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02/04/2015

The Unbearable Rightness of Handwashing

by Nanette Elster, JD, MPH and Kayhan Parsi, JD, PhD

You may have seen at your doctor’s office a poster showing a climber scaling a sheer cliff. Purportedly a public service ad (PSA), the casual viewer would assume that the poster is warning against the dangers of climbing. In fact, the poster warns people about the danger of not using sunscreen. The ad cleverly upends our typical perception of risk (that climbing is dangerous) with a much more pedestrian but even greater risk (getting skin cancer from too much sun). Have we gotten to the point that we need a similarly provocative PSA telling us of the health benefits of washing hands?

According to the Centers for Disease Control (CDC), “Clean hands save lives.”  The World Health Organization (WHO), states that “Clean hands protect against infection.”   Maybe this recent poster by the CDC makes the message more impactful: “One trillion germs can live in one gram of poop. (That’s the weight of a paper clip)” Shouldn’t that be enough to convince anyone that restaurant workers should have clean hands if they are handling the food we eat?  Not according to Sen. Thom Tillis (R. N.C.) who was recently speaking about his opposition to too much government regulation.  He said:  “I don’t have any problem with Starbucks if they choose to opt out of this policy as long as they post a sign that says we don’t require our employees to wash their hands after leaving the restroom. The market will take care of that.”  Upon hearing this, one could mistakenly believe this was a story from the Onion. Unfortunately, it’s not. While we need not debate the fact that the requirement to post a sign is in itself a regulation, we can, more, importantly discuss the basics of hand hygiene, not to mention common sense and common courtesy.

Is hand washing that onerous that every person should run the risk of contracting E-Coli, Hepatitis A or the flu each and every time he or she chooses to grab a cup of coffee or enjoy a meal out?  The Tenth Amendment gives the states wide latitude through police powers to “protect the health and welfare of the citizenry.” While some may argue that the State is not required to protect the health and welfare of the citizenry, others will argue that this is exactly what is required under the Fourteenth Amendment.

With regard to basic hygiene, the evidence seems clear–handwashing is effective in stopping the spread of communicable disease.  The CDC is crystal clear about this—handwashing saves lives. Simply put, handwashing:

Handwashing hygiene is a practice that greatly reduces the burden of infectious diseases. Why would any responsible official believe that this is something best left to the free market? Does our animosity to government regulation really extend to regulations that are sensible, beneficial and pose little to no burden?

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