversation

MARK BRODIE: James, first off, what do you see in this proposal?

JAMES HODGE: Well, one of the first things you see in regards to a proposal like this is a pretty aggressive effort to amend our state constitution to adopt something that for a lot of Arizonans will seem like a very favorable position. We want to provide freedom for individuals to make their own choices about what medical care they receive without government interference.

I mean, that sounds like a very good proposal, and it sounds like the sort of thing that a lot of Arizona voters might go for. It's not the sort of thing you might get past Gov. (Katie) Hobbs in relation to her desk, because what happens with this resolution is so critical.

While that general proposition of people having the autonomous choices to make for their medical care is a solid one backed up by constitutional law, what this proposal does via resolution is actually tries to chip away at the sort of traditional longstanding exceptions to that that we have implemented via government and in private sector.

And it's that effort that will look or will feel problematic and be problematic for persons as we go forward with this, should it get to the ballot.

BRODIE: Well, so one of the issues that critics of this proposal bring up is that they say it will essentially end school vaccine requirements. Do you see it that way?

HODGE: It very well could. It's a very significant issue and a problem underlying the language here, because when I said what we offer here in this resolution is a standard proposition of you should make your own autonomous choices about your medical care is a very good one.

But when you start understanding what and how we've actually provided exceptions to that in the interest of protecting the public's health, like vaccine mandates, which are all about protecting the public's health as well as your health in addition.

This particular resolution has every chance of voiding those long standing vaccine recommendations as well as other medical testing and prognosis issues, which are so critical to how we actually protect community health to the degree. To which that occurs, it will raise significant threats to the health of not just the public, but individuals as well.

BRODIE: In addition to vaccines, do you see other sort of public health potential issues with this proposal?

HODGE: Oh, you bet. Listen, vaccine mandates are so critical. Although we use the term mandate, it's really talking just about conditional vaccines. We're going to ask that you get vaccinated as a condition upon which you get to go to school or travel or engage in this certain employment.

But it goes well beyond that, Mark, because what this particular resolution attempts to say is that government cannot impose any restriction or fail to provide you any benefit for your decision not to undergo any type of medical procedure or engage with any medical product.

So let me give you a good example where that could come up as a very significant issue. So let's say we have a specific instance of a person with tuberculosis in Maricopa County. Now we would want to actually test that person for TB to make sure that if they have it, we can provide the appropriate responses, including treatment and some very strong, good guidance about how to avoid contact with others if you're contagious.

This particular resolution challenges even that notion that we could actually semi-require that person done to go very minimal, almost noninvasive testing for the purposes of checking their tuberculosis status.

When you're talking about the type of testing and screening and social distancing measures that we regularly utilize to protect the health of everybody across Arizona being threatened by this sort of existing constitutional language that can be embedded into our Arizona Constitution, creating all sorts of conflicts with existing constitutional norms, Mark, that's where you find the sort of implications here could be profound.

I'll give you one other example if you'd like it, because I think it's equally worth noting. Listen, there's a lot of enterprises in Arizona that you just can't run safely without the types of vaccination requirements or otherwise that we have in place.

Hospitals is a good example of that. And to the degree to which we could run a hospital without vaccine mandates requiring health care workers to get vaccinated for specific conditions, the types of conditions that could harm patients if they got infected at the hospital — this even threatens that.

While it doesn't stop a private hospital from actually requiring vaccinations among their employees, those private hospitals typically rely on government requirements for those vaccine purposes to the degree to which government can't require it, whether a hospital will, or a daycare facility or a long-term care facility Mark, all of those particular requirements could fall away. And that could result in significant harms to patients and to personnel within hospitals and other settings.

I mean, the damage of this could be quite profound.

BRODIE: So the sponsor of this proposal has said that he's not against vaccines, he's against mandates. So I wonder if there's something to be said for the public health community, the health care provider community, to maybe make a better case to their patients, to the public about why vaccines are important and safe, or why some of these other procedures and methods and techniques are things that we should want to do as opposed to being told we have to do.

HODGE: That's a great point. And listen, I think we all understand some of what we're seeing with the representative's statements to that effect. Nobody wants to be told by government what medical treatment you have to receive. It feels like that when you're dealing with the terms like "vaccine mandates" and other from other sort of initiatives.

But the simple reality here is that this is not one of those choices that government's making to actually impose upon your bodily autonomy. It's exactly the opposite of that. We are providing through society, through this sort of vaccine conditional sort of assessment, an opportunity for you to live safely within your employment and school and travel and other settings.

And so to that end, if the representative supporting this resolution is truly in favor of vaccines and wants everybody to get it, then what and how we actually provide for that through conditional vaccines is exactly the right way to accomplish that via government.

Government's highly recommending you get vaccinated for participation in multiple different fronts. To the degree to which you choose not to be vaccinated, that's your choice still. Nobody's physically compelling autonomous persons to get vaccinated. And sometimes people believe that is the case. It's not. That's not supported by state law. And it's not the case for any autonomous adult. Take children off that, because parents make those decisions for their children.

But in the end, what we have to understand is that if you want to participate in society, if you want to go to school, if you want to travel, if you want to work in this specific setting where disease spread is predictable and avoidable, vaccination is one of the minimal expectations we set for those purposes, with very, very little risk of harm to anybody being vaccinated proven over multiple dozens of years.

I think you might compare it roughly to the privilege of driving in Arizona. If you want the privilege of driving in Arizona or across the United States, you'll obey the traffic rules, because that's one of those things that we can expect of you to engage in those rules for the safety of all of us.

If you want to participate in specific aspects of society, vaccination and other medical interventions — minimal as they are — that's part of that equation.