People are free to make all the bad choices they want when it comes to themselves, but not when they put others in danger and incur costs that we all must pay. This is where we find ourselves today with the COVID-19 vaccine. Until now, the default has been to err on the side of liberty, allowing individuals a maximum of free choice and personal responsibility.
But as the pandemic has evolved, this model is no longer viable. With the highly infectious delta variant surging, the unvaccinated are posing direct risks to the health and well-being of the immunocompromised, the frail and the elderly, and especially young children, who cannot yet be vaccinated. The ethical challenge is crystal clear: The actions – or, in this case, the inactions – of the unvaccinated pose clear risks for society writ large. As the old saying goes: Your right to swing your arm ends where my nose begins.
Hold eligible adults accountable
While a few have valid medical reasons to avoid vaccination, less than 60% of eligible Americans are fully vaccinated. Some adults who are eligible but unvaccinated insist they are being unfairly singled out for criticism – that “not getting the 'jab' is the new Scarlet Letter,” as conservative writer Patrick Hampton put it, and that forcing them to disclose their status is totalitarianism.
They are enabled by the right-wing news media, conservative politicians and even some celebrities. Florida Gov. Ron DeSantis has challenged Centers for Disease Control and Prevention guidelines that incentivize cruise ship employees and passengers to be vaccinated. Eric Clapton recently declared he will not perform in venues that ban the unvaccinated.
Until now, society has pussy-footed around the right of the unvaccinated to inflict harm. We have implored them to do the right thing, creating incentives like free beer and lottery tickets for them to do so. The Biden administration mandated late last week that federal workers be vaccinated or regularly tested, a wave of businesses announced vaccine requirements, and some Republican officials are imploring the unvaccinated to get it done.
But instead of focusing on how to contain spread from unvaccinated people, the CDC put the onus on the rest of us – advising the vaccinated and especially children to again mask up indoors. Why should kids and the vaccinated bear this burden? The right thing to do is to impose restrictions on those who choose to go unvaccinated.
The Christian thing to do: Stop using religion to fight the COVID-19 vaccine. Get vaccinated.
The unvaccinated have every right to make themselves sick, but do they have the right to infect their own or other people’s children – like the 13-year-old daughter of an unvaccinated mom in Arkansas who was recently put on a ventilator? The unvaccinated make up more than 97% of those who are hospitalized from COVID-19. Do they have the unfettered right to overwhelm local health care systems, denying medical care to others who need it? To potentially cause more school closings, damaging the lifelong prospects of young children while exacting a huge economic toll on the rest of us?
Vaccine passports are essential
Ethical dilemmas often entail tough choices, but this one is easy. The choice to not vaccinate does far more harm than any infringement of the rights of the unvaccinated. While society cannot and should not force anyone to vaccinate, we can and should require them to take responsibility for their choices.
The unvaccinated should be required to disclose their status, so that the people they come into contact with can make informed decisions about their own health and safety. They should be required to mask and distance when they are in public spaces. They should be required to quarantine when they travel. To make all this possible, we need to accelerate the use of effective vaccine passports. And health insurance companies can and should impose added costs on the unvaccinated, just as they do for smokers.
What would Ben Franklin do?: 'Medical freedom' isn't an American value. The Founders promoted vaccines and public health.
Before vaccines were available, we were all subject to public health restrictions. One of us is an American who lives in Toronto. Before he was vaccinated and until very recently, under Canadian government rules, he had to quarantine for 14 days whenever he traveled across the U.S. border into Canada. If he broke the quarantine and infected someone, under Canadian government rules at the time, he would have been subject to steep fines and even possible imprisonment. The same kinds of restrictions should continue for those who choose not to be vaccinated.
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Liberty is not a value without limits. Saying someone is free does not mean they have no responsibilities, duties or obligations to others.
As Albert Camus wrote about a different plague: “On this earth there are pestilences and there are victims – and as far as possible, one must refuse to be on the side of the pestilence.”
Richard Florida (@Richard_Florida) is University Professor at the University of Toronto. Arthur Caplan (@ArthurCaplan) is the Mitty Professor of Bioethics and founder of the Division of Medical Ethics at the NYU Grossman School of Medicine.
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This article originally appeared on USA TODAY: COVID vaccine: Require restrictions, higher insurance of unvaccinated