The measles outbreaks continue to spread, with New York City declaring a public health emergency and requiring people in four ZIP codes to have their children vaccinated or face penalties, including a fine of US$1,000 and or imprisonment.

Since September 2018, 285 measles cases have been reported in Brooklyn and Queens, mainly in neighborhoods where ultra-Orthodox Jews have chosen to not have their children vaccinated.

The Centers for Disease Control and Prevention, said that from Jan. 1 to April 4, 2019, 465 individual cases of measles have been confirmed in 19 states. This is the second-highest number of cases since the CDC declared measles eliminated in 2000; in 2014, 667 cases occurred.

Cases have still been occurring each year, often brought into the United States from international travelers. Officials believe that to be the cause of the outbreak in Rockland County, New York, where 168 cases were reported as of April 8, 2019.

Rockland public health officials issued a ban that would keep unvaccinated children out of public places, but a judge overruled that on April 5. On April 9, county officials said they would appeal.

But there are limits to what health care providers, public health officials and legislators can do. It is crucial to consider both the power – and the limits – of potential solutions that will provide education, medical care and protection for the public while still upholding principles of informed consent, parental decision-making and sustaining public trust.

As a professor who researches and teaches health law, public health law and medical ethics, I think it’s worth clarifying what states can or cannot legally do when responding to cases of communicable disease.

A right to refuse medical care

The law recognizes the right of an individual to refuse medical interventions. Health law has a strong history of recognizing bodily integrity: Adults can choose whether to accept or reject a proposed medical intervention, even in instances where public health authorities conclude a vaccine would benefit both the individual and society. The Supreme Court has recognized parents’ ability to direct the care and control of their children, including consenting or forgoing medical treatment for their child except in very specific circumstances.

In the 1905 Jacobson v. Massachusetts case, the Supreme Court upheld a state law delegating power to local health officials mandating that adults receive one smallpox vaccine in the midst of an epidemic or pay a fine (about $130 today). Under the concept of police power, states have a duty to enact laws that promote the health, safety and welfare of its residents. Public health authorities may offer vaccines as a method of prevention, but medical professionals, public health authorities and even courts may not legally compel a person to submit to a vaccine.

The Jacobson decision also set forth limits on police power, yet subsequent cases addressing vaccine mandates discarded these requirements, extending multiple vaccine mandates to school attendance for disease not in circulation and in the absence of an epidemic.

Deferring to respected scientific consensus as a means to justify forced medical interventions in the name of individual benefit and the public good has historically resulted in some of the most egregious constitutional and human rights atrocities in the U.S. The mass forcible sterilization during the eugenics movement is but one example.

The history of science and medicine further demonstrates the fallibility of commonly accepted medical knowledge, such as when Bayer introduced heroin as a safe, non-addictive substitute for morphine, or physicians prescribed Bendectin and thalidomide to relieve nausea, only to find these medications resulted in babies born with severe birth defects.

Public good, personal rights

The law is also quite clear that public health authorities and law enforcement may place restrictions on a person’s individual liberty – including religious liberty – in situations where a person’s actions pose a direct, immediate and compelling harm to others, such as using venomous snakes in religious worship or asserting a nonexistent “right” to use an illegal substance such as marijuana when operating a motor vehicle.

In public health law relating to communicable disease, this constitutes a very specific standard: A person must have a present disease, and this person’s actions must pose a direct threat to others.

For example, health officials may seek a quarantine order or civil commitment for a person with active tuberculosis who continues to frequent highly populated public spaces until the person is no longer contagious.

Even in such a case, health authorities can offer treatment and limit a person’s movement to prevent infecting others, but the law does not permit forcibly medicating a competent person against his will.

Accordingly, legal precedent does not support quarantining vast geographic areas of healthy persons who have not been exposed to the communicable illness, but would support tailored voluntary isolation and quarantine of persons who have been exposed to, or currently have, the illness.

What health officials can do to protect children

The CDC classifies vaccines as one of the top 10 public health achievements. The vast majority (about 98%) of parents across the U.S. as a whole comply with the state law mandated schedule of vaccines for their children.

Vaccines, like any other FDA-approved product such as a prescription drug or medical device, carry a set of risks and benefits. These calculations vary depending on the vaccine, its efficacy, safety, potential side effects, the severity of the illness the vaccine aims to protect against, and the individual to whom it is administered.

Vaccine science and practice similarly evolved with historical mistakes (the Cutter incident) and ongoing disputes about risks and benefits for individual vaccines like flu and anthrax.

To promote vaccination for children, health officials may offer educational campaigns and set up free clinics for parents to bring their children. State laws may also mandate vaccines as a condition for school attendance, or require excluding unvaccinated children during an active outbreak at their school.

However, if states offer a religious or nonmedical exemption, courts have been clear that health officials and school officials do not have discretion to require the child’s parent to identify with an organized religion or reject the sincerity of the parent’s beliefs because this violates the First Amendment.

Harm to community

Public health professionals worry that parents who forgo vaccination are placing their child and the community at risk. Some have advocated that the state should step in with coercive measures such as eliminating any nonmedical exemptions for all children or intervene by force, such as classifying parents’ decision as child neglect or seeking a court order to vaccinate the child.

In my opinion, these strategies rely on a distortion of legal precedent, dismiss longstanding authority of parents to make decisions for their children, and threaten to undermine an already fractured public trust.

Cases that uphold state intervention to protect a child by compelling medical treatment generally require that the child has an illness, the illness is severe and life-threatening, and the risks and benefits of intervening are assessed.

This requires medical professionals and health officials to maintain precision in distinguishing whether the parents are deciding to forgo recommended vaccines, or whether they are refusing medical care for a critically ill child. Indeed, a recent case in Chandler, Arizona, demonstrated how a climate of coercion and force may result in parental fear and refusal to constructively engage with state officials for even an ill child.

State public health officials have the duty to protect residents from illness and communicable disease, but these strategies must fall within appropriate legal parameters. Dismissing these legal boundaries or justifying unnecessary force not only undermines fundamental liberties, but in my view fuels parental and community distrust of health officials and sets back the ultimate goals of protecting the public.

Katherine Drabiak, Assistant Professor, University of South Florida

This article is republished from The Conversation under a Creative Commons license. Read the original article.

On April 21, Christians will be celebrating Easter, the day on which the resurrection of Jesus is said to have taken place. The date of celebration changes from year to year.

The reason for this variation is that Easter always falls on the first Sunday after the first full moon following the spring equinox. So, in 2020, Easter will be celebrated on April 12, and on April 4 in 2021.

I am a religious studies scholar specializing in early Christianity, and my research shows that this dating of Easter goes back to the complicated origins of this holiday and how it has evolved over the centuries.

Easter is quite similar to other major holidays like Christmas and Halloween, which have evolved over the last 200 years or so. In all of these holidays, Christian and non-Christian (pagan) elements have continued to blend together.

Easter as a rite of spring

Most major holidays have some connection to the changing of seasons. This is especially obvious in the case of Christmas. The New Testament gives no information about what time of year Jesus was born. Many scholars believe, however, that the main reason Jesus’ birth came to be celebrated on December 25 is because that was the date of the winter solstice according to the Roman calendar.

Since the days following the winter solstice gradually become longer and less dark, it was ideal symbolism for the birth of “the light of the world” as stated in the New Testament’s Gospel of John.

Similar was the case with Easter, which falls in close proximity to another key point in the solar year: the vernal equinox (around March 20), when there are equal periods of light and darkness. For those in northern latitudes, the coming of spring is often met with excitement, as it means an end to the cold days of winter.

Spring also means the coming back to life of plants and trees that have been dormant for winter, as well as the birth of new life in the animal world. Given the symbolism of new life and rebirth, it was only natural to celebrate the resurrection of Jesus at this time of the year.

The naming of the celebration as “Easter” seems to go back to the name of a pre-Christian goddess in England, Eostre, who was celebrated at beginning of spring. The only reference to this goddess comes from the writings of the Venerable Bede, a British monk who lived in the late seventh and early eighth century. As religious studies scholar Bruce Forbes summarizes:

“Bede wrote that the month in which English Christians were celebrating the resurrection of Jesus had been called Eosturmonath in Old English, referring to a goddess named Eostre. And even though Christians had begun affirming the Christian meaning of the celebration, they continued to use the name of the goddess to designate the season.”

Bede was so influential for later Christians that the name stuck, and hence Easter remains the name by which the English, Germans and Americans refer to the festival of Jesus’ resurrection.

The connection with Jewish Passover

It is important to point out that while the name “Easter” is used in the English-speaking world, many more cultures refer to it by terms best translated as “Passover” (for instance, “Pascha” in Greek) – a reference, indeed, to the Jewish festival of Passover.

In the Hebrew Bible, Passover is a festival that commemorates the liberation of the Jewish people from slavery in Egypt, as narrated in the Book of Exodus. It was and continues to be the most important Jewish seasonal festival, celebrated on the first full moon after the vernal equinox.

At the time of Jesus, Passover had special significance, as the Jewish people were again under the dominance of foreign powers (namely, the Romans). Jewish pilgrims streamed into Jerusalem every year in the hope that God’s chosen people (as they believed themselves to be) would soon be liberated once more.

On one Passover, Jesus traveled to Jerusalem with his disciples to celebrate the festival. He entered Jerusalem in a triumphal procession and created a disturbance in the Jerusalem Temple. It seems that both of these actions attracted the attention of the Romans, and that as a result Jesus was executed around the year A.D. 30.

Some of Jesus’ followers, however, believed that they saw him alive after his death, experiences that gave birth to the Christian religion. As Jesus died during the Passover festival and his followers believed he was resurrected from the dead three days later, it was logical to commemorate these events in close proximity.

Some early Christians chose to celebrate the resurrection of Christ on the same date as the Jewish Passover, which fell around day 14 of the month of Nisan, in March or April. These Christians were known as Quartodecimans (the name means “Fourteeners”).

By choosing this date, they put the focus on when Jesus died and also emphasized continuity with the Judaism out of which Christianity emerged. Some others instead preferred to hold the festival on a Sunday, since that was when Jesus’ tomb was believed to have been found.

In A.D. 325, the Emperor Constantine, who favored Christianity, convened a meeting of Christian leaders to resolve important disputes at the Council of Nicaea. The most fateful of its decisions was about the status of Christ, whom the council recognized as “fully human and fully divine.” This council also resolved that Easter should be fixed on a Sunday, not on day 14 of Nisan. As a result, Easter is now celebrated on the first Sunday after the first full moon of the vernal equinox.

The Easter bunny and Easter eggs

In early America, the Easter festival was far more popular among Catholics than Protestants. For instance, the New England Puritans regarded both Easter and Christmas as too tainted by non-Christian influences to be appropriate to celebrate. Such festivals also tended to be opportunities for heavy drinking and merrymaking.

The fortunes of both holidays changed in the 19th century, when they became occasions to be spent with one’s family. This was done partly out of a desire to make the celebration of these holidays less rowdy.

But Easter and Christmas also became reshaped as domestic holidays because understandings of children were changing. Prior to the 17th century, children were rarely the center of attention. As historian Stephen Nissenbaum writes,

“…children were lumped together with other members of the lower orders in general, especially servants and apprentices – who, not coincidentally, were generally young people themselves.”

From the 17th century onward, there was an increasing recognition of childhood as as time of life that should be joyous, not simply as preparatory for adulthood. This “discovery of childhood” and the doting upon children had profound effects on how Easter was celebrated.

It is at this point in the holiday’s development that Easter eggs and the Easter bunny become especially important. Decorated eggs had been part of the Easter festival at least since medieval times, given the obvious symbolism of new life. A vast amount of folklore surrounds Easter eggs, and in a number of Eastern European countries, the process of decorating them is extremely elaborate. Several Eastern European legends describe eggs turning red (a favorite color for Easter eggs) in connection with the events surrounding Jesus’ death and resurrection.

Yet it was only in the 17th century that a German tradition of an “Easter hare” bringing eggs to good children came to be known. Hares and rabbits had a long association with spring seasonal rituals because of their amazing powers of fertility.

When German immigrants settled in Pennsylvania in the 18th and 19th centuries, they brought this tradition with them. The wild hare also became supplanted by the more docile and domestic rabbit, in another indication of how the focus moved toward children.

As Christians celebrate the festival this spring in commemoration of Jesus’ resurrection, the familiar sights of the Easter bunny and Easter eggs serve as a reminder of the holiday’s very ancient origins outside of the Christian tradition.

This is an updated version of a piece published on March 21, 2018.

Brent Landau, Lecturer in Religious Studies, University of Texas at Austin

This article is republished from The Conversation under a Creative Commons license. Read the original article.