Over the past few weeks we’ve had letters to the editor expressing outrage that people opposed to COVID-19 vaccination are refusing the treatment. We’ve also heard from the latter, who complain that an unwanted medical procedure is being all but forced on them.
Some of this airing of views has been expressed in terms that might give offence. Hopefully we can all agree that moderation is more likely to be persuasive.
What follows is our best effort at presenting both sides of this debate, giving due weight to the concerns of each.
Those who wish to refuse vaccination make several points. First, and perhaps most compelling, there is a longstanding principle that before someone is given a medical procedure, their informed consent must first be obtained.
This principle is intended to correct the power imbalance between patients and caregivers. In a hospital setting or a doctor’s office, the latter have enormous power, the former very little.
Informed consent gives patients an equal footing.
Supporting that argument is the concern that if we abandon the need for consent in this instance, where will it end? While this is a slippery-slope argument that can be used against any public policy, it does at least serve to mark out an apparent hypocrisy.
More people die each year from abuse of tobacco and alcohol than do from COVID. Yet our governments not only permit the sale of these products, in the case of alcohol they actively market it.
The reason, of course, is revenue production. But isn’t this double talk?
It’s also argued that COVID vaccines are new on the scene, and as such not adequately field tested. Why should we trust them?
The history of medicine is littered with novel drugs and procedures that later turned out badly. Surely anyone concerned about this has the right of refusal.
And what about people who have health issues that make vaccination unwise. Haven’t they a right to steer clear?
On the other side of the debate, no one disagrees that people with medical problems should be able to refuse vaccination. But this should be verified by a physician, not through poorly sourced hearsay.
Second, it is by no means unheard-of for medical procedures to be imposed without patient consent. Babies at birth are given a series of what are, in effect, mandatory tests looking for rare hereditary disorders.
Public health officers have the authority to order TB patients quarantined if they refuse treatment. In extreme cases, patients with drug-resistant TB may have to spend years of their life in confinement.
Again, it is the law in Canada that persons who are HIV-positive must in certain circumstances disclose that fact to prospective sex partners.
Failure to do so is a criminal act, punishable with up to a life sentence in prison. Canada has one of the highest incarceration rates for this offence in the world.
Certainly this is not strictly a case of forcing someone into a medical procedure, though it is an intrusion on personal privacy.
But more important, it establishes the principle that people may not knowingly act in a manner that puts the health of others at risk.
And that is perhaps the most compelling argument to be made on this side of the debate. People who refuse COVID vaccination are not just putting their own lives at risk. They are endangering the health of others.
These, then, are the arguments on both sides.
Our own view is that, while we acknowledge there is a case against compulsory vaccination, we are bound to say that the health of the community as a whole must come first.
The right to withhold consent is an important right, but like other freedoms, it too has limits.
