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AdminLawFinalPaperPowerpoint.pptx
Integrating Values – The Legality, Morality, and Community Welfare of Florida
Surgeon General’s Controversial Public Health Regulations
Roodberly C Etienne
Nova Southeastern University
Admin Law & Ethics in Pub Sec
February 27, 2025
Abstract
This paper analyzes the recent public health rules the Florida Surgeon General issued, which have generated substantial controversy across the state (Florida Health, 2022).
It also investigates the legislative underpinnings and the moral and societal implications of these policies while focusing on the ban that recommends rejecting vaccinations for children.
These decisions are evaluated through legal analysis, stakeholder considerations, and policy considerations.
It also evaluates the possible impact or social consequences of these policies on public confidence in health institutions and the threats to vulnerable groups.
Introduction
The paper analyses Florida Surgeon, Joseph Ladapo general recommendations about COVID-19 vaccines.
This discussion uses a “3-dimensional” approach to consider the legal, ethical, and community consequences of these recommendations, particularly his stance on mRNA COVID-19 vaccines.
Ladapo, heads the FDOH, and has expressed doubts about mRNA vaccines, which include DNA fragments and extended mRNA circulation, lower respiratory tract infection risks, and autoimmune diseases (Florida Health. 2022).
These concerns have been disputed directly by the FDA and CDC citing their scientific and regulatory practices to significantly reduce vaccine lethality while asserting that data strongly suggests the COVID-19 vaccines’ efficacy in preventing severe cases of COVID-19.
Significance of the research
The position of the Florida Surgeon General is essential for several reasons.
First, it goes against the grain of scientific and medical communities, and if this type of information is promoted, it can lead to the erosion of public confidence in public health organizations (Florida Health, 2022).
Second, the recommendations can directly affect health behaviors and vaccination, predisposing specific populations to severe COVID-19 illness and fatalities.
Third, it poses several concerns about the scientific and political roles of state health departments, particularly with respect to translating scientific evidence into actionable policy recommendations.
Lastly, these recommendations' legal and ethical implications reflect the tension between patient self-governance and state mandate in the interest of public well-being.
Background
The Florida Department of Health (FDOH) is a governmental organization whose primary role is to safeguard the citizens and visitors of Florida1.
The FDOH was created in 1996 (Florida Health. 2022).
The department currently oversees county health departments in all of the 67 counties in the state of Florida (Florida Health. 2022).
FDOH performs various functions that include epidemiology, food borne diseases investigation, disaster response, communicable diseases regulation, health promotion and education, women health, public health dentistry nutrition, immunization, environmental health and medical quality assurance.
Currently, Dr. Joseph Ladapo serves as the state surgeon and the health officer for the state of Florida (Florida Health. 2022).
The FDOH issued guidelines in December 2021 against the COVID-19 mRNA vaccines, stating that the risks of getting vaccinated outweigh the benefits for children and young adults.
On January 3, 2024, Ladapo urged a ban on the use of mRNA COVID-19 vaccines across Florida.
Introduction Legal Section
The legal foundation for the FDOH is found in Chapter 20.43 of the Florida Statutes.
This chapter grants the FDOH its legal identity, allowing it to establish an organizational structure and clarifying its official functions.
For example, Section 20.43 emphasizes the authority to lead and oversee public health policies and designates the Florida Surgeon General as the agency's chief official. This enabling legislation is crucial as it delineates the scope of the FDOH’s powers.
Administrative agencies work through rule making or through adjudication.
Rulemaking is the process of establishing broad norms that apply across the board across a large number of cases concerning a large number of people or entities.
Adjudication deals with individual Legal relationships between parties involved in a dispute are definitive in determining their legal rights and obligations.
B. Statement of Relevant Legal Principles and Rules of Law
Publication and Notice:
An official press release by the Florida Department of Health (FDOH), released on March 7, 2023, formally opposes the covid-19 vaccinations for children.. Link:
https://www.floridahealth.gov/newsroom/2023/03/20230307-updated-health-alert.pr.html
This is a method of giving public notice is the FDOH’s best approach for getting its message out and driving changes in people’s behavior in relation to vaccines.
Due Process Challenges:
The Florida Department of Health (FDOH) recommends that its actions be treated as administrative measures, which are subject to both procedural and substantive due process scrutiny.
Procedural due process ensures that anyone whose life, liberty, or property is affected by the government is treated fairly by receiving proper notice and an opportunity to be heard.
The equal protection clause guarantees that all individuals are entitled to equal protection under the law; no rights can be violated by the government without a compelling state interest and appropriate means.
Litigation
Although direct legal challenges to the FDOH COVID-19 vaccine recommendations have not occurred, tensions increased significantly when the policies received outspoken criticism from health organizations and pediatricians, such as the American Academy of Pediatrics (AAP) (La Forgia et al., 2021).
III. Ethics Section
A. Introduction to the Ethical Section
Law is defined as the principles and standards of conduct established by a state and enforced by its institutions.
Ethics refers to the principles and standards relevant to decision-making and actions, regardless of legal consequences.
Government administrators are expected to observe higher ethical standards than general business managers for several reasons.
To protect and promote public welfare.
Second, they have access to more sensitive information and organizational resources and, therefore, must exercise more responsibility (Cobianchi et al., 2022).
Finally, their actions may affect the welfare of others in society, making ethical evaluation crucial in decision-making processes.
Legal positivism is a philosophy that postulates that law and morality have different domains. Under this theory, the Florida Surgeon General's recommendations against mRNA COVID-19 vaccines are justiciable and ethical if they are made legal and lawful (Jain et al., 2021).
While Legal positivism helps establish legal rationality, it fails to consider ethical reasoning as the foundation for public policies.
III. Ethics Section
B. Utilitarianism and Stakeholder Analysis of FDOH Vaccine Recommendations
Utilitarianism is a moral theory that asserts an action is right to the extent that it can generate the greatest happiness for the largest number of people (Cobianchi et al., 2022).
In the context of FDOH’s advisory against mRNA COVID-19 vaccines, a utilitarian evaluation must weigh the benefits of mRNA COVID-19 vaccines for all stakeholders involved.
According to utilitarian theory, an action is moral if it enhances the general welfare of society
The consequences of higher infection rates, increased complications, strained healthcare capacity, indecision among parents, and the erosion of public health measures do not justify compliance with certain political agendas or a preference for autonomy regarding medical choices (Tseng & Wang, 2021).
The policy entails several negative impacts while providing minimal benefits to other stakeholders in the equation
III. Ethics Section
PART C: Ethical theory of choice
Ethical egoism is an ethical theory that prescribes actions that are good and right are those that serve an individual’s self interest (Tilley, 2023).
This theory states that for any action to be deemed right, people should perform activities that are in the interest of everyone.
Ethical egoism is a theory that claims that selfishness should be the driving rule in exercising free will while not necessarily being wholly self-serving.
Ethical egoism suggest that people act rationally to choose actions that yield a net benefit to an individual.
In ethical egoism, regulations become unethical when they severely limit people’s freedom and/or impose a lot of responsibilities on them that would hinder self-actualization.
The ethical nature of a regulation depends on the extent to which the people who are in a position to enforce and benefit from the rule maximize the benefit from the rule.
III. Ethics Section
Part D. Personal Ethical Assessment of the FDOH’s Recommendations
The FDOH guidelines on the VTO and advice against mRNA vaccines, especially for children and youths, are unethical.
This puts political interests and ideological positioning above the welfare, especially of people in the population who are vulnerable (Cobianchi et al., 2022).
Some potential increased risks during an outbreak for the people at risk include severe illness, long-term health effects, and even death.
Additionally, the erosion of public trust in health institutions and the circulation of fake news weakens the basis for efficient and effective public health policy. .
Thus, the FDOH’s recommendations against mRNA COVID-19 vaccines can be considered unethical given the harm done to people, the denial of scientific evidence, and the rampant mistrust.
Recommendations
According to Cobianchi et al. (2022) a more ethical approach would entail adherence to evidence-based practice, safeguarding of vulnerable groups, and clear communication.
Government agencies must ensure that they base their decisions on research instead of succumbing to politically driven decisions
IV. Community Welfare Section
A. Social Policies and Administrative Agencies
According to Crash Course (2017) social policies are broadly defined as government measures by various political structures at central, state and local levels aimed at improving the quality of life in the society.
Such strategies are intended to promote positive shifts in the quality of citizens’ lives due to programs, rules, and other measures.
Some of the U.S. federal social policies are Medicare and Medicaid initiated in 1965 aimed at healthcare for aged and poor persons, and the Affordable Care Act of 2010 aimed at health insurance coverage and healthcare quality,
IV. Community Welfare Section
B. What ‘social policy’ does your administrative agency’s rule, regulation, or action advance?
While FDOH publicly advocates for the right to refuse mRNA COVID-19 vaccines and ensure the rights of parents to make decisions concerning their children, it ultimately undermines important public health initiatives.
There is an unspoken ‘social policy’ at play, where the state is going against federal and scientific norms and even the CDC and FDA (Crash Course 2017).
While these recommendations may appear to promote autonomy of those who wish to make decisions consistent with their beliefs and values, it erodes the public’s confidence in medical practices and can lead to parents making decisions that endanger the lives of their children (Jain et al., 2021).
Some of the concerns of our FDOH may be, to what extent it is a genuine commitment to the principles of individual liberty — or a way to achieve an ulterior government agenda.
IV. Community Welfare Section
C. Community Welfare Recommendations by the FDOH
Those who endorse FDOH’s recommendations against mRNA covid-19 vaccines base their decision on autonomy and the aspiration to avoid even remote adverse effects.
Low vaccination levels increase COVID-19 risks for the population, including the elevated rates of infection, higher admission to healthcare facilities, and increased deaths.
This would stretch our healthcare capacity, thus putting more pressure on the system and making it costly for individuals, families, and the health system as a whole.
The mixed messages from state and federal health departments creates a confusion and mistrust, and any reinforcement of the FDOH guidelines can cause people to question the authorities and experts in the future.
While this action may serve the political objective of the state government and offer authority and autonomy to people who desire to make personal decisions based on their beliefs and values, the effects associated with these meddlesome elements render the regulation inconsequential and problematic to the community and the whole healthcare system (Crash Course 2017).
IV. Community Welfare Section
D. Community Welfare Recommendations
To address the limitations in the Covid-19 mRNA vaccines recommendations, the following general and specific recommendations should be made:
The FDOH must ensure its vaccination policy is consistent with that of the CDC and provide the public with clear, evidence-based information.
To enhance community welfare and empower parents to make informed decisions regarding vaccinations, the FDOH regulation should be redrafted with a focus on balanced information and community engagement.
As part of its public health, outreach program the FDOH should use funding to organize civic meetings across Florida as well as maintain a well-developed website. The events will need to have medical experts, scientists, and public health officials who present different perspectives regarding COVID-19 vaccines..
The FDOH should also create accessible educational resources and distribute them to the public which present both risks and benefits of COVID-19 vaccines in a balanced manner (Florida Health. 2022).
The FDOH needs to work together with healthcare providers to guarantee their constant access to updated COVID-19 vaccine information and their capability to deliver unprejudiced patient counselling (Florida Health. 2022).
IV. Community Welfare Section
E. Community Welfare Conclusion
This section suggests that the DOH’s measures against mRNA COVID-19 vaccines, despite advocating for medical liberty, is a threat to community wellbeing (Florida Health. 2022).
The negative outcomes include the incidence and spread of diseases, overloading of healthcare facilities, and deterioration of confidence in medical services (Jain et al., 2021).
To better serve the welfare of the communities and meet the obligations of public health, the FDOH needs to adopt the following recommendations:
The need for evidence-based decision making,
The need to address vaccine information dissemination and community health misconceptions, and
The need to engage federal policymakers and medical professionals.
The FDOH must strike a balance between preserving the autonomy of the people it serves and meeting its goal to protect as many people in the state of Florida as possible from life-threatening diseases.
V. Conclusion
A Restatement of Major "3 Value" Conclusions.
Based on the a “3-value model", this paper reveals significant legal, ethical, and community welfare concerns stemming from the Florida Department of Health's (FDOH) controversial recommendations against mRNA COVID-19 vaccines, particularly for children and young adults.
Despite lacking formal rulemaking procedures, FDOH publicized its position through press releases, leaving the issue of procedural due process particularly the provision of adequate public notice and participation in question.
The recommendations are unethical from a utilitarian approach and from a personal ethical viewpoint as well.
In the context of utilitarianism, the benefits of supporting individual liberty and free choice in medical matters are overshadowed by the adverse consequences for public health, such as the more widespread spread of infectious diseases and the burden on healthcare facilities.
This perspective is consistent with my ethical analysis where the FDOH has prioritized political objectives over the moral responsibility of implementing effective interventions for vulnerable populations.
Additionally, in terms of public health benefit, the policy negatively impacts the overall population trends as well, eradicating the possibility of a healthy society due to declined vaccination rates.
V. Conclusion
B. Overall Conclusions, Personal Opinions, Recommendations, and Predictions
Overall, the FDOH's recommendations represent a concerning deviation from evidence-based public health practices, potentially jeopardizing the health and well-being of Floridians and eroding public trust in health institutions.
The FDOH, led by Dr. Ladapo, has expressed safety and efficacy concerns regarding the mRNA vaccines.
In future, the FDOH needs to stick to scientific protocols, use more effective communication techniques to counter vaccine misinformation and partnerships with federal agencies and other stakeholders and the medical profession.
If no changes are made soon, the public will continue to lose confidence in health-related organizations, and further health emergencies may occur in the state unnecessarily.
Taking into consideration the Surgeon General’s approach, there is need to restore the generation of objective, transparent and evidence-based policies that can safeguard the Florida people’s health and trust in health governance.
References
Cobianchi, L., Verde, J. M., Loftus, T. J., Piccolo, D., Dal Mas, F., Mascagni, P., ... & Kaafarani, H. M. (2022). Artificial intelligence and surgery: ethical dilemmas and open issues. Journal of the American College of Surgeons, 235(2), 268-
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Crash Course. (2017). Social Policy: Crash Course Government and Politics #49. In
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Florida Health. (2022). Florida Department of Health. Www.floridahealth.gov.https://
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Jain, V., Schwarz, L., & Lorgelly, P. (2021). A rapid review of COVID-19 vaccine prioritization in the US: alignment between federal guidance and state practice. International journal of environmental research and public health, 18(7), 3483.
https://www.mdpi.com/1660-4601/18/7/3483
La Forgia, A., Bond, A. M., Braun, R. T., Kjaer, K., Zhang, M., & Casalino, L. P. (2021). Association of surprise-billing legislation with prices paid to in-network and out-of- network anesthesiologists in California, Florida, and New York: an economic analysis. JAMA Internal Medicine, 181(10), 1324- 1331.
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Rubin, R. (2022). When physicians spread unscientific information about COVID-
Tilley, J. J. (2023). On deducing ethical egoism from psychological egoism. Theoria, 89(1), 14-30.
Tseng, P. E., & Wang, Y. H. (2021). Deontological or utilitarian? An eternal ethical dilemma in outbreak. International journal of environmental research and public health, 18(16), 8565.
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