The other day Neil Oliver made a point about freedom and Covid. I know Neil very slightly. He has sent a few kind messages, but I know him no more than that. I have watched his TV programmes regularly. We happen to agree about the constitutional debate in Scotland, but we disagree about other things. I think we disagree about the Covid vaccine. But we absolutely agree about freedom.
I am strongly in favour of the Covid vaccine. I have been vaccinated twice and will immediately take any vaccine that is offered in the future. But I respect the right of other people to disagree about this. Reasonable people can disagree about issues like this and it is crucial that they are allowed to do so. The right to disagree is what makes us a free society.
While I was keen, indeed eager to be vaccinated for Covid, my husband remained sceptical. We discussed this. Each put forward arguments. But it came down to a basic feeling due to our different backgrounds and beliefs. We agreed to differ, but also to respect our choices.
My husband was born in the Soviet Union. As a child he found that he had minimal freedom of choice regarding medical treatment. He was vaccinated for all sorts of things including for diseases he was unlikely to be exposed to. The state said you must be vaccinated and along with the rest of his school class he had to accept whatever was injected into him. He resented it then and resents it now. He wants to be in control of what goes into his body. He wants the right to say No. I believe he ought to have that right even if I disagree with him. This is the difference between living in Britain and the Soviet Union.
One of the key principles of modern medicine is consent. As adults we have the right to refuse medical treatment even if doctors and experts disagree with us. For instance, Jehovah’s Witnesses frequently refuse blood transfusions for religious reasons. They do so even when as a consequence they will die. So too someone might decide that cancer treatment is not worth it. Some elderly people choose not to be resuscitated if they get ill. There are other instances where someone chooses to have a medical operation, that I might consider to be unnecessary. I find it baffling, for instance that someone might want to amputate a healthy leg, but there are examples of this. But each of us must have the freedom to choose medical treatment or else avoid it. This is fundamental to living in a free society.
But while refusing to accept cancer treatment might kill me, it is unlikely to have any effect on anyone else. One of the arguments for vaccination is that it affects other people too.
Take the example of measles vaccination. In order to prevent outbreaks of measles it is necessary that a certain proportion of the population is vaccinated. If I refuse to have my child vaccinated, there is the possibility that it will catch measles and infect someone else. The same goes for Covid.
What we do or refrain from doing has consequences for ourselves, but also for other people. But to limit our freedom of choice because it has consequences for others is dubious because everything, we do might have a consequence for someone else.
When I drive a car, everyone else depends on me driving without making a mistake. Let’s say I don’t sleep particularly well one night. This might make it slightly more risky that I have a car accident. But to suggest that I morally ought not to drive because of this slight extra risk would be an unjustified infringement on my freedom to go to work. As we age, our reactions slow, which might mean we are gradually less likely to stop in time if a child walks in front of our car, but it would be an appalling loss of freedom to say that only those with perfect reactions should be allowed to drive.
Each of us in our daily lives can infect other people, with colds or flu, but we do not require everyone with flu symptoms to be locked down at home. Only certain very dangerous infectious diseases like typhus and typhoid have traditionally required us to remain isolated.
It is reasonable morally to require someone with pneumonic plague to lose his freedom, because the consequence to other people is very likely to be deadly. But I do not believe that this should be extended to relatively mild diseases. Covid 19 is a notifiable disease, but we must be very careful in extending loss of freedom to such diseases.
Covid kills between 0.5 and 1% of those who catch it. While the risk of dying for those over 70 is relatively high, the risk for everyone else is much lower to the point where children are at a very small risk of dying. But other ordinary infectious diseases also kill. If I have flu and infect an elderly person he might well die. Historical flu pandemics have had similar risks to Covid. Spanish flu in 1918-1919 was far more deadly. Do we really want to limit our rights to move freely amongst the population because of an infectious disease that just might kill someone else? There is clearly a balance. While I would be happy to have my freedom limited if I had typhus, I would be unhappy if every time I had a cough, a cold, or a temperature I was forced by law to stay at home.
The freedom to live a risky lifestyle, smoking, obesity, excessive drinking, has consequences for other people, because the lifestyle of everybody has consequences for how likely it is for us to require medical treatment. Each of us pays taxes for healthcare, we do not say that obese people should pay more or be denied treatment for illnesses that are a consequence of their obesity. Nor do we restrict the freedom of people to climb mountains or play Rugby because they are more likely to be injured. Our freedom requires us to be able to choose to do things that are risky, even if it has consequences for other people.
People who choose not to be vaccinated for Covid may just be opposed to this vaccination for a variety of reasons, but they may also be balancing risk versus reward. The Government decided not to give the AstraZeneca vaccine to under 40s, because it deemed that the risk reward calculation made it unjustified. So too the Government has decided that under 18s will usually not be vaccinated at present.
The reason was children are very unlikely to die. But clearly unvaccinated children can infect other people. But we must balance the likelihood of a child infecting someone else with the risk to the child from taking the vaccine. But if this calculation works for children, it must also be open to adults. If the rights of children require us to refrain from vaccinating them, then the right to freedom of choice with regard to vaccines must be extended to adults. If it is not wrong for children to infect others because of lack of vaccination, it cannot be wrong for adults to infect someone because of lack of vaccination. If the Government is allowed to make a risk reward calculation for children, each of us ought to be allowed to make a similar risk reward calculation about ourselves.
A twenty-year-old adult is very unlikely to die from Covid he may therefore reasonably conclude that it is not worth the slight risk from being vaccinated. I might disagree with that decision. I do. But I would not wish to deprive him of the choice to make it.
Neil Oliver is therefore not being selfish if he decides to not be vaccinated. The decision is not different in principle from choosing or refusing a flu vaccine. We are fortunate I believe that large numbers of people in Britain have chosen to be vaccinated. The consequence of those relatively few sceptical people refusing is unlikely to kill anyone who has been vaccinated. The risk if there is one is therefore mainly to Neil himself. Even if he catches Covid and infects someone else there will be only ever a small chance the other person would die. But that is morally no different and no more selfish than going on the bus while coughing and spluttering, which too might kill someone. Which of us has not done this or something similar?
Freedom of choice is something we have fought wars to maintain. It was worth losing hundreds of thousands in both World Wars. We have lost sight of this as our freedom has been eroded since the pandemic began. We have duty to others and we ought not to act recklessly, but each of us has a duty too to balance our desire for safety with the right of others to exercise their freedom. If we don’t, we will quickly find that our right to drink, smoke, be fat or engage in risky activities will be curtailed by a government intent on protecting us from ourselves. We are already moving in that direction, for which reason I defend Neil Oliver’s right to freedom over his own body. Without it none of us will have any freedom worth having at all.
This post was originally published by the author on her personal blog: Lily of St. Leonards (effiedeans.com)