I’ve been seeing an awful lot of copyright violations on this blog lately. First two Sinfests, and now an unattributed Cectic (which is licensed CC, but requires attribution). If you got permission, PZ, please say so.
birgerjohanssonsays
Do this on Darth Cheney, please.
tbp1says
I ALMOST wish doctors would do this.
I’ve always said–not seriously I hasten to add–that if I were a firefighter, lifeguard, or just a good Samaritan passerby who had literally just risked my own life to save someone else’s, and the first thing they did was to thank some nonexistent deity for their rescue, I would throw them back in the water or the fire and let said deity work it out.
Matt Penfoldsays
I’ve been seeing an awful lot of copyright violations on this blog lately. First two Sinfests, and now an unattributed Cectic (which is licensed CC, but requires attribution). If you got permission, PZ, please say so.
I always try to link to the source — this one links to the site I was sent, but not to cectic itself, which seems to be defunct. If anyone has a link to the original, of course I’ll update it.
Thanking an omnipotent guy that either made you ill or let you get sick, instead of the regular people for all their real efforts is callous, wether your religious or not.
Besides, I’ve never seen a doctor go to a recovering patient to say “you should thank me/ the medical team” or “you should say that science amazing” or “you should give money for research now!”. I’ve seen them congratulating the patient, sayng they fought well, that they should get better, hang on, that sort of thing.
The instistence of some religious to go thank God first does not strike me as dripping compassion for those affected.
It reminds me of someone pointing out that in regards to the Doctors telling people “you’re lucky to be alive/to have survived that one/to walk away without major injury” doesn’t mean anything. Of COURSE Doctors are going to say that to any patient. What Doctor is going to go in and say “Wow I’ve never seen such a wimp in all my career!” Yet people keep using that comment as evidence for miracles.
csmillersays
… Although the Christian Scientists seems to being doing their best. However, it is very hard to arrange a proper double-blind trial along these lines.
There are a few parents who have done something like that, generally with disastrous results
But there are few crediting God who actually ignore the value of medical science and its practitioners. God gave us medical discoveries, or whatever nonsense they can use to try to keep the spectacularly unsuccessful God in the loop.
That, I think, is sort of the point of the man on the roof in the flood (as I risk banhammer). It’s to tell believers that God rarely, if ever, does things “without help,” and that they’re not faithless when using medicine, boats, etc., to save themselves. Pretty much BS, but then they get to thank God for whatever good luck they encounter, while recognizing that people and science do a whole lot of good.
A lot of people think that “God helps those who help themselves” is in the Bible, after all. Deliberate conflation to us, yet magic has generally been understood as sort of an “edge,” hence the prayers for sports teams. I mean, why bother to play after you asked God to win it for you? Well, because it just doesn’t work that way, obviously (or “God wants us to do our best, blah blah”).
About a year and half ago, I almost died. I was in the hospital for about seven months, 14 surgeries, etc.
I would get so angry when my parents and visitors from their church would always gush, “God saved you! He must have so much for you to do!” (Especially when I was incapacitated or intubated, so I couldn’t even say anything to that bullshit.) The worst was when they would say it in front of the nurses or doctors–people who worked their asses off, against pretty good odds, around the clock, during the holidays, in order to save my life. I would always try to say something like, “I think the amazing doctors and nurses had something to do with that,” and they would hastly agree, with the caveat that of course, God was guiding their hands etc. BLECH.
Also, all of the Sinfests definitely included links directly back to the original.
truthspeakersays
EEB
29 June 2012 at 11:35 am
I would get so angry when my parents and visitors from their church would always gush, “God saved you! He must have so much for you to do!”
I guess God didn’t have anything for my niece to do. He let her die after six months.
ravensays
Quite a few people do it to themselves.
Around 100 children a year are killed by faith healing in the USA.
The number of adults who go faith healing and die isn’t well known. It’s perfectly legal for adults to reject modern medicine. The number is likely to be high though, most of us have seen it happen one time or another, sometimes more than once.
It’s perfectly legal for adults to reject modern medicine.
As it should be.
It’s terrible, yes, but I can’t think of one reason to compel a competent adult into having a medical procedure that they don’t want.
Gnumann, quisling of the MRA nationsays
It’s terrible, yes, but I can’t think of one reason to compel a competent adult into having a medical procedure that they don’t want.
You can perhaps make the case for communicable diseases.
For example: If some arsehole goes around spreading syphilis (by neglect or intent) – I would say that forced treatment is more humane than the alternatives.
For example: If some arsehole goes around spreading syphilis (by neglect or intent) – I would say that forced treatment is more humane than the alternatives.
I’ve seen this argument with TB* and honestly, yes I do understand the need to protect the general public, but on the other hand, we don’t even force people to be immunized against infectious disease, so where does the line get drawn?
*A few years back, a dude with WHOA INFECTIOUS TB got on an international flight and it caused a big panic.
We do though have protocols for holding a quarantine.
Quarantine isn’t the same as forcing someone to undergo a medical procedure. That guy with TB? Shouldn’t have been allowed on the plane. But that’s a different issue than forcing treatment.
(It wasn’t the best example, since now I remember that he had a drug-resistant strain, so not quite what Gnumann was talking about.)
Shplanesays
I’m pretty sure that posting a comic on your blog isn’t something that anyone could ever reasonably get sued for.
If prayer worked then our healthcare cost would drop overnight and all the Christian hospitals would close. So why do religious people maintain hospitals anyway?
Tualhasays
Yeah, wow. If that’s where you think I’m coming from I guess I’ll just fuck off now.
marilovesays
Tualha: He links to the source. Why are you holding on to this?
Gnumann, quisling of the MRA nationsays
but on the other hand, we don’t even force people to be immunized against infectious disease, so where does the line get drawn?
I was talking from “ought” and not “is”. And in my “ought” mandatory vaccines for some diseases (for people without contra-indications o.c). That’s another cup of tea though (especially as people refusing crucial vaccines aren’t refusing them for themselves.
The point I was trying to make was another one. If a person spreads harmful disease in a culpable fashion, the society need to react. That can either be done with prison, perhaps in solitary confinement or by forced treatment. In that scenario I think forced treatment usually is the least invasive action.
And honestly, I’m not 100% sure where I stand on the issue in any case– where does someone’s right to bodily autonomy end when we’re talking about exposing other people that don’t have any sort of choice in the matter? Both extremes make me feel squicky.
Yeah, wow. If that’s where you think I’m coming from I guess I’ll just fuck off now.
Please
stonygroundsays
If there is a copyright infringement I would think that it was up to the cartoonist or his lawyer to complain. I suspect that creative types have to balance the downside of people using their material without paying for it with the upside of free publicity.
I was going to comment about the faithful killing their children by relying on prayer rather than medicine but others have beaten me to it. I have a feeling that when the smallpox vaccine was first used, the RCC forbade Catholics to use it but changed their minds when it started to look as though the majority of their flock were going to end up dead, leaving only protestants alive.
Attempts to use vaccinations to eradicate polio from the planet have hit the buffers due to paranoid Muslim preachers telling people that the whole thing is an evil Western plot to eliminate Muslims by making them sterile.
This makes me feel not so bad for telling an Army chaplain that praying for a successful outcome for my surgery was fucking stupid, and that I preferred to depend on the training and skills of my surgeon. OTOH it was orthopedic surgery so the surgeon thought HE was god already.
John Horstmansays
@34: Of course, with a proper public healthcare system, anyone would be able to opt in to a vaccination and not need to rely on herd immunity, rendering the unvaccinated a threat only to those who opt out. I view intrusions on bodily autonomy to be less severe than interventions in bodily integrity, so I would not support mandatory vaccination, but would support quarantining, and probably indefinite quarantine (lifetime incarceration) if necessary. I think I’m pretty much with Audley on this.
Then again, I also think we should focus medical resources on repairing/preventing debilitating illness and injury over fatal illness and injury, as I think the well-being of those who are alive is more important than the extension of life per se. I recognize that others think living at all costs is the preferable course, so I sometimes wind up at functional impasses in debates around medical ethics, as my presupposed idea of what constitutes a “best” outcome can be radically different from others’.
diannesays
Attempts to use vaccinations to eradicate polio from the planet have hit the buffers due to paranoid Muslim preachers telling people that the whole thing is an evil Western plot to eliminate Muslims by making them sterile.
OTOH, there was a genuine CIA* plot involving fake vaccines in Pakistan, so it’s hard to call this entirely irrational.
*I think that was the sponsoring organization. I may have it wrong.
If one of my family members said this to me while they were in the hospital, I would probably flip out. A rant comes to mind about the doctors, nurses, and people who donate to the hospital and how they should thank every single person who walks in the room to help them.
It’s so ungrateful.
andyosays
I’m pretty sure the author of cectic must appreciate being linked (and even reproduced and linked) by the blogs. I’m sure many of us know of it because of the science/skeptic blogs.
macrophagesays
I wish this was true. You’d be shocked by the anti-science creationism I hear coming out of MDs’ mouths on a regular basis. The doctors here are extremely conservative in their political views. The nurses aren’t much better. The vast majority are highly professional in their medical practices, but as soon as the conversation turns political it’s…scary.
macrophagesays
Whoops, bad html is bad. I tried to quote robo at #11: “There are no anti-science creationists in ICU.”
Of course, with a proper public healthcare system, anyone would be able to opt in to a vaccination and not need to rely on herd immunity, rendering the unvaccinated a threat only to those who opt out.
Not true. There are always people who can’t be vaccinated. Mostly it’s the immunocompromised and people with allergies to vaccine ingredients, and the very young. Also, vaccines are not 100.000% effective. They simply don’t “take” in some people; rates vary with different vaccines but can be as high as 10%. We all need the herd immunity, even those of us living in places with decent health care systems.
Gnumann, quisling of the MRA nationsays
bodily autonomy to be less severe than interventions in bodily integrity, so I would not support mandatory vaccination, but would support quarantining, and probably indefinite quarantine (lifetime incarceration) if necessary.
Did it ever occur to you that you should consider severity of the measure in addition to the kind of measure?
I can’t be certain, but I’m not quite sure you got Audley on board.
Amphioxsays
OTOH, there was a genuine CIA* plot involving fake vaccines in Pakistan, so it’s hard to call this entirely irrational.
I thought that plot used real vaccines, and used the vaccination program as a cover to get on-the-ground info for tracking down OBL.
A. Rsays
Vaccines: Have I ever mentioned how much I friggin love vaccines? Thusly, I am for mandatory vaccination in most cases, considering that it is minimally invasive, and the benefits so far outweigh the risk and invasion.
Amphioxsays
Regarding mandatory vaccination:
We can use the same test as can use with anything here:
1) Would such a law be necessary? If we can get sufficient numbers of people to do it voluntarily, with public education programs and incentives, then there is no need for mandatory laws.
2) Would such a law be practical? How easy would it be to enforce it? What will you do to the people who do not comply? How will you find them? How will you punish them? Who pays for it?
3) Would such a law be heavy-handed? (This will depend on the details of the answers to 2).
My own view is that while 3 is not an issue (mandatory vaccination would not be heavy-handed, or at least does not have to be if administered properly), it is 1) not necessary – the alternatives available of incentives and public education are sufficient to achieve the public health policy goal of establishing adequate herd immunity in the population to prevent the targeted serious diseases, even despite the efforts of the anti-vaxxer movement, and 2) would be quite a nightmare to actually enforce, and therefore should not be instituted.
This consideration, incidentally, needs to be made independently for each vaccine and each disease vaccinated against, because the details of the virulence of the disease and its severity, and the effectiveness of the individual vaccine and its side effect profiles, matter.
Amphioxsays
At any rate, in combating anti-vaxxer movement and the threat they pose to herd immunity, public education and incentives to encourage willing vaccination should be tried first/modified/continued before attempting legislation of mandatory vaccination for the general public, for most of the common vaccines/vaccinated diseases.
For the moment.
Gnumann, quisling of the MRA nationsays
@Ampiox: I generally agree – and definitely on the disease-by-disease-basis.
But as we see resurgence of mumps and other bads, I’m not quite sure on 1 yet.
The other thing, as I mentioned before, is that people who refuse vaccines usually don’t do it on their own behalf, but refuse vaccines for their children. It not only puts the herd immunity at risk, but also the child.
Enforcement is of course a question, but for this issue a small fine would be adequate (at least in the current state of affairs). Not to ensure 100 % compliance of course, but it’s usually quite normative anyhow.
Though our different assessments of enforceability might be due to different health care regimes.
hotshoesays
Amphiox –
Right now in the US we are having epidemics of whooping cough and children have died from it – mostly babies too young to be immunized. In CA, 10 babies died in 2010 in spite of (nationwide) mandatory immunization required of school-age children. The main problem is that the “mandatory” program had too many exemptions in it, not just the necessary exemptions for children who medically cannot be vaccinated, but also “religious” or “I just don’t give a shit” exemptions that only required a parent’s checkmark on a school form.
With whooping cough, the other part of the problem is that the vaccine used in recent decades was formulated to reduce side effects, but apparently did not lead to as long-lasting immunity as the older formulation or as surviving the disease itself. When that part of the problem became clear last year, CA passed a new law making a booster shoot of whooping cough vaccine mandatory for all children entering school grades 7-12. Also, they made public health commercials, made free vaccines available to (some) adults who were parents/caretakers of very young children, etc.
It seems to have worked, as you say, for the moment. CA had no deaths from whooping cough in 2011 nor any so far in 2012.
But I don’t see any moral difference between mandatory vaccination of an 18-year-old high school senior and mandatory vaccination of the same 18-year-old, or her 21-year-old sister, when they’re out of school.
I totally approve of mandatory vaccination wherever and whenever it’s needed.
A. Rsays
Amphiox: I’m with you on disease by disease. Seasonal Influenza vaccines, for example, should never be made mandatory. MMR however…
Amphioxsays
Enforcement is of course a question, but for this issue a small fine would be adequate (at least in the current state of affairs). Not to ensure 100 % compliance of course, but it’s usually quite normative anyhow.
Well here’s the issue with enforcement. In the US, where there is no universal healthcare system, and therefore no centralized database with medical information to track people down, where people can jump at will from doctor to doctor, how will you even know who does and does not get vaccinated?
What will you do with people who lie to their new doctors, saying they are vaccinated when they are not, to avoid the law? Will you legislate mandatory blood tests for antibodies to prove vaccination status?
Would mandating vaccination actually discourage some anti-vaxxer parents from letting their children see any doctors at all? Would that end up causing even more harm than failure to vaccinate? Would persecution of anti-vaxxers end up martyring them, making even more people sympathetic to their arguments, dropping the rates of voluntary vaccination/compliance with the law even further?
What if your mandate-and-fine law was challenged in court? Would it stand? (I think in the US it would not).
What would you do if anti-vaxxers simply chose to pay the fine, even parade it as a badge of honor, instead of vaccinating? How would that further the actual public health goal of improving herd immunity?
Remember, the goal is improvement of public health by establishment of herd immunity. Mandatory vaccination is only one of several strategies available to you to accomplish this goal. Is it the best strategy available? Would it actually work to result in more vaccinated people? How much more would it cost (not just in monetary terms)?
Amphioxsays
When there is a definite epidemic threat, a temporary, local mandatory universal vaccination program could be justifiable, depending on the nature of the epidemic threat – and AFAIK this is already done and accepted.
I can’t be certain, but I’m not quite sure you got Audley on board.
Considering that I don’t quite know where I stand on the issue, I think you’re right, G.
A. Rsays
Amphiox: Then what do you suggest? We’ve seen what anti-vax parents can do to public health. Would incentives really make then change their minds? Just how effective is herd immunity? (Not very, unless you have a very high percentage of people vaccinated.) How many anti-vax parents see actual physicians regularly anyway? What happens when, or rather if, their children (are able to) grow up and have children they can refuse to vaccinate? It’s not as simple as education and rewards for some people.
adhocsays
@Tualha
I’m sure cectic hates their stuff appearing on Pharyngula. Luckily they already know how to prevent it from happening again:
Since the postulated methods aren’t going to work without an unacceptable level of invasive oppression, then implementing them and not implementing them will have no practical effect, and implementing them costs us something, while not implementing them costs us nothing.
So both options just results in the current status quo, and I’d rather pay nothing to keep the status quo than pay something and still end up with the same status quo.
Basically, if you can’t reasonably enforce a law, even if otherwise the law is a good idea, then you shouldn’t make such a law – it is just a waste of time and resources better spent elsewhere.
Education and rewards will always not work for some, but by continuing them, and seeking more effective means of communicating them, the result will be to keep that number low. Remember that it isn’t the hardline anti-vaxxers who are the problem for public health, their numbers are and will remain too small to be an impact by themselves, it is the many people mislead and confused by their rhetoric who do not vaccinate that results in the loss of herd immunity, and most of these people are likely to respond to education and rewards.
Never forget that vaccination is an invasive medical procedure, requiring a violation of bodily integrity. If anyone else shoved a needle into your arm without your consent, or forced you to swallow something against your will, it is assault. In accepting mandatory universal vaccination you are saying that it is alright for a government to assault its own citizens, if the assault is sufficiently minor, and it is for their own “good”, and the good of others, with the definition of “good” up to the government to declare.
Before going that far I would want to see definitive evidence that the problem is really vast enough to warrant such extremes, and that no other less extreme options are on the table to try.
A. Rsays
Amphiox: That is all true, but I wonder if the status quo is not more likely to change without our intervention than we think.
I’ve been seeing an awful lot of copyright violations on this blog lately. First two Sinfests, and now an unattributed Cectic (which is licensed CC, but requires attribution). If you got permission, PZ, please say so.
Do this on Darth Cheney, please.
I ALMOST wish doctors would do this.
I’ve always said–not seriously I hasten to add–that if I were a firefighter, lifeguard, or just a good Samaritan passerby who had literally just risked my own life to save someone else’s, and the first thing they did was to thank some nonexistent deity for their rescue, I would throw them back in the water or the fire and let said deity work it out.
Try clicking on the cartoon.
I always try to link to the source — this one links to the site I was sent, but not to cectic itself, which seems to be defunct. If anyone has a link to the original, of course I’ll update it.
Here is the url to the original comic.
http://cectic.com/014.html
What Would House Do?
Thanking an omnipotent guy that either made you ill or let you get sick, instead of the regular people for all their real efforts is callous, wether your religious or not.
Besides, I’ve never seen a doctor go to a recovering patient to say “you should thank me/ the medical team” or “you should say that science amazing” or “you should give money for research now!”. I’ve seen them congratulating the patient, sayng they fought well, that they should get better, hang on, that sort of thing.
The instistence of some religious to go thank God first does not strike me as dripping compassion for those affected.
@Kassad
It reminds me of someone pointing out that in regards to the Doctors telling people “you’re lucky to be alive/to have survived that one/to walk away without major injury” doesn’t mean anything. Of COURSE Doctors are going to say that to any patient. What Doctor is going to go in and say “Wow I’ve never seen such a wimp in all my career!” Yet people keep using that comment as evidence for miracles.
… Although the Christian Scientists seems to being doing their best. However, it is very hard to arrange a proper double-blind trial along these lines.
There are no anti-science creationists in ICU.
There are a few parents who have done something like that, generally with disastrous results
But there are few crediting God who actually ignore the value of medical science and its practitioners. God gave us medical discoveries, or whatever nonsense they can use to try to keep the spectacularly unsuccessful God in the loop.
That, I think, is sort of the point of the man on the roof in the flood (as I risk banhammer). It’s to tell believers that God rarely, if ever, does things “without help,” and that they’re not faithless when using medicine, boats, etc., to save themselves. Pretty much BS, but then they get to thank God for whatever good luck they encounter, while recognizing that people and science do a whole lot of good.
A lot of people think that “God helps those who help themselves” is in the Bible, after all. Deliberate conflation to us, yet magic has generally been understood as sort of an “edge,” hence the prayers for sports teams. I mean, why bother to play after you asked God to win it for you? Well, because it just doesn’t work that way, obviously (or “God wants us to do our best, blah blah”).
Glen Davidson
About a year and half ago, I almost died. I was in the hospital for about seven months, 14 surgeries, etc.
I would get so angry when my parents and visitors from their church would always gush, “God saved you! He must have so much for you to do!” (Especially when I was incapacitated or intubated, so I couldn’t even say anything to that bullshit.) The worst was when they would say it in front of the nurses or doctors–people who worked their asses off, against pretty good odds, around the clock, during the holidays, in order to save my life. I would always try to say something like, “I think the amazing doctors and nurses had something to do with that,” and they would hastly agree, with the caveat that of course, God was guiding their hands etc. BLECH.
Also, all of the Sinfests definitely included links directly back to the original.
I guess God didn’t have anything for my niece to do. He let her die after six months.
Quite a few people do it to themselves.
Around 100 children a year are killed by faith healing in the USA.
The number of adults who go faith healing and die isn’t well known. It’s perfectly legal for adults to reject modern medicine. The number is likely to be high though, most of us have seen it happen one time or another, sometimes more than once.
Raven:
As it should be.
It’s terrible, yes, but I can’t think of one reason to compel a competent adult into having a medical procedure that they don’t want.
You can perhaps make the case for communicable diseases.
For example: If some arsehole goes around spreading syphilis (by neglect or intent) – I would say that forced treatment is more humane than the alternatives.
Gnumann:
I’ve seen this argument with TB* and honestly, yes I do understand the need to protect the general public, but on the other hand, we don’t even force people to be immunized against infectious disease, so where does the line get drawn?
*A few years back, a dude with WHOA INFECTIOUS TB got on an international flight and it caused a big panic.
It should work the other way too. If a doctor said that a patient getting better was God’s work (or a miracle), they should give up their salary.
@Audley
We do though have protocols for holding a quarantine. Vaccination is permitted because it relies on herd immunity.
PZ, I quote from the Sinfest site:
That would seem to require a bit more than just linking back to his site to be in the clear. It’s not under a CC license like Cectic.
Ing,
Quarantine isn’t the same as forcing someone to undergo a medical procedure. That guy with TB? Shouldn’t have been allowed on the plane. But that’s a different issue than forcing treatment.
(It wasn’t the best example, since now I remember that he had a drug-resistant strain, so not quite what Gnumann was talking about.)
I’m pretty sure that posting a comic on your blog isn’t something that anyone could ever reasonably get sued for.
Right? I mean, surely it isn’t that bad.
Fair use covers satire, parody and commentary.
Would Ishida sue? Likely not. Would he think it was rude? Quite possibly. Would he email PZ and ask him to stop doing it? Also quite possibly.
It does seem odd that PZ is so punctilious about other kinds of manners, e.g. non-harrassment, and is letting this slide.
@Tualha
http://fairuse.stanford.edu/Copyright_and_Fair_Use_Overview/chapter9/9-a.html
Christ, what an asshole.
Seriously Taulha I bet you’re so happy with your “HJAHAHAHAHAH GOTCHA” you’re not sitting in creamed pants.
Cause you know. Women, dey iz just like property!
If prayer worked then our healthcare cost would drop overnight and all the Christian hospitals would close. So why do religious people maintain hospitals anyway?
Yeah, wow. If that’s where you think I’m coming from I guess I’ll just fuck off now.
Tualha: He links to the source. Why are you holding on to this?
I was talking from “ought” and not “is”. And in my “ought” mandatory vaccines for some diseases (for people without contra-indications o.c). That’s another cup of tea though (especially as people refusing crucial vaccines aren’t refusing them for themselves.
The point I was trying to make was another one. If a person spreads harmful disease in a culpable fashion, the society need to react. That can either be done with prison, perhaps in solitary confinement or by forced treatment. In that scenario I think forced treatment usually is the least invasive action.
Gnumann,
Gotcha. I was thinking “is”.
And honestly, I’m not 100% sure where I stand on the issue in any case– where does someone’s right to bodily autonomy end when we’re talking about exposing other people that don’t have any sort of choice in the matter? Both extremes make me feel squicky.
Please
If there is a copyright infringement I would think that it was up to the cartoonist or his lawyer to complain. I suspect that creative types have to balance the downside of people using their material without paying for it with the upside of free publicity.
I was going to comment about the faithful killing their children by relying on prayer rather than medicine but others have beaten me to it. I have a feeling that when the smallpox vaccine was first used, the RCC forbade Catholics to use it but changed their minds when it started to look as though the majority of their flock were going to end up dead, leaving only protestants alive.
Attempts to use vaccinations to eradicate polio from the planet have hit the buffers due to paranoid Muslim preachers telling people that the whole thing is an evil Western plot to eliminate Muslims by making them sterile.
The squicky I can understand.
This makes me feel not so bad for telling an Army chaplain that praying for a successful outcome for my surgery was fucking stupid, and that I preferred to depend on the training and skills of my surgeon. OTOH it was orthopedic surgery so the surgeon thought HE was god already.
@34: Of course, with a proper public healthcare system, anyone would be able to opt in to a vaccination and not need to rely on herd immunity, rendering the unvaccinated a threat only to those who opt out. I view intrusions on bodily autonomy to be less severe than interventions in bodily integrity, so I would not support mandatory vaccination, but would support quarantining, and probably indefinite quarantine (lifetime incarceration) if necessary. I think I’m pretty much with Audley on this.
Then again, I also think we should focus medical resources on repairing/preventing debilitating illness and injury over fatal illness and injury, as I think the well-being of those who are alive is more important than the extension of life per se. I recognize that others think living at all costs is the preferable course, so I sometimes wind up at functional impasses in debates around medical ethics, as my presupposed idea of what constitutes a “best” outcome can be radically different from others’.
Attempts to use vaccinations to eradicate polio from the planet have hit the buffers due to paranoid Muslim preachers telling people that the whole thing is an evil Western plot to eliminate Muslims by making them sterile.
OTOH, there was a genuine CIA* plot involving fake vaccines in Pakistan, so it’s hard to call this entirely irrational.
*I think that was the sponsoring organization. I may have it wrong.
If one of my family members said this to me while they were in the hospital, I would probably flip out. A rant comes to mind about the doctors, nurses, and people who donate to the hospital and how they should thank every single person who walks in the room to help them.
It’s so ungrateful.
I’m pretty sure the author of cectic must appreciate being linked (and even reproduced and linked) by the blogs. I’m sure many of us know of it because of the science/skeptic blogs.
Whoops, bad html is bad. I tried to quote robo at #11: “There are no anti-science creationists in ICU.”
Not true. There are always people who can’t be vaccinated. Mostly it’s the immunocompromised and people with allergies to vaccine ingredients, and the very young. Also, vaccines are not 100.000% effective. They simply don’t “take” in some people; rates vary with different vaccines but can be as high as 10%. We all need the herd immunity, even those of us living in places with decent health care systems.
Did it ever occur to you that you should consider severity of the measure in addition to the kind of measure?
I can’t be certain, but I’m not quite sure you got Audley on board.
I thought that plot used real vaccines, and used the vaccination program as a cover to get on-the-ground info for tracking down OBL.
Vaccines: Have I ever mentioned how much I friggin love vaccines? Thusly, I am for mandatory vaccination in most cases, considering that it is minimally invasive, and the benefits so far outweigh the risk and invasion.
Regarding mandatory vaccination:
We can use the same test as can use with anything here:
1) Would such a law be necessary? If we can get sufficient numbers of people to do it voluntarily, with public education programs and incentives, then there is no need for mandatory laws.
2) Would such a law be practical? How easy would it be to enforce it? What will you do to the people who do not comply? How will you find them? How will you punish them? Who pays for it?
3) Would such a law be heavy-handed? (This will depend on the details of the answers to 2).
My own view is that while 3 is not an issue (mandatory vaccination would not be heavy-handed, or at least does not have to be if administered properly), it is 1) not necessary – the alternatives available of incentives and public education are sufficient to achieve the public health policy goal of establishing adequate herd immunity in the population to prevent the targeted serious diseases, even despite the efforts of the anti-vaxxer movement, and 2) would be quite a nightmare to actually enforce, and therefore should not be instituted.
This consideration, incidentally, needs to be made independently for each vaccine and each disease vaccinated against, because the details of the virulence of the disease and its severity, and the effectiveness of the individual vaccine and its side effect profiles, matter.
At any rate, in combating anti-vaxxer movement and the threat they pose to herd immunity, public education and incentives to encourage willing vaccination should be tried first/modified/continued before attempting legislation of mandatory vaccination for the general public, for most of the common vaccines/vaccinated diseases.
For the moment.
@Ampiox: I generally agree – and definitely on the disease-by-disease-basis.
But as we see resurgence of mumps and other bads, I’m not quite sure on 1 yet.
The other thing, as I mentioned before, is that people who refuse vaccines usually don’t do it on their own behalf, but refuse vaccines for their children. It not only puts the herd immunity at risk, but also the child.
Enforcement is of course a question, but for this issue a small fine would be adequate (at least in the current state of affairs). Not to ensure 100 % compliance of course, but it’s usually quite normative anyhow.
Though our different assessments of enforceability might be due to different health care regimes.
Amphiox –
Right now in the US we are having epidemics of whooping cough and children have died from it – mostly babies too young to be immunized. In CA, 10 babies died in 2010 in spite of (nationwide) mandatory immunization required of school-age children. The main problem is that the “mandatory” program had too many exemptions in it, not just the necessary exemptions for children who medically cannot be vaccinated, but also “religious” or “I just don’t give a shit” exemptions that only required a parent’s checkmark on a school form.
With whooping cough, the other part of the problem is that the vaccine used in recent decades was formulated to reduce side effects, but apparently did not lead to as long-lasting immunity as the older formulation or as surviving the disease itself. When that part of the problem became clear last year, CA passed a new law making a booster shoot of whooping cough vaccine mandatory for all children entering school grades 7-12. Also, they made public health commercials, made free vaccines available to (some) adults who were parents/caretakers of very young children, etc.
It seems to have worked, as you say, for the moment. CA had no deaths from whooping cough in 2011 nor any so far in 2012.
But I don’t see any moral difference between mandatory vaccination of an 18-year-old high school senior and mandatory vaccination of the same 18-year-old, or her 21-year-old sister, when they’re out of school.
I totally approve of mandatory vaccination wherever and whenever it’s needed.
Amphiox: I’m with you on disease by disease. Seasonal Influenza vaccines, for example, should never be made mandatory. MMR however…
Well here’s the issue with enforcement. In the US, where there is no universal healthcare system, and therefore no centralized database with medical information to track people down, where people can jump at will from doctor to doctor, how will you even know who does and does not get vaccinated?
What will you do with people who lie to their new doctors, saying they are vaccinated when they are not, to avoid the law? Will you legislate mandatory blood tests for antibodies to prove vaccination status?
Would mandating vaccination actually discourage some anti-vaxxer parents from letting their children see any doctors at all? Would that end up causing even more harm than failure to vaccinate? Would persecution of anti-vaxxers end up martyring them, making even more people sympathetic to their arguments, dropping the rates of voluntary vaccination/compliance with the law even further?
What if your mandate-and-fine law was challenged in court? Would it stand? (I think in the US it would not).
What would you do if anti-vaxxers simply chose to pay the fine, even parade it as a badge of honor, instead of vaccinating? How would that further the actual public health goal of improving herd immunity?
Remember, the goal is improvement of public health by establishment of herd immunity. Mandatory vaccination is only one of several strategies available to you to accomplish this goal. Is it the best strategy available? Would it actually work to result in more vaccinated people? How much more would it cost (not just in monetary terms)?
When there is a definite epidemic threat, a temporary, local mandatory universal vaccination program could be justifiable, depending on the nature of the epidemic threat – and AFAIK this is already done and accepted.
Gnumann (and John H):
Considering that I don’t quite know where I stand on the issue, I think you’re right, G.
Amphiox: Then what do you suggest? We’ve seen what anti-vax parents can do to public health. Would incentives really make then change their minds? Just how effective is herd immunity? (Not very, unless you have a very high percentage of people vaccinated.) How many anti-vax parents see actual physicians regularly anyway? What happens when, or rather if, their children (are able to) grow up and have children they can refuse to vaccinate? It’s not as simple as education and rewards for some people.
@Tualha
I’m sure cectic hates their stuff appearing on Pharyngula. Luckily they already know how to prevent it from happening again:
http://cectic.com/129.html
At the moment, A.R., I suggest nothing.
Since the postulated methods aren’t going to work without an unacceptable level of invasive oppression, then implementing them and not implementing them will have no practical effect, and implementing them costs us something, while not implementing them costs us nothing.
So both options just results in the current status quo, and I’d rather pay nothing to keep the status quo than pay something and still end up with the same status quo.
Basically, if you can’t reasonably enforce a law, even if otherwise the law is a good idea, then you shouldn’t make such a law – it is just a waste of time and resources better spent elsewhere.
Education and rewards will always not work for some, but by continuing them, and seeking more effective means of communicating them, the result will be to keep that number low. Remember that it isn’t the hardline anti-vaxxers who are the problem for public health, their numbers are and will remain too small to be an impact by themselves, it is the many people mislead and confused by their rhetoric who do not vaccinate that results in the loss of herd immunity, and most of these people are likely to respond to education and rewards.
Never forget that vaccination is an invasive medical procedure, requiring a violation of bodily integrity. If anyone else shoved a needle into your arm without your consent, or forced you to swallow something against your will, it is assault. In accepting mandatory universal vaccination you are saying that it is alright for a government to assault its own citizens, if the assault is sufficiently minor, and it is for their own “good”, and the good of others, with the definition of “good” up to the government to declare.
Before going that far I would want to see definitive evidence that the problem is really vast enough to warrant such extremes, and that no other less extreme options are on the table to try.
Amphiox: That is all true, but I wonder if the status quo is not more likely to change without our intervention than we think.