Opinion | Individual sovereignty means that people can make their own choices, based on their own assessment of risk. It means that others can advise them, but not compel them. It is a basis for modern human rights and natural law. Public health practitioners like to voice support for these principles, but also really feel good about telling people what to do, based on their expertise and superior knowledge. This is why fascism tends to have a strong healthcare component.
COVID Vaccines are Part of Life
Health bureaucrats have really found their feet during the COVID years, prohibiting children from going to school, families and friends from meeting, and people walking in more than one direction in supermarket aisles or sitting alone on park benches. They banned the use of safe repurposed medicines, claiming they were fit only for animals whilst continuing to use them for other human diseases. Then they mandated injections with novel pharmaceutical products, banning people from working or traveling without them. They have benefitted their sponsors but impoverish the majority with virtual impunity. They rightly feel important, the guardians of society.
But all is not well. While medical fascism has paid well for three years, the public are starting to show signs of lack of trust—perhaps they are sick of being told what is best for them. They may be starting to think they are best placed to assess their own risks and priorities, and act accordingly.
Growing mistrust may stem from a realization that few of the COVID response measures seem to have brought much benefit. They successfully promoted poverty whilst transferring wealth upwards, disproportionately benefiting those promoting the response. They had old people locked up in solitary confinement, so they died alone rather than with family. They declared that those calling for informed consent are a threat to society, and children a threat to adults. Perhaps mistrust is justified.
Now many are proposing a ban on COVID-19 vaccines. They are convinced, on reasonable evidence, that these novel pharmaceuticals probably do net harm overall. They note the unprecedented rate of adverse events associated with the vaccines, from rising mortality to falling birth rates. They worry about mRNA vaccines concentrating in ovaries and adrenal glands, and crossing the placenta to unborn babies, with no long-term data on safety. Many who were standing for freedom of choice regarding ivermectin or hydroxychloroquine are now backing this movement.
Understanding safety and effectiveness of the COVID-19 vaccines is complicated, as the initial randomized clinical trials were damaged by evidence of incompetence and lack of transparency. The manufacturers themselves were unable to show all-cause benefits. Trials for carcinogenicity and genotoxicity, normally mandatory for the genetic therapeutic class to which these substances belong, were also avoided simply by changing the name from genetic therapeutic to ‘vaccine.’ This renaming had required a broadening of the definition of vaccine, as mRNA must co-opt the person’s cellular machinery, like a medicine, in order to eventually stimulate an immune response.
Pharma in general, including these vaccine manufacturers, have appalling histories of fraud. This is shaky ground for trusting a new class of pharmaceuticals, and considerable propaganda and censorship have been required to project a positive image.
However, for better or worse, COVID-19 vaccines do now exist. Lots of people have had them and lots of people, for reasons best known to themselves, continue to request boosters. The vast majority are clearly not dying. People also skydive, go rock climbing and base jumping, risky activities but with generally non-mortal outcomes. While a marketed pharmaceutical is not quite equivalent to a cliff face, both carry inherent risk and theoretical benefits. Anyone partaking of them should be fully aware of the risks and provide informed consent.
The Right to Choose
Truly informed consent is one of the most unpopular ideas in medicine. The idea that the health professional is there merely to inform a patient’s sovereign, independent decision is difficult for a self-entitled profession to accept. Most believe they have a right to limit the public’s freedom when they deem it necessary. While many on both sides of the COVID vaccine debate act with good intent (and sometimes switch sides accordingly), their positions on mandates or bans require that governments use authoritarian approaches to implement public health policy.
As this article will upset well-meaning people, my argument needs further explanation. A belief common to those for and against the COVID response holds that people need to be protected from toxic substances and from malfeasance by doctors or pharmaceutical companies. It assumes that health professionals have a special place in society, shielding the public from areas where they lack knowledge and therefore cannot make sound judgment.
These arguments are reasonable, and in a world where all people live by high standards of integrity and ethics they might represent the safest approach. Unfortunately none of us seem able to infallibly uphold such standards. As 1930s Germany showed, and the COVID response reiterated, the public health establishment is particularly vulnerable to influence and abuse by political or corporate sponsors.
While a penchant for authoritarianism is well-established within medicine, the inclination to ban pharmaceuticals is relatively new. The doctor-patient relationship previously determined use based on context and history, informed (one hoped) by an honest regulatory system. Ivermectin and hydroxychloroquine would have been managed similarly to occasionally deadly penicillin; available at the doctor’s discretion with the patient’s agreement.
Many in the West are getting fat on carbohydrates. However, we don’t ban sugar, but we do encourage the public to eat less, because it’s slowly killing them. We ban smoking where it directly affects others, but don’t ban people from taking risks when alone or among those who consent. Some would like to, but there are always people who wish to ban books, limit free speech, and impose their preferences on others. Decent societies should tolerate them but not indulge them.
Who Should be in Charge?
The primacy of decision-making within the doctor-patient relationship was based on recognition that illness is not just about a virus. It is the result of these within a body with particular genetic makeup, past exposure history, and underlying immune competence. Its severity further depends on the cultural context and value system of the sick person. Lastly but most importantly, it was based on the principle that the patient is a free, independent being, with primary rights over their own body. A doctor could refuse to perform a requested service, but could not force one. Insanity was the only exception. This is fundamental to medical ethics.
Medical practice also traditionally assumed that the doctor has a responsibility to help the patient, or a requirement to cause no harm. This requires expertise and may involve refusal to do all that a patient requests; the doctor is an advisor of the individual and not their subordinate. For this relationship to work, it must be free of conflict of interest and provided with reliable evidence and opinion. Various professional governing boards are supposed to support this process, so these boards and regulators must also be free of conflict of interest.
Public health should be no different—public health practitioners have a role in providing evidence-based guidance to help populations make decisions on health in their own interest. But in the end, the population’s values—cultural and religious – and its weighing of this advice against other priorities it faces, will determine the response. Within this community response, each sovereign individual has a right to decide their participation and actions.
The Nuremberg Code was written to address the harm caused when these principles are abrogated, even if ‘for the greater good.’ Opposing them requires a belief that one person should have rights over another. This may manifest as preventing those considered less desirable from giving birth, destroying an ethnic group considered inferior, studying untreated disease outcomes at Tuskegee, or coercing vaccination as a criteria to earn a living. Like any other group, the health professions simply have no right to impose their will on others. The historic results of ignoring this are obvious.
Market Forces are Preferable to Self-Entitlement
Here we are in 2023 with the COVID vaccines established on the market, amidst allegations of fraud and misrepresentation of data, poor safety and efficacy, and a lack of clear overall benefit. Their target illness is confined in severity to a small segment of the population, nearly all of whom now have good post-infection immunity. The vaccines do not stop or substantially reduce transmission, and may over time increase it.
Mass vaccination in this context is obviously a flawed policy. Mandating a non-transmission blocking vaccine for immune people at minimal intrinsic risk could only be driven by gross ignorance or corporate profit. The use of behavioral psychology to instill fear and the use of coercion are clearly unethical by any modern ethical standard. The many people who have lost their jobs and homes, and were publicly vilified for standing on principle and refusing to submit to such practice, have a clear right to redress. Those who committed fraud should have to answer for it. Those who abandoned the precautionary principle and informed consent should be required to justify their actions and their right to continue to practice.
None of this should remove the right of the public to make their own decisions on accessing these new genetic vaccines as a currently marketed commodity. Where expected harm clearly outweighs benefit, no medical practitioner should offer it, just as it would be inappropriate to offer Thalidomide to a pregnant woman with nausea. Where there are plausible grounds for overall benefit, if should be available as an option. These individuals can decide, based on the information available. While this group of potential beneficiaries appears diminishingly small, it remains conceivable that elderly obese diabetics with no prior COVID infection may benefit. Market forces can then decide whether the product is viable, rather than authoritarian dictates.
In the meantime, the COVID vaccines must pass full regulatory approval as a valid, reasonably safe product. This opens a can of worms, as most were only accepted under emergency use authorization (EUA) and the companies aborted their Phase 3 clinical trials, normally required for approval, by vaccinating the control arms. Valid approval would require submission of data at least confirming overall benefit in people who remain at high risk for COVID. Large trials involving non-immune people would now seem impossible.
A Way Out
To fix the health and societal disaster of the past three years, the public does not need more dictates from the self-appointed medical guardians who caused it. Too many have proven unworthy and incompetent. The problem is deeper than the availability or withdrawal of a vaccine. Public health professionals have forgotten the primacy of individual freedom—of the right of each person to set their own priorities and manage their own bodies. The public are sovereign, not the doctors who wish to lead or mislead them.
With reducing interest in vaccine boosters, it appears the public may solve the vaccine access issue themselves. A free flow of information and genuine informed consent will probably accelerate this. So would a responsible attitude from medical journals and regulatory agencies, if they can emerge from the yoke of their sponsors.
These are problems caused by the public health establishment. This establishment should reform itself, and never again presume it has the right, or the character, to dictate to others. The public will make mistakes, but these will pale beside the mess the health professions have already created.
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This article was originally published by the Brownstone Institute. David Bell, Senior Scholar at Brownstone Institute, is a public health physician and biotech consultant in global health. He is a former medical officer and scientist at the World Health Organization (WHO), Program Head for malaria and febrile diseases at the Foundation for Innovative New Diagnostics (FIND) in Geneva, Switzerland, and Director of Global Health Technologies at Intellectual Ventures Global Good Fund in Bellevue, Washington.