Hypocrisy Is The Last Refuge

My friend Gaelan:

NTodd I just have to ask one thing that really irks me about your "science" position on this question of civil rights: you are pro choice on medical decisions like abortion, birth control, alternative medical care, right? But on the choices related to whether someone buys health insurance or vaccinations, you side with corporate lobbyists who want to disallow choice, in favor of forcing people to do things against their will, in the name of "science" or "greater good". 

Please help me understand how this does not make you a hypocrite. I really don't want to see you as a hypocrite.

And I sure don't want to see my friend as a sanctimonious hypocrite who advocates for "individiual choice" to not require children to be vaccinated to attend public schools and daycares--because the parents hate Big Pharma as I do, or are afraid of the vanishingly small chances of side effects--yet is happy to enjoy the social and health benefits of herd immunity created by the rest of us who do comply with a scientifically-supported state mandate.  So I won't.  Would that I could be afforded the same courtesy in an area of disagreement.

 

I do, in fact, accept the need for state mandates when the public good is at stake, just as I accept the need for taxes.  Hence, my current tepid support for the ACA/ObamaCare: I fought against it, but once it passed over our paltry resistance, I began to celebrate the positive, incremental reforms it brought despite the entrenchment of private insurance interests.  And the crux of the whole mechanism is requiring individuals to either purchase insurance or pay into the collective insurance system via the tax code.  All well within Congress' constitutional powers, consistent with precedent, and good for the general welfare of our nation.

 

My stance on immunization is similar, informed by history and science as well as my interpretation of the social contract and our constitutions, both state and Federal.

As John Stuart Mill observed in On Liberty:

The only part of the conduct of any one, for which he is amenable to society, is that which concerns others. In the part which merely concerns himself, his independence is, of right, absolute. Over himself, over his own body and mind, the individual is sovereign.

I accept as axiomatic that a woman has the right to control her own body and reproductive destiny, in line with what Mill and the other original liberals/libertarians posited.  Yet even that, at least according to the Supreme Court, has some limitations as all rights do: there is an unfettered right to terminate a pregnancy until viability, then after that states can argue they have a compelling interest in the fetus' health and well-being.  Where I draw that line is quite different than many states, but that's not germane to this argument.  The issue is a balance of rights and needs when there is a conflict.

When a child is born, the state has an even more compelling, long-recognized interest in its safety.  That is in part why we have laws controlling child labor, banning child abuse, preventing them from drinking or driving or voting.  There is a great deal of deference to the parents who have the ultimate responsibility and rights to determine how best to raise and care for the kids, but the state will intervene when deemed necessary.

 

But there's a larger issue, and that is of the public health.  If you have an abortion, you aren't causing other people to have abortions.  If you decide to have protected sex, you aren't forcing other people to have sex (and you are, oddly enough, protecting the public health by reducing the spread of STDs).

 

Vaccination is a different animal entirely because an individual family's choice doesn't just impact them, but our society at large.  It can impact my family, and I will do all in my power to protect them from those of you who don't immunize your kids.  Exercise your conscience, but don't expect to get all the benefits of the state if you don't.

 

It would be grand if we all could declare our own little Grand Duchies with our own little laws and live our own little lives without interference from all those barbarians outside the gates, but the world doesn't work like that.  It's a shame, but we have to interact with other Duchies at some point, and that means resolving conflict between us, and sometimes giving shit up.

As George Washington, in his capacity of president of the Philadelphia Convention, noted in his letter accompanying the new Constitution's transmittal to Congress:

It is obviously impracticable in the federal government of these states, to secure all rights of independent sovereignty to each, and yet provide for the interest and safety of all: Individuals entering into society, must give up a share of liberty to preserve the rest. The magnitude of the sacrifice must depend as well on situation and circumstance, as on the object to be obtained. It is at all times difficult to draw with precision the line between those rights which must be surrendered, and those which may be reserved...

Democratic and republican forms of government are messy and full of conflict between individuals and their rights.  We all have natural rights to ourselves, property and fruits of our labor, but we cede a certain portion to government (e.g., the right to not be taxed, or as libertarians call it, not be robbed) so that we might increase our overall protection.  The formula is a difficult one and there is no single way to achieve this, but we work hard to create constitutions that try balancing individual rights and the powers necessary for government to protect them.

So, in the case of immunization, we have to weigh a variety of things and not be absolutely beholden to individual rights.  If you want your kid to go to my kids' daycare, get them their shots.  If you want them to go to my kids' school, get them their shots.  If you have the luxury of staying home to care for and school them, bully for you!

But, Horatio, one should not be sanguine about the real need for vaccines, your philosophy notwithstanding.  We eliminated small pox through universal cooperation.  And we see exactly what happens when we lose that.

Generally speaking--it varies a bit depending on the type of disease--we require about 93-95% compliance to achieve herd immunity.  Complete universality is, like most things, probably not feasible nor strictly necessary because we're fragmenting the population and making transmission more difficult for the bugs.  I'm not sure if this counts as irony beyond a Morissettean sense, but it is of interest to me that folks who don't get immunized are still protected so long as everybody else does the right thing.

It's very convenient, and reminds me of an exchange between Thomas Jefferson and John Adams.  In the wake of Shay's Rebellion, Jefferson famously lauded revolution while he was safely in France:

I hold it that a little rebellion now and then is a good thing, and as necessary in the political world as storms in the physical. Unsuccessful rebellions, indeed, generally establish the encroachments on the rights of the people which have produced them. An observation of this truth should render honest republican governors so mild in their punishment of rebellions as not to discourage them too much. It is a medicine necessary for the sound health of government.

However, that was before the excesses of the French Revolution, which made him reconsider a bit.  Many years later his friend Adams wrote testily:

The coolest and firmest minds, even among the Quakers in Philadelphia, have given their Opinions to me that nothing but the Yellow Fever could have saved the United States from the total Revolution of Government.

I have no doubt You was fast asleep in Philosophical Tranquility...

It's very easy to demand a philosophical exemption for yourself if you are still going to benefit from the actions of others.  As I observed in the original FB thread, I could just as easily ignore stop signs because I can count on everybody else being alert and following the rules--traffic laws are an encroachment on my individual liberty, yo.

There are no guarantees in life, but we can mitigate threats.  You non-immunized people probably will not come in contact with a contagion if 95% of us have gotten our shots, but there's still a chance you could run into somebody whose immunity is wearing down, is in between vaccinations, what have you.  Even the shots themselves are not 100% effective, and can carry small risks including hospitalization and death, just as the diseases themselves.  Yet we can greatly reduce the impact and likelihood of contracting disease by following protocols that have been developed since Edward Jenner.

And while you might be upset--rightly, in my opinion--with the nature of corporatism and might be concerned--again, rightly--that immunization has some downsides, I don't think it's unreasonable, tyrannical or hypocritical for me to question where the bounds of your individual liberty are in relation to mine and the rest of the state's.  We're not even talking about some criminal penalties being imposed on people who do not comply: we're saying if you want to fully participate in society, particularly places where a vulnerable population congregates, you need to put a little skin in the game.

ntodd