So, in this sense, vaccination should be an individual choice? This is something which concerns the individual, but has consequences for society as a whole.
Emphatically: YES. Bodily integrity is something that is very high on the list of things that a person should have a say over. Whether they do it because they are mis-informed, dumb, irrational or religious doesn't matter, they still should have the final say over whether or not they get a specific injection or not.
There are many things that concern the individual that have consequences for society as a whole, in fact, it is very hard to point at a single thing that concerns an individual that has absolutely no consequence for society. And many of those things are regulated to benefit society. But your body is yours and yours alone and that's a good thing even if there are negative consequences for society.
Fortunately the anti-vaxxers are a small minority instead of a large majority so the risk is somewhat controllable and fortunately the only people at risk are those that have not been vaccinated yet (a risk that for many diseases is extremely small) so the consequences for society as a whole are manageable.
If that should change dramatically then this should be revisited but for now I'm pretty happy to support this even though I would never apply it to myself or my children (who, ironically, don't get to chose because the argument isn't really framed right, it's not an individual choice but in almost all cases a choice for a parent about their child...). This also ties in with religious freedom, and as an atheist you might find it surprising that I'm a big proponent of that, I don't believe in any of this but I will definitely defend the right of others to believe in whatever they want, including in things that may make them make sub-optimal choices when it comes to their own health or the health of their kids.
If you start to take away those rights you will end up with a very unhealthy society, far more unhealthy (and unhealthy on a different plane) than the society that has to deal with some actual health issues in a small part of their population.
One of my relatives was vaccinated for pertussis, and yet still came down with it one day. Their parent had a hard time convincing the doctors to even test for it because, in their minds, it was no longer an option.
Even later, it came out that the particular vaccine that my relative had been given had a markedly lower effective duration than had been initially advertised.
So even if other entities make all the "safe" choices (presuming they're not immunocompromised or otherwise unable to be vaccinated), disruptions in herd immunity can have problematic consequences.
Loss of herd immunity effects those who have gotten the vaccine as well (especially with vaccines that have more significant failure rates). Choosing to not vaccinate your child and expecting everybody else's children at the public school you send them to to just deal is about more than personal bodily integrity.
As an analogue: if you want to categorize the non-vaccinated person as a 'drunk driver' who is not allowed to partake in traffic then you prioritize (rightly, imo) their choice to be drunk over the risk they pose to the lives and health of others because the chances of causing a serious accident are large enough - and we have the evidence to back that up - that we collectively have decided against people having that particular freedom.
So if that's your argument (which I don't know for sure) you definitely have a point.
The counter point (to that convenient strawman :) ) is that the chances of someone getting ill are not as easy to determine and that that someone might have gotten ill anyway. Cause and effect are a lot more distant in that case and much harder to relate to each other.
This is wishy-washy logic. There are real evidence/data-based scientific studies that show the specific measurable increase in infections of various diseases based on how many members of the population refuse the available vaccines. There have been flare-ups in California with dozens of people becoming infected (and some dying) when herd immunity is lost. This is not hypothetical; it is simply fact. Similarly, it's hard to say whether any individual pack-a-day smoker will die from lung cancer, but we know that, in aggregate, smoking significantly increases your risks of dying from lung cancer, so to make wishy-washy statements attempting to justify smoking as maybe not unhealthy would similarly fall on deaf ears.
And lastly -- this isn't all theoretical. I want you to watch a video of an infant, too young for vaccination, that has contracted whooping cough thanks to failure of herd immunity (i.e. anti-vaxxers). Even with all the benefits of modern medicine there is a good chance that infants like this one that contract whooping cough will die. This is what enabling anti-vaxxers does: https://www.youtube.com/watch?v=S3oZrMGDMMw
There are some pretty basic elements at play here and if you want to over-rule the right to basic bodily integrity you're going to have to do better than to quote statistics.
By that rule we should force everybody to eat healthy, to have an alcohol lock in every car and so on.
Finally your emotional appeal is nothing but the 'think of the children' argument.
Yes, it is a tragedy, no that does not mean that anti-vaxxers should not have the right to do as they please with their own bodies.
Principles only matter when there is a price to pay and in this case that price could very well be my own child. Even so, I still stand by my support of those that decide otherwise because not to do that means giving the state way too much power over our bodies.
Of course they do, but their bodily integrity does not extend to forcing others to give up theirs.
I realize this is a difficult subject because it seems so obvious to people schooled in biology and statistics but the 'greater good' here is that we have a society where you get to make that choice. That there is a price to pay for that is something that right now a majority of the non-scientifically trained people feels is a trade-off worth making.
Freedoms always carry a price, and in some cases that means that people die. Those can be old people, young people or people somewhere in the middle but it is unavoidable.
From a purely rational perspective this may not make sense to you but people are not purely rational beings, they tend to feel they should have a right to say 'no' to someone that wants to stick a needle in their arm for 'the greater good'.
The only way I see to solve this is to encourage education and to hope for informed consent, not force.
Anti-vaxxers for the most part are people that have been duped either by religion or by fear mongering that vaccinations are bad, this makes it an education issue, not an our-way-or-the-highway issue.
For example, in my country there are mandatory check-ups for children every couple years, which include a baseline of vaccination unless opted out. There are also mandatory check-ups conducted in schools (IIRC teeth and also vaccination - interdisciplinary, so to speak).
Remember that this set includes people that cannot receive the vaccine because of e.g autoimmune disorders, serious allergic reactions, etc. These people need the herd immunity to keep the general risk of infection low. As long as the number of anti-vaxxers is very small, they similarly benefit from the herd immunity as "free riders".
Once the number of free riders crosses a threshold[1], non-linear effects can rapidly amplify the spread of the disease among the population. Preventing any disease from gaining a "critical mass" in the population is an important part of how they work.
> Fortunately the anti-vaxxers are a small minority
Unfortunately that isn't really true in some areas.[2]
> so the consequences for society as a whole are manageable.
That management has already started to fail in CA (and other areas), where the rapid decrease in vaccination rates cause measles and whooping cough outbreaks[3].
[1] https://en.wikipedia.org/wiki/Herd_immunity#Mechanism
[2] https://www.cdc.gov/mmwr/preview/mmwrhtml/mm6341a1.htm?s_cid...
[3] https://www.advisory.com/daily-briefing/2014/09/30/in-wealth...
I believe that that line is drawn pretty accurately at the moment, there is a strong push towards vaccination, there is education and there are all kinds of programs to make sure it happens. And yet we can not force this onto people that don't want it. I'm sure that there are plenty of people that would rather see this resolved 'for the greater good', I'm just not one of those people and I feel quite strongly about this even if it is a right I myself would never make use of because I disagree with the basic premises of those that want it that way.
But I recognize their rights and will defend them.
No, vaccines are not 100% effective. For example, the H3N3 vaccine was 90% effective[1]. So the only people at risk are those not yet vaccinated...and an additional 10% of the people who did get the vaccine.
Also, as noted in another reply, many, many people can't get vaccinated and rely on those of us who can to not be spreading the disease around. You can't vaccinate a newborn, for example.
There's a lot of value in bodily autonomy, and it's definitely questionable to mandate vaccines, but that has to be weighed against the costs, and that requires understanding and honestly acknowledging the costs.
That's hardly the fault of the people who didn't get vaccinated.
> Also, as noted in another reply, many, many people can't get vaccinated and rely on those of us who can to not be spreading the disease around.
True
> You can't vaccinate a newborn, for example.
Also true, I'm painfully aware of that one.
> There's a lot of value in bodily autonomy, and it's definitely questionable to mandate vaccines, but that has to be weighed against the costs, and that requires understanding and honestly acknowledging the costs.
Yes again. This also includes honestly looking at the other side of the argument: if you want science rather than regular imprecise human reasoning to take over at all levels of society you will end up with a society where freedom of religion and all kinds of other goodies that we have come to agree are good for all of us are going to be thrown out.
I would rather see steps in that direction come about by consent than by force. We're all so tremendously fanatical about protecting life, at the same time those abortion clinic bombers claim they are doing the exact same thing.
Extremist positions (such as the anti-vaxxers) are not going to yield because of a push by force-majeure. The only way you're going to get such a position to be changed is by endless education and information so that finally, hopefully soon but better later than never people will decide that this is for the best of their kids.
And if they don't then all you'll end up doing is alienating that part of society even further from reason and that's the last thing you want.
Science is a good thing, let's not make it seem as though it is perfect and let's not repeat the exact same mistakes that religions perform over and over again, such as deciding how others should live their lives. The miracles of modern medicine are large enough that they can speak for themselves and over a long enough time-span the anti-vaxxers movement will be just another blip.
But if you start to push back you are only making it bigger, better to respect their right to make the wrong decisions than to force them creating even more resentment and ill-will.
> Science is a good thing, let's not make it seem as though it is perfect
Uh....I want our decisions to be based on evidence. Science is not a moral theory, and I'm not pretending it is, but it our most reliable source of empirical data. Science never says "you should do X", so you don't have to worry about that. It only says "Best data available says that doing X will result in in Y with probability P".
> But if you start to push back you are only making it bigger, better to respect their right to make the wrong decisions than to force them creating even more resentment and ill-will.
I'm all for a pragmatic, effective approach to getting people to vaccinate, and I want one that balances people's rights. I also agreed that turning the issue into a culture war is counter-productive.
At the same time, I want to get people to vaccinate, and while I won't hold them down and jab a needle in their arm to do it, I am in favor of doing what we can to effectively get them to vaccinate.
Anecdote: I have a friend who got sick during the Ebola scare, and had recently been in [an Ebola-free country in] Africa, so the police came by and forced her to go to the hospital where they determined she didn't have Ebola and sent her a bill. Which she had to pay.
I'd argue that forcing her to go to the hospital was reasonable (or would have been if it hadn't been predicated on the idea that "Africa" is one homogenous place full of Ebola), but that charging her for it was not. I think we as a society have the right to demand people with serious contagious diseases be quarantined and receive treatment, and that we as a society should pay for that.
I assume that at least if she had Ebola, you'd agree with overriding her bodily autonomy for a forced quarantine. That's further on the freedom end of the "bodily autonomy vs. societal well-being" scale than I'm on, but still one that recognizes the trade-offs and makes a thoughtful, pragmatic balance rather than holding one goal, bodily-autonomy, as completely outweighing the other.
I don't actually know if you'd agree with the forced quarantine, but I'm making the assumption that, like most everybody, you agree that the trade-off is sometimes worthwhile.
With vaccines you absolutely reasonably take the stance that requiring them is the wrong balance, but you seem to be arguing as if even evaluating the cost-benefit is wrong--at least judging by your initial post. "But your body is yours and yours alone and that's a good thing even if there are negative consequences for society."
It's hard to draw a line about where the balance lies, and it feels more principled to say "value X always outweighs value Y", but very, very few people are willing to take the hard stance. Instead they take the hard stance where they've drawn the line, and pretend that's the non-arbitrary line, dismissing the reductio as "well, yes, in that example it's obvious".
Are you willing to actually go with "bodily autonomy trumps societal consequences in every situation"? Or are you striking a balance? Because if you're striking a balance, the debate has to be about where the balance lies, not just "bodily autonomy uber alles". And that requires--in addition to moral beliefs--using empirical data ("science") about what the costs and benefits are.
But we don't live in societies ruled by scientists, as much as we would like. And it's not as if scientists are perfect either, they have their own shortcomings, both individually and as a group.
> Science is not a moral theory, and I'm not pretending it is, but it our most reliable source of empirical data.
Yes, so consider it a failure of communication that not everybody sees it that way. And it's up to the scientists to figure out better ways of communication. It's a sales job.
> Science never says "you should do X", so you don't have to worry about that. It only says "Best data available says that doing X will result in in Y with probability P".
Yes, but by the first press release that will already have been changed into 'you should do X or terrible thing Y will happen'.
And that's not even getting into those scientists who let themselves be harnessed into doing active wrong.
So scientists are not above doubt and would do well to remember that the vote of an anti-vaxxer counts for just as much as the vote of an MIT graduate and that the latter are likely in the minority. So you have to at least try to figure out a way to bridge the gap if you want the problem to be solved.
> I'm all for a pragmatic, effective approach to getting people to vaccinate, and I want one that balances people's rights. I also agreed that turning the issue into a culture war is counter-productive.
> At the same time, I want to get people to vaccinate, and while I won't hold them down and jab a needle in their arm to do it, I am in favor of doing what we can to effectively get them to vaccinate.
So, what would you do other than what we do today?
> Anecdote: I have a friend who got sick during the Ebola scare, and had recently been in [an Ebola-free country in] Africa, so the police came by and forced her to go to the hospital where they determined she didn't have Ebola and sent her a bill. Which she had to pay.
> I'd argue that forcing her to go to the hospital was reasonable (or would have been if it hadn't been predicated on the idea that "Africa" is one homogenous place full of Ebola), but that charging her for it was not.
Agreed on all counts.
> I think we as a society have the right to demand people with serious contagious diseases be quarantined and receive treatment, and that we as a society should pay for that.
Yes.
But vaccination against diseases that are endemic and that have far lower incidence rates, mortality and so on are a different thing than ebola, which has a quality all its own. Also, visiting a country with an elevated risk was a decision made of free will whereas being born is not.
> I assume that at least if she had Ebola, you'd agree with overriding her bodily autonomy for a forced quarantine.
I do.
> That's further on the freedom end of the "bodily autonomy vs. societal well-being" scale than I'm on, but still one that recognizes the trade-offs and makes a thoughtful, pragmatic balance rather than holding one goal, bodily-autonomy, as completely outweighing the other.
Yes. And it is also roughly where society is at these days.
> I don't actually know if you'd agree with the forced quarantine, but I'm making the assumption that, like most everybody, you agree that the trade-off is sometimes worthwhile.
I do.
> With vaccines you absolutely reasonably take the stance that requiring them is the wrong balance, but you seem to be arguing as if even evaluating the cost-benefit is wrong--at least judging by your initial post. "But your body is yours and yours alone and that's a good thing even if there are negative consequences for society."
In principle yes, I think that is a very high bar to cross and there should be an extremely carefully laid out argument if you want to cross that line. And we do have mechanisms for that if it is so required up to and including placing children in foster care if their parents do not take proper care of them.
But such a maneuver should always carry the signature of a judge.
> It's hard to draw a line about where the balance lies, and it feels more principled to say "value X always outweighs value Y", but very, very few people are willing to take the hard stance. Instead they take the hard stance where they've drawn the line, and pretend that's the non-arbitrary line, dismissing the reductio as "well, yes, in that example it's obvious".
It's never simple. But I'm comfortable with hard lines being drawn and judges being allowed to cross those lines at their discretion. That's enough of a safeguard for me.
> Are you willing to actually go with "bodily autonomy trumps societal consequences in every situation"?
Yes, unless a judge overrules that.
> Or are you striking a balance?
I think that's balanced enough because it allows evaluation on a case-by-case basis whilst erring on the side of caution and giving maximum power to the individual as long as they are capable of taking the responsibility for that power. Just like we are able to commit people to mental institutions against their will and without their consent but only after a very thorough look at the case.
> Because if you're striking a balance, the debate has to be about where the balance lies, not just "bodily autonomy uber alles".
No, but it's a good default.
> And that requires--in addition to moral beliefs--using empirical data ("science") about what the costs and benefits are.
Obviously, and the empirical data so far does not warrant a de-facto 'vaccinate or be relieved of your parental duties' regime. It may come to that but for now we don't have it and there are all kinds of options that should be maxed out first before we'd let it get that far.
It's funny, I wonder how the debate would go if the choice were a life ending injection because of the cost to society instead of a life-saving injection at the beginning to statistically expand your life-span.
I'm pretty sure a lot of the people arguing for vaccination would switch sides to 'bodily integrity' in an eye-blink.