4 ms·

I'm missing the arguments for why any of these guidelines are supposedly ethical. The implication of these are that a handful of individual's rights to refuse e

I'm missing the arguments for why any of these guidelines are supposedly ethical. The implication of these are that a handful of individual's rights to refuse e.g. vaccines is appropriately balanced against a potentially huge loss of life and societal disruption. I guess it depends on what system of ethics one goes by. If one believes that you should NEVER force someone to do something against their will and accept the losses as unfortunate but preferable to life under "oppression" this might be defended as ethical. I think that from a principle of least harm, forcing people to get vaccines is not too difficult to justify, however.

photochemsyn 4y ago
A major assumption in the 'principle of least harm' on forcing people to get vaccines is that the vaccines are well-characterized in terms of efficacy and side-effects. In the case of the smallpox vaccine, it was a sterilizing vaccine (i.e. there were zero breakthrough cases post-vaccination as far as I know, so it could be used to effectively eliminate the virus from human populations), and the side-effects, though quite severe in some cases (far more than anything reported with Covid vaccines as far as I know), were well-characterized. For example: Inoculation with vaccinia virus is highly effective for the prevention of smallpox infection, but it is associated with several known side effects that range from mild and self-limited to severe and life-threatening. (2003) "Smallpox Vaccine: The Good, the Bad, and the Ugly" http://www.clinmedres.org/content/1/2/87.short http://www.clinmedres.org/content/1/2/87.short The Covid vaccines are uniformly non-sterilizing, i.e. breakthrough cases are common, even apparently the norm (this may be due to rapid evolution of new virus strains relative to older clinical trials) and the side effects seem to be relatively poorly characterized (heart issues with young adults? fact or fiction?). Hence, glowing stories like this Nov 2020 report on the Moderna vaccine might need some reconsideration: https://www.science.org/content/article/absolutely-remarkable-no-one-who-got-modernas-vaccine-trial-developed-severe-covid-19 https://www.science.org/content/article/absolutely-remarkabl... One could argue, at this point, that a Covid vaccination is really only net beneficial to the elderly, obese and immunocompromised (comparable arguments have been made for the influenza vaccine). One could also argue that for-profit pharmaceutical corporations (who have refused to release patent rights to other manufacturers, which would drive down costs) have large conflicts of interest relative to their desire to maximize profits by pushing vaccination on those for whom it serves no beneficial purpose.
- dcanelhas 4y ago
  These guidelines aren't specific to COVID though, and they are not conditioned upon any projected efficacy or disease severity. They are laid out as a matter of principle, valid even assuming, say a 90% fatal disease and a 90% effective vaccine with only minor side-effects.
  - DuskStar 4y ago
    There's two general reasons for a person to get a vaccine. One is that it makes them healthier, and the other is that it makes society healthier. If the person gets to choose, then there's a natural counterbalance against things that are harmful to the person but good for society. Only an idiot would turn down a vaccine that has a 90% chance of saving their life. If society gets to choose, then forcibly sterilizing poor single mothers/disabled people /those of poor breeding/etc might be on the table again. (It's a health intervention that is bad for the individual but also leads to a healthier next generation)
    - deleted 4y ago
      [deleted]
    - maxerickson 4y ago
      Vaccines generally don't make you healthier, they protect you from potential illness (so you keep a baseline in the future rather than increasing). Forcible vaccination is bad, but I think it's hard to start from freedom of association and then argue that a vaccinated majority can't choose to exclude unvaccinated people from things. This is society choosing, but the consequence isn't forced vaccination, it's telling the unvaccinated "good luck, stay away from here".
- HIveMIND0LogIsT 4y ago
  >One could argue, at this point, that a Covid vaccination is really only net beneficial to the elderly, obese and immunocompromised Maybe, maybe not "The Incidence and Effect of Adverse Events Due to COVID-19 Vaccines on Breakthrough Infections: Decentralized Observational Study With Underrepresented Groups" https://formative.jmir.org/2022/11/e41914 https://formative.jmir.org/2022/11/e41914
peteradio 4y ago
> forcing people to get vaccines Does it not depend on the vaccine? What if instead we had a therapeutic which shortened an individuals infectious period, would you also feel comfortable forcing that? What if the disease in question disproportionately affected group A but not group B, would you also feel comfortable forcing that vaccine upon group B?
osigurdson 4y ago
This is getting close to the core inflection point. The question is, where do these ethics systems come from? Why do some people value collectivism over individualism and vice versa? These beliefs seem to be deeply held and very hard to change.

photochemsyn 4y ago

A major assumption in the 'principle of least harm' on forcing people to get vaccines is that the vaccines are well-characterized in terms of efficacy and side-effects. In the case of the smallpox vaccine, it was a sterilizing vaccine (i.e. there were zero breakthrough cases post-vaccination as far as I know, so it could be used to effectively eliminate the virus from human populations), and the side-effects, though quite severe in some cases (far more than anything reported with Covid vaccines as far as I know), were well-characterized. For example: Inoculation with vaccinia virus is highly effective for the prevention of smallpox infection, but it is associated with several known side effects that range from mild and self-limited to severe and life-threatening. (2003) "Smallpox Vaccine: The Good, the Bad, and the Ugly" http://www.clinmedres.org/content/1/2/87.short http://www.clinmedres.org/content/1/2/87.short The Covid vaccines are uniformly non-sterilizing, i.e. breakthrough cases are common, even apparently the norm (this may be due to rapid evolution of new virus strains relative to older clinical trials) and the side effects seem to be relatively poorly characterized (heart issues with young adults? fact or fiction?). Hence, glowing stories like this Nov 2020 report on the Moderna vaccine might need some reconsideration: https://www.science.org/content/article/absolutely-remarkable-no-one-who-got-modernas-vaccine-trial-developed-severe-covid-19 https://www.science.org/content/article/absolutely-remarkabl... One could argue, at this point, that a Covid vaccination is really only net beneficial to the elderly, obese and immunocompromised (comparable arguments have been made for the influenza vaccine). One could also argue that for-profit pharmaceutical corporations (who have refused to release patent rights to other manufacturers, which would drive down costs) have large conflicts of interest relative to their desire to maximize profits by pushing vaccination on those for whom it serves no beneficial purpose.

dcanelhas 4y ago
These guidelines aren't specific to COVID though, and they are not conditioned upon any projected efficacy or disease severity. They are laid out as a matter of principle, valid even assuming, say a 90% fatal disease and a 90% effective vaccine with only minor side-effects.
- DuskStar 4y ago
  There's two general reasons for a person to get a vaccine. One is that it makes them healthier, and the other is that it makes society healthier. If the person gets to choose, then there's a natural counterbalance against things that are harmful to the person but good for society. Only an idiot would turn down a vaccine that has a 90% chance of saving their life. If society gets to choose, then forcibly sterilizing poor single mothers/disabled people /those of poor breeding/etc might be on the table again. (It's a health intervention that is bad for the individual but also leads to a healthier next generation)
  - deleted 4y ago
    [deleted]
  - maxerickson 4y ago
    Vaccines generally don't make you healthier, they protect you from potential illness (so you keep a baseline in the future rather than increasing). Forcible vaccination is bad, but I think it's hard to start from freedom of association and then argue that a vaccinated majority can't choose to exclude unvaccinated people from things. This is society choosing, but the consequence isn't forced vaccination, it's telling the unvaccinated "good luck, stay away from here".
HIveMIND0LogIsT 4y ago
>One could argue, at this point, that a Covid vaccination is really only net beneficial to the elderly, obese and immunocompromised Maybe, maybe not "The Incidence and Effect of Adverse Events Due to COVID-19 Vaccines on Breakthrough Infections: Decentralized Observational Study With Underrepresented Groups" https://formative.jmir.org/2022/11/e41914 https://formative.jmir.org/2022/11/e41914

peteradio 4y ago

> forcing people to get vaccines Does it not depend on the vaccine? What if instead we had a therapeutic which shortened an individuals infectious period, would you also feel comfortable forcing that? What if the disease in question disproportionately affected group A but not group B, would you also feel comfortable forcing that vaccine upon group B?

osigurdson 4y ago

This is getting close to the core inflection point. The question is, where do these ethics systems come from? Why do some people value collectivism over individualism and vice versa? These beliefs seem to be deeply held and very hard to change.