In Maryland, get kids shots or go to jail

Last update: November 16, 2007 - 6:21 PM

Two months into the school year, more than 2,000 students in Upper Marlboro, Md., outside the nation's capital, had yet to get the shots they needed to attend class. So the school system decided it was through playing nice.

Parents in Prince George's County have been ordered to appear at a special court hearing today where they will be given a choice: Get their children vaccinated on the spot or risk up to 10 days in jail and fines.

It is one of the strongest efforts made by a U.S. school system to ensure its youngsters receive their shots.

Prince George's County school officials and prosecutors said parents have been duly warned about the need for vaccinations over the past year. They said the goal isn't to throw parents in jail but to protect public health and get kids who have been barred from school back to class. Under Maryland law, parents can obtain exemptions for religious or medical reasons.

"The message is get your kids vaccinated or get an exemption," said Prince George's County State's Attorney Glenn Ivey. "You can't just sit on the fence."

FAT BRITISH PATIENTS DENIED SURGERIES

For two years, Frances Kinley-Manton says, she had arthritis in her hips that was so painful it kept her in a wheelchair. She wanted hip replacement surgery. But doctors at Britain's National Health Service said she was too fat for the operation.

Her doctor told the 210-pound woman to lose about 30 pounds before he would consider her for surgery.

Unable to drop the weight through dieting, the 68-year-old Scotland resident took out a mortgage on her house to pay for a private operation on the Mediterranean island of Malta. She had her first hip operation in July. Now she's awaiting surgery on the other hip.

"I had no alternative," she said from the island. "NHS said they wouldn't operate on me because I'm overweight, but I think they were just trying to keep their costs down." Since the first operation, Kinley-Manton said she's lost about 10 pounds, is walking more and is less dependent on her wheelchair.

Patient advocates say Kinley-Manton is one of a small but possibly growing number of patients being denied nonessential surgeries by British health authorities because of their weight. No statistics exist on how many people are in a similar position, but patients' groups say they are getting a steady stream of complaints.

Doctors say that obese people are at higher risk for surgical complications such as infections and pneumonia, and that asking patients to lose weight is a fair request.

In Britain, some doctors appear to be setting a body mass index of 30 -- considered obese in Britain and the United States -- as an informal cutoff point for elective surgery. In the United States there are no absolute limits, but U.S. doctors seem to be more lenient.

Fat patients have a statistically higher risk for complications for almost any medical procedure.

"In a hip replacement, if the patient is obese, the doctor might not be able to see everything he needs to see," said Dr. Timothy Bhattacharyya, an attending orthopedic surgeon at Massachusetts General Hospital and spokesman for the American Academy of Orthopaedic Surgeons.

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