A Quick Note on the Ethics of Vaccine Denial

For some reason that completely eludes me, an unusually high number of people seem to have jumped on the anti-vaccine bandwagon.  I’m not going to say anything here about the safety and efficacy of vaccines since so many others have done a fantastic job of that, and I would end up doing little more than copying and pasting their posts.  For anyone unsure of the science behind vaccinations, I would strongly urge that you become a regular reader of http://www.sciencebasedmedicine.org/.  In short, vaccines both work and are safe.  This is especially important now as we are in the midst of a pandemic as a result of the H1N1 virus, the so-called “swine flu.”  The danger posed by this new version of H1N1 makes vaccinations all the more important at this time.

Let me do a very brief rundown of why vaccinations are more than a great idea.  Vaccinations have the potential to save numerous lives, including those of children.  Last week, the CDC says that there were 35 flu-related pediatric deaths reported.  Of those, 27 were confirmed to be cases of H1N1.  Seven others were not subtyped, so it is not known if these were H1N1, though it is possible.  Only one of those deaths is known to not be a case of H1N1.  Further, "Since April 2009, CDC has received reports of 234 laboratory-confirmed pediatric deaths:  198 due to 2009 H1N1, 35 pediatric deaths that were laboratory confirmed as influenza, but the flu virus subtype was not determined, and one pediatric death associated with a seasonal influenza virus” (http://www.cdc.gov/h1n1flu/update.htm).  (Please note that this link is updated with new information each week, so I cannot guarantee that the quote will appear past December 6.)  The point of all this is that children are dying from the flu, and overwhelmingly, the version that is killing them is the H1N1 strain.  As such, the need to vaccinate children against this more dangerous strain of the flu should be clear.

With the above in mind, the question now becomes what kind of damage is done by being an anti-vaxxer.  I’ve written before on here about the ethical element of belief.  In short, actions have moral consequences.*  Beliefs inform actions.  That is, you act in the ways you do because of a particular set of beliefs.  If it makes sense to say you should act in some way, then you need to have the appropriate beliefs that would give rise to such actions.  Clearly, then, you should believe certain things as well.  For brevity, let’s cash this out as saying you should only believe those things for which you have good reason.  Certainly in terms of medicine, I’m going to take it to be uncontroversial that “good reason” is evidence.  The case of anti-vaxxers makes it very clear why all of this matters.

If you go about telling people that vaccinations are dangerous, and that you have evidence this is the case, you are putting them at risk.  Perhaps worse, you are putting the children around them at risk as well.  As the numbers above show, this virus is killing many more children than the typical flu.  What the evidence also overwhelmingly shows is that vaccines are both safe and efficacious.  If you disagree, you had better have a lot of hard evidence and numbers, because, unless you do, that means that holding such beliefs is immoral.  And by hard evidence I don’t meant what Jenny McCarthy said, or what some guy claiming to be an infectious disease specialist on Fox News said.  I mean you had better have actual numbers and peer-reviewed studies that show those numbers are legitimate, because the evidence in favor of the safety and efficacy of vaccines is staggering. 

When you tell someone that they and their kids should avoid a potentially life-saving treatment on the basis of bad reason, you are putting children at risk.  You are doing something wrong.  You are doing something immoral.  If you believe things that would put you in a position to unnecessarily increase the risk to children’s lives, especially in such a dramatic fashion, you are doing something immoral.  I want this to get through as it seems so few people consider the consequences of what they’re doing.

I get the strong impression that people don’t get the full weight of what they’re doing here.  This is not a political issue.  This is not a time to worry about saving face because of your past stated beliefs.  This is not some kind of game.  People are dying over this.  Children are dying in greater numbers than usual.  Again, this virus is worse than the typical flu.  The numbers don’t lie.  Before you tell someone, even off-handedly, that vaccines are dangerous, that they cause autism, that they have mercury in them, or whatever other piece of garbage you’ve picked up off the street, think about what you’re doing.  Think about the consequences.  Check your facts.  Before you tell someone something that could put their child in the grave, make sure what you’re saying is right.  If you don’t, at least some of the responsibility for what happens to those children is on your shoulders.

 

 

 

*This is, of course, assuming you buy into there being some kind of morality.  I am not interested in the meta-ethical foundations of any particular system here.  As long as some moral system works, then what I’m saying follows.

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10 Responses to “A Quick Note on the Ethics of Vaccine Denial”

  1. John Says:

    Nice article, Jim. There is no doubt that their anti-vax stance is unreasonable and dangerous. My question: are they really immoral, if they truely believe what they are saying, or are they just dangerously ignorant? Is dangerously ignorant an immoral state?

    • Jim Says:

      I would argue that they’re immoral because they have no justification for their beliefs. Now, ought implies can, so, of course, these people have to have the ability to believe otherwise. There are those people who, because of various mental deficiencies, cannot be held accountable for their beliefs. But, as long as you have the ability to seek out evidence, and certainly when the evidence is so abundant and easy to access, as it is in this case, you have a moral responsibility to only affirm those things for which you have good reason. To do otherwise is, I think, immoral, and it is immoral for the reasons I pointed out.
      We act based on beliefs, and actions have moral content. Surely, then, the beliefs themselves must have moral content. For that reason, I think that we are morally obligated to only believe certain things, namely those things for which we have good reason.

      • James Gray Says:

        First, you have to prove that we have a moral obligation to be informed.

        Second, although “ought” does imply “can” that doesn’t imply that we “can” know everything or be ideally informed. That might not be possible. There has to be a reasonable amount of time a person should devote to knowing various things. I’m not convinced everyone should spend hours of their life to know a lot about these vaccines. There are all kinds of things we need to do with our time. Someone might find other morally beneficially forms of behavior equally or more important.

        Instead of relying on people’s beliefs to be true (or justified), why not just ask people not to be so arrogant? Why not just ask people to honest? They shouldn’t lie and say that they have proof the virus is dangerous if they don’t. The belief itself doesn’t warrant that kind of dangerous behavior. It’s dangerous no matter what you believe because we have to be aware that we are fallible.

        Third, the moral content of beliefs is still unclear. Do beliefs have moral content? Perhaps but that doesn’t tell me which beliefs are morally obligated. Even scientists often disagree with the most justified beliefs in order to try out new ideas.

        Fourth, if a vaccine is necessary for the health of human kind, we shouldn’t rely on everyone spending hours learning about it. Sometimes we need just about everyone on a vaccine. In that case there needs to be some kind of law that gets people to get the vaccine or something.

        You can tell people what they are morally obligated to believe, but I doubt that will convince them to change their mind. They might sincerely believe you are the one who needs to believe something else. A lot of people read conspiracy theories which claim A is true, and some other source claims A is false. A non-expert might not be able to know for sure who is telling the truth, even after spending several hours doing research. (Global Warming also comes to mind.) We can’t expect people to devote their entire lives learning about every single moral issue.

        • Jim Says:

          I don’t see any of those to be issues at all. Another way to say this, the way I put it in an earlier post, is that we are obligated to accept as justification for our beliefs only those things for which we have good reason. I am in no way suggesting that one needs to be an expert on every subject. Indeed, most of our beliefs rely on so-called experts and the consensus amongst them. I see no problem with that. The problem as I have laid it out would be that class of beliefs that people hold for bad reasons.

          • James Gray Says:

            I might not be quite sure what you want to argue. I think you want to argue that we have a moral obligation to only accept beliefs that are justified. I don’t know if I agree with this, but I would agree to a weaker version: Conclusions drawn from poor reasoning should neither be affirmed nor denied.

            My problem with this argument is that it seems wrong to say everyone is obligated to do something that they don’t understand. The rest of my reply relates to that issue.

            You said, “There are those people who, because of various mental deficiencies, cannot be held accountable for their beliefs.” Does this only apply to people with mental handicaps, or to everyone not educated in philosophy?

            Lots of people spend hours of their time to find out if vaccines are good or bad. They simply are unable to grasp which side is more plausible. They don’t know who to believe and they don’t understand how cost/benefit analysis works.

            For example, Bill Maher has a general distrust of drugs and vaccines because they exist in our society due to the profit motive. It’s hard to know if you can trust a scientist when their research is being funded by “big pharma” and we don’t know whose research is being funded by big pharma in the first place. Bill Maher might not be able to know which expert he can trust. He might not even be able to know who to trust after he has read both sides and/or seen a debate on the issue. This kind of reasoning is something very few people seem capable of. I don’t know if I could do it without a philosophy education (and I hope that I am right that I can do it).

            Perhaps the best way to solve the problem isn’t by demanding that people reject their poorly reasoned beliefs, but by demanding that society start educating people appropriately and introduce philosophy as a requirement for all citizens.

            I don’t know if “most scientists” even understand the practical implications to their findings. Not all scientists agree what we need to do about global warming, even though they all agree it is happening.

            You said, “We are obligated to accept as justification for our beliefs only those things for which we have good reason.” The practical problem with this statement is that no one thinks it applies to them. Do people really want to have a belief that is poorly reasoned? People tend to think they are perfectly rational and it’s everyone else who needs to learn more about logic and rationality. Most people have no idea what logic and rationality are really about. I’ve been spending a lot of time thinking about it only because of my interest in philosophy.

            I’m sure almost everyone would agree with the statement, “We shouldn’t believe something based on poor reasoning.” People simply don’t know how.

            You said, “When you tell someone that they and their kids should avoid a potentially life-saving treatment on the basis of bad reason, you are putting children at risk. You are doing something wrong.” I’m not convinced there is a person like this who knows that their belief is based on poor reasoning.

            Perhaps I didn’t explain my third point sufficiently. I said that the “moral content of our beliefs” is unclear. What I meant was that it’s unclear whether or not we are obligated to accept a particular belief or not (even if it is well-reasoned.) When exactly is a person obligated to accept a belief? It sounds like you want to admit that we have no obligation to have an opinion about something that we’re uninformed about. You also want to say that foolish people might not be obligated if they have a mental deficiency. In that case, I don’t know who exactly your argument applies to. Who knows they have a poor reason for believing something, but decide to believe it anyway?

          • Jim Says:

            I agree that conclusions drawn from poor reasoning shouldn’t be affirmed or denied. I certainly don’t mean one should believe something isn’t the case because they don’t have good reason to think it is the case. That, of course, is also a positive belief, and that’s exactly what I suggest you shouldn’t have without good reason.
            I’ll say again that I think, in general, the consensus of experts constitutes good reason. This is based upon the belief that the process of becoming an expert in our society is a process that helps to ensure that those with such a title have done the appropriate amount of work and study that there is good reason to think that their consensus indicates the correct position. Of course, there is no guarantee of such, but I don’t think that is necessary as it seems that no such guarantee is ever available. Also, there are exceptions to this, especially when you are yourself an expert on the subject in question. You might have uncovered evidence of which your peers aren’t aware, or any number of other issues may have arisen. Also, a notable exception would be when someone has claimed, or even been given, the title of expert, yet the field itself is one in which there is no stringent process to obtain such status, or there is some other good reason to think the entire field is bunk. I can think of several such exceptions, and were I writing a dissertation on the subject, I would, of course, need to go into more detail, but none of this seems to detract from the general point.
            In no way do I mean to suggest that a lack of studying philosophy is a mental handicap.
            Bill Maher is a perfect example here. He has been corrected about the factual inaccuracy of his position multiple times, yet he continues to assert his quackery. His belief that there is some conspiracy on the part of all medical researchers all over the world to fool us into taking vaccines for which there isn’t even some huge profit is absurd. The evidence against his position is overwhelming. As he has no good reason for his initial distrust of the totality of western medicine, which is, by his own words, his larger problem, nothing that follows from that is good reasoning, either. And he is, I think, a good model for the anti-vax crew. He pretends to care about evidence, but he picks and chooses what and whom he accepts, and he then often distorts what he uses. I think he is more than merely mistaken. I think he is immoral for doing so.
            The fact that people often want to rationalize their immoral behavior seems irrelevant. People often want to give excuses as to why their unambiguously immoral actions were not, in fact, immoral. So what? Killing your spouse when neither you nor anyone else is in direct danger from them is immoral. Yet everyday people do just that and attempt to rationalize why they shouldn’t be held accountable, why it really wasn’t wrong. I don’t see the difference between the rapist who insists his victim was “asking for it” and the people you’re describing, qualitatively.
            I think people do know that, generally, evidence is required to hold a belief. If someone made the claim that styrofoam painted to look like steel is as strong as actual steel, and for that reason we should build bridges out of it to save money, I think that everyone of sound mind and the least bit of acquaintance with those items would demand the evidence of such a thing before they allowed bridges to be built out of styrofoam, and that evidence would have to be substantial, for obvious reasons. And, of course, I could list innumerable similar examples. The simple fact is that people do demand such good reason in most of the facets of their lives, and that suggests to me that they are perfectly aware of what counts as good reason and what doesn’t in these practical cases, regardless of their philosophical training.
            You ask who is aware of their poor reason for believing, yet believes anyway. The obvious answer is that lots of people do this, and many are explicit about it. Faith is precisely such “poor reason.” There many people are explicit about the unjustified nature of their beliefs, yet they hold them anyway, and they call that faith.
            Further, one could ask “who knows their actions are immoral, but decides to do them anyway?” In the same way that it would seem that anyone who knows they have bad reason for their belief would change that belief, so it would seem that anyone who knows the action they are doing is immoral would cease that action. And yet… I will not attempt to explain why people do the things they do. Suffice to say that, clearly, they do exactly those things.

          • James Gray Says:

            Thank you for this response. I understand your position pretty well now.

  2. John Says:

    Jim, are we not back where we started? If they do not know that their beliefs are based on bad reasoning, and I’ll go out on a limb and say that I find it relatively easy to accept that some of them genuinely believe that their reasoning is sound, then I can’t quite see how they’re being immoral (given that they have been honest of course)

    Perhaps I don’t give them enough credit; perhaps they are just new-age morons and actively ignore public health advice because they are wankers. But if not, well, I don’t know.

    • Jim Says:

      I suppose I think they do know their beliefs are without justification, and they just don’t care. I don’t see that as any different from the actions people commit that they unambiguously recognize as immoral, yet they commit them anyway. If you stand in pulpit and proclaim that it is evil to cheat on your wife, and then you cheat on your wife, it’s clear you’ve done something immoral. Yet, this happens everyday. Why? Beats me. An easy answer is that people are jerks. Maybe that’s the case, maybe it’s not, but I don’t see that as relevant to whether or not such actions are immoral. I think most people would agree. Just replace ‘actions’ with ‘beliefs’ in that sentence, and that’s my position.

  3. stacy Says:

    I keep writing things and deleting them. To be succinct, I guess I would ask what you would think of someone who is not hardline anti-vaccine, but who may be cautiously skeptical or have some doubt? Now you might say, “Well, this is important, you better figure out what you believe.” But that doesn’t mean they will. So what about them? What are they?

    p.s. Don’t be too hard on me, you know I have no education in philosophy : )


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