I’ve long felt that administrative tribunals set up to judge the validity of a vaccine exemption are precisely this: practicing medicine without a license. CA has been doing this with childhood vaccinations for some time, increasingly squeezing and attempting to strong-arm physicians who write exemptions. It is wrong.
These tribunals also violate CA law by practicing medicine without having done what the law calls a “good faith medical evaluation,” which I am sure is likewise required by other state’s laws. What they actually do is slavishly apply some list that the CDC published to specific cases. But there is no reason to believe that the CDC list is comprehensive, given the individual variation and patient-specific factors that are found everywhere in medicine. It is in part because each patient is unique that physicians — until recently — are generally granted wide discretionary latitude in patient care.
Practice guidelines published by the CDC or professional societies are not recipe books for the practice of medicine. They are general guidelines, nothing more. Clinical prudence is always required to apply evidence and principles to specific cases, and no guidelines are sufficiently comprehensive to cover all cases or include all statistical outliers. What we see here represents an egregious example of a trend in medicine toward homogenization that will not have salutary consequences.
Aaron Kheriaty, MD, Professor of Psychiatry, UCI School of Medicine