Science and Law: Wong Wai v. Williamson: Why racism makes bad public health policy

September 11, 2016

public health

gavel


WONG WAI v. WILLIAMSON

103 F. 1 (C.C.N.D. Cal. 1900)

The case of Wong Wai in San Francisco presents an interesting opportunity to understand how public health policy can go wrong when it is based on fear and prejudice rather than research and evidence.

Historical Background

In the late 19th century, the California Gold Rush led to an increase of Chinese migrant workers, who were used as cheap labor in gold mining and railroad construction. They were referred to as “coolies,” a mispronunciation of the Chinese word “苦力,” (Pinyin: kūlì) pronounced koo-LI, meaning bitter work. This led to anti-Asian backlash, such as the Chinese Massacre of 1871, where 17 to 20 Chinese men were tortured and hanged in the streets by an angry mob of around 500 white men, who also took the opportunity to loot the local homes and businesses. At the official level, the government passed the Naturalization Act in 1870,  which extended citizenship only to “aliens of African nativity and to persons of African descent,” (source) specifically excluding people of Asian descent, who supposedly would be unable to assimilate into American society. In 1882 President Chester A. Arthur signed the Chinese Exclusion Act, barring virtually all Chinese immigration until its repeal in 1943. This was the first U.S. immigration law targeting a specific race. This was followed by the Scott Act, which prohibited laborers from reentering if they left  the U.S. The end result was that many Chinese families were left separated, with laborers now stuck as permanent aliens, and their families in China unable to join them in the U.S.

It was in this environment that San Francisco introduced a new public health measure that “required persons of Chinese ancestry to undergo inoculation against the bubonic plague by a ‘serum known as ‘Haffkine Prophylactic” and prohibited uninoculated Chinese residents from traveling outside the city.”

The court has been asked to decide whether or not this public health measure is constitutional. But in order to answer this question, we need a rational analysis of the relevant facts to ensure we properly balance individual rights with public safety.

What are the issues involved in the case?

This hits two primary public health issues – compulsory vaccination and involuntary quarantine, but mostly the latter.

The Supreme Court actually ruled only a few years later, in the 1905 case Jacobson v. Massachusetts, that compulsory vaccination itself did not constitute an unacceptable violation of individual autonomy, because of the legitimate government interest in protecting public health.

However, compulsory vaccination itself was not the most important issue. Quarantine constituted a much more concerning threat to the liberty of residents of Chinese descent. The San Francisco Board of Health needed to prove why it was necessary to quarantine people of Chinese descent, and ONLY them, and the logic of restricting them to the city’s confines. Quarantine is an essential public health strategy, but is only acceptable when the government can demonstrate the need for it and apply it in a way that meets public health goals without unnecessarily infringing upon individual liberty.

How did the court analyze this case?

The Circuit Court judges found numerous gaping holes in the logic of the San Francisco public health officials. In their decision, Judge Morrow pointed out that there was a large Chinese ethnic population in the “Chinese Quarter” of the city, and they were not restricted from moving throughout the city, which would be logical if the local authorities were trying to prevent a public health crisis. In fact, the public health board had taken no steps to designate specific neighborhoods or districts as unsanitary or infected.

Furthermore, there was no evidence suggesting that the Chinese population was any more likely to carry, develop, or spread bubonic plague. Non-Asian persons could just as easily introduce disease to the city in a city of around 350,000. Judge Morrow remarked that the regulations were “boldly directed against the Asiatic or Mongolian race as a class, without regard to the previous condition, habits, exposure to the disease, or residence of the individual” and even went as far as to label the regulations as “discrimination” lacking any evidence.

Conclusion and follow-up analysis

The court correctly permitted an injunction, preventing San Francisco from enforcing this discriminatory policy. It was an important victory in a time of prejudice against and persecution of Asian immigrants, and also helped establish important case law precedent demonstrating the restrictions on quarantine as a public health strategy.

This case also shows the importance of a forward-thinking judicial branch that is unswayed by the will of the angry mob. If the court had been as affected as the public by anti-immigrant and anti-Chinese sentiment, they could have easily allowed this kind of discrimination under the flimsy guise of public health. The lessons of this case are in fact not limited to public health policy or East Asians. Modern prejudices against people of Middle Eastern descent and Islamic faith can have an equally harmful influence on public policy.

The important lesson here is that public policy has to be based on scientific facts and evidence, not popular sentiment, fear, and prejudice, if we truly desire to protect the public.

 

See also: Bioethics and Public Health Law by Orentlicher, Bobinski, and Hall

Advertisements
, , , , , ,

About jslachman381

I'm a Yale graduate who majored in History of Science, Medicine, and Public Health.

View all posts by jslachman381

Subscribe

Subscribe to our RSS feed and social profiles to receive updates.

No comments yet.

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s

%d bloggers like this: