As a doctor in a COVID unit, I’m running out of compassion for the unvaccinated. Get the shot

Anita Sircar

The Los Angeles Times

Originally published 17 Aug 21

Here is an excerpt:

The burden of this pandemic now rests on the shoulders of the unvaccinated. On those who are eligible to get vaccinated but choose not to, a decision they defend by declaring, “Vaccination is a deeply personal choice.” But perhaps never in history has anyone’s personal choice affected the world as a whole as it does right now. When hundreds and thousands of people continue to die — when the most vulnerable members of society, our children, cannot be vaccinated — the luxury of choice ceases to exist.

If you believe the pandemic is almost over and I can ride it out, without getting vaccinated, you could not be more wrong. This virus will find you.

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If you believe if I get infected I’ll just go to the hospital and get treated, there is no guarantee we can save your life, nor even a promise we’ll have a bed for you.

If you believe I’m pregnant and I don’t want the vaccine to affect me, my baby or my future fertility, it matters little if you’re not alive to see your newborn.

If you believe I won’t get my children vaccinated because I don’t know what the long-term effects will be, it matters little if they don’t live long enough for you to find out.

If you believe I’ll just let everyone else get vaccinated around me so I don’t have to, there are 93 million eligible, unvaccinated people in the “herd” who think the same way you do and are getting in the way of ending this pandemic.

If you believe vaccinated people are getting infected anyway, so what’s the point?, the vaccine was built to prevent hospitalizations and deaths from severe illness. Instead of fatal pneumonia, those with breakthrough infections have a short, bad cold, so the vaccine has already proved itself. The vaccinated are not dying of COVID-19.

SARS-CoV-2, the virus that causes COVID-19, has mutated countless times during this pandemic, adapting to survive. Stacked up against a human race that has resisted change every step of the way — including wearing masks, social distancing, quarantining and now refusing lifesaving vaccines — it is easy to see who will win this war if human behavior fails to change quickly.

The info is here.

Science Skepticism Across 24 Countries

Rutjens, B. T., et al., (2021). 

Social Psychological and Personality Science. 

https://doi.org/10.1177/19485506211001329

Abstract

Efforts to understand and remedy the rejection of science are impeded by lack of insight into how it varies in degree and in kind around the world. The current work investigates science skepticism in 24 countries (N = 5,973). Results show that while some countries stand out as generally high or low in skepticism, predictors of science skepticism are relatively similar across countries. One notable effect was consistent across countries though stronger in Western, Educated, Industrialized, Rich, and Democratic (WEIRD) nations: General faith in science was predicted by spirituality, suggesting that it, more than religiosity, may be the ‘enemy’ of science acceptance. Climate change skepticism was mainly associated with political conservatism especially in North America. Other findings were observed across WEIRD and non-WEIRD nations: Vaccine skepticism was associated with spirituality and scientific literacy, genetic modification skepticism with scientific literacy, and evolution skepticism with religious orthodoxy. Levels of science skepticism are heterogeneous across countries, but predictors of science skepticism are heterogeneous across domains.

From the Discussion

Indeed, confirming previous results obtained in the Netherlands (Rutjens & van der Lee, 2020)—and providing strong support for Hypothesis 6—the current data speak to the crucial role of spirituality in fostering low faith in science, more generally, beyond its domain-specific effects on vaccine skepticism. This indicates that the negative impact of spirituality on faith in science represents a cross-national phenomenon that is more generalizable than might be expected based on the large variety (Muthukrishna et al., 2020) of countries included here. A possible explanation for the robustness of this effect may lie in the inherent irreconcilability of the intuitive epistemology of a spiritual belief system with science (Rutjens & van der Lee, 2020). (If so, then we might look at a potentially much larger problem that extends beyond spirituality and applies more generally to “post-truth” society, in which truth and perceptions of reality may be based on feelings rather than facts; Martel et al., 2020; Rutjens & Brandt, 2018.) However, these results do not mean that traditional religiosity as a predictor of science skepticism (McPhetres & Zuckermann, 2018; Rutjens, Heine, et al., 2018; Rutjens, Sutton, & van der Lee, 2018) has now become irrelevant: Not only did religious orthodoxy significantly contribute to low faith in science, it was also found to be a very consistent cross-national predictor of evolution skepticism (but not of other forms of science skepticism included in the study).

The research is here.

Physicians united: Here’s why pulling out of WHO is a big mistake

Andis Robeznieks
American Medical Association
Originally published 8 July 20

Here is an excerpt:

The joint statement builds on a previous response from the AMA made back in May after the administration announced its intention to withdraw from the WHO.

Withdrawal served “no logical purpose,” made finding a solution to the pandemic more challenging and could have harmful repercussions in worldwide efforts to develop a vaccine and effective COVID-19 treatments, then-AMA President Patrice A. Harris, MD, MA, said at the time.

Defeating COVID-19 “requires the entire world working together,” Dr. Harris added.

In April, Dr. Harris said withdrawing from the WHO would be “a dangerous step in the wrong direction, and noted that “fighting a global pandemic requires international cooperation “

“Cutting funding to the WHO—rather than focusing on solutions—is a dangerous move at a precarious moment for the world,” she added

The message regarding the need for a unified international effort was echoed in the statement from the physician leaders.

"As our nation and the rest of the world face a global health pandemic, a worldwide, coordinated response is more vital than ever,” they said. “This dangerous withdrawal not only impacts the global response against COVID-19, but also undermines efforts to address other major public health threats.”

The info is here.

Document ‘informed refusal’ just as you would informed consent

James Scibilia
AAP News
Originally posted October 20, 2018

Here is an excerpt:

The requirements of informed refusal are the same as informed consent. Providers must explain:

• the proposed treatment or testing;
• the risks and benefits of refusal;
• anticipated outcome with and without treatment; and
• alternative therapies, if available.

Documentation of this discussion, including all four components, in the medical record is critical to mounting a successful defense from a claim that you failed to warn about the consequences of refusing care.

Since state laws vary, it is good practice to check with your malpractice carrier about preferred risk management documentation. Generally, the facts of these discussions should be included and signed by the caretaker. This conversation and documentation should not be delegated to other members of the health care team. At least one state has affirmed through a Supreme Court decision that informed consent must be obtained by the provider performing the procedure and not another team member; it is likely the concept of informed refusal would bear the same requirements.

The info is here.

Should Governments Invest More in Nudging?

Shlomo Benartzi, John Beshears, Katherine L. Milkman, and others
Psychological Science 
Vol 28, Issue 8, pp. 1041 - 1055
First Published June 5, 2017

Abstract

Governments are increasingly adopting behavioral science techniques for changing individual behavior in pursuit of policy objectives. The types of “nudge” interventions that governments are now adopting alter people’s decisions without coercion or significant changes to economic incentives. We calculated ratios of impact to cost for nudge interventions and for traditional policy tools, such as tax incentives and other financial inducements, and we found that nudge interventions often compare favorably with traditional interventions. We conclude that nudging is a valuable approach that should be used more often in conjunction with traditional policies, but more calculations are needed to
determine the relative effectiveness of nudging.

The article is here.

Science debate: Should we embrace an enhanced future?

Alexander Lees
BBC.com
Originally posted September 9, 2017

Here is an excerpt:

Are we all enhanced?

Most humans are now enhanced to be resistant to many infectious diseases. Vaccination is human enhancement. Apart from "anti-vaxxers" - as those who lobby against childhood inoculations are often dubbed - most of us are content to participate. And society as a whole benefits from being free of those diseases.

So what if we took that a pharmaceutical step further. What if, as well as vaccines against polio, mumps, measles, rubella and TB, everyone also "upgraded" by taking drugs to modify their behaviour? Calming beta-blocker drugs could reduce aggression - perhaps even helping to diffuse racial tension. Or what if we were all prescribed the hormone oxytocin, a substance known to enhance social and family bonds - to just help us all just get along a little better.

Would society function better with these chemical tweaks? And might those who opt out become pariahs for not helping to build a better world - for not wanting to be "vaccinated" against anti-social behaviours?

And what if such chemical upgrades could not be made available to everyone, because of cost or scarcity? Should they be available to no one? An enhanced sense of smell might be useful for a career in wine tasting but not perhaps in rubbish disposal.

A case in point is military research - an arm of which is already an ongoing transhumanism experiment.

Many soldiers on the battlefield routinely take pharmaceuticals as cognitive enhancers to reduce the need to sleep and increase the ability to operate under stress. High tech exoskeletons, increasing strength and endurance, are no longer the realms of science fiction and could soon be in routine military use.

The article is here.

The Implications of Libertarianism for Compulsory Vaccination

Justin Bernstein
BMJ Blogs
Originally posted April 24, 2017

Here is an excerpt:

Some libertarians, however, attempt to avoid the controversial conclusion that libertarianism is incompatible with compulsory vaccination. In my recent paper, “The Case Against Libertarian Arguments for Compulsory Vaccination,” I argue that such attempts are unsuccessful, and so libertarians must either develop new arguments, or join Senator Paul in opposing compulsory vaccination.

How might a libertarian try to defend compulsory vaccination? One argument is that going unvaccinated exposes others to risk, and this violates their rights. Since the state is permitted to use coercive measures to protect rights, the state may require parents to vaccinate their children. But for libertarians, this argument has two shortcomings. First, there are other, far riskier activities that the libertarian prohibits the government from regulating. For instance, owning and using automobiles or firearms imposes far more significant risk than going unvaccinated, but libertarians defend our rights to own and use automobiles and firearms. Second, one individual going unvaccinated poses very little risk; the risk eventuates only if many collectively go unvaccinated, thereby endangering herd immunity. Imposing such an independently small risk hardly seems to be a rights violation.

The entire blog post is here.

Victims, vectors and villains: are those who opt out of vaccination morally responsible for the deaths of others?

Euzebiusz Jamrozik, Toby Handfield, Michael J Selgelid
Journal of Medical Ethics 2016;42:762-768.

Abstract

Mass vaccination has been a successful public health strategy for many contagious diseases. The immunity of the vaccinated also protects others who cannot be safely or effectively vaccinated—including infants and the immunosuppressed. When vaccination rates fall, diseases like measles can rapidly resurge in a population. Those who cannot be vaccinated for medical reasons are at the highest risk of severe disease and death. They thus may bear the burden of others' freedom to opt out of vaccination. It is often asked whether it is legitimate for states to adopt and enforce mandatory universal vaccination. Yet this neglects a related question: are those who opt out, where it is permitted, morally responsible when others are harmed or die as a result of their decision? In this article, we argue that individuals who opt out of vaccination are morally responsible for resultant harms to others. Using measles as our main example, we demonstrate the ways in which opting out of vaccination can result in a significant risk of harm and death to others, especially infants and the immunosuppressed. We argue that imposing these risks without good justification is blameworthy and examine ways of reaching a coherent understanding of individual moral responsibility for harms in the context of the collective action required for disease transmission. Finally, we consider several objections to this view, provide counterarguments and suggest morally permissible alternatives to mandatory universal vaccination including controlled infection, self-imposed social isolation and financial penalties for refusal to vaccinate.

The article is here.

Measles, Vaccination, and the Tragedy of the Commons

By Katharine Brown
Bioethics Forum
Originally published on February 25, 2015

Here is an excerpt:

To understand why, think of vaccination and the quest for herd immunity as a collective action problem. Garrett Hardin’s “tragedy of the commons” illustrates the basic logic of collective action problems. Imagine that 50 farmers share common land (“the commons”) upon which they graze their sheep. The commons are lush, and so each farmer can easily allow four sheep to graze at a given time without depleting the resource. But imagine that each farmer seeks to maximize his own good (what economic theory refers to as “rational” behavior) and it is better for him to graze more sheep than fewer. The farmers will, in effect, be “free-riding” – in this case, taking more than their fair share of the common resource while benefitting from the restraint of others. The trouble is that, while adding one more sheep to the commons does not deplete the resource, adding 50 does. The combined actions of each farmer, acting rationally, leads to an outcome that is worse for all.

The tragedy of the commons reveals that what is good for the individual is at odds with what is good for all. This is the basic logic of collective action problems. We see a similar logic in the case of vaccines. If most get vaccinated, then everyone will be better off. But it would be best for any particular individual if all others got vaccinated and he or she did not.

The entire article is here.