True.
But it IS an indicator that the Authority Figure is FOS.
And, FWIW, irony is lost on one of the authors. Wow…
Posted on 02/29/2024 4:30:35 AM PST by DoodleBob
The Association of Bioethics Program Directors (ABPD) represents nearly 100 bioethics centers across North America. The ABPD’s members are leaders in evaluating ethical practices in the health professions and have participated in drafting institutional, statewide, and national health policies. In fall 2021, the ABPD issued a statement and a companion piece for Health Affairs Forefront describing why universal COVID-19 vaccine mandates, with exceptions only for medical contraindications, were ethically recommended at that time. In fall 2023, the ABPD membership approved a new position statement that universal COVID-19 vaccine mandates are not presently ethically supportable.
The values and principles that guided our earlier position remain the same, but the context has evolved. Understanding why our group has changed its position can offer general lessons about the ethical necessity of changing policy and practice recommendations when circumstances evolve, and about what such changes—and resistance to them—reveals about public health actors and advocates.
During the Delta wave of COVID-19 in 2021, the ABPD recommended universal mandatory vaccination against SARS-CoV-2—with limited medical exceptions—because evidence over the prior year had consistently shown vaccination to be: remarkably safe; highly protective against hospitalization and death; and moderately effective at preventing transmission of the infection to others. In addition, by fall 2021, vaccines were widely and freely available in the US, and extensive measures had been taken to improve vaccine uptake, including education campaigns and direct financial incentives. Yet, vaccination rates in many areas remained alarmingly low; mandates were known to improve vaccination rates in other conditions, and early studies suggested that they could to the same for COVID-19 (these findings have since been confirmed). Equally important, health systems worldwide were under tremendous strain, with most cases of severe COVID-19 arising among unvaccinated individuals, and this strain was affecting the care of many patients, not just those with COVID-19 infections, resulting in worse health outcomes and increased death rates.
The combination of these factors made a universal requirement to be vaccinated against COVID-19 ethical at that time. We also recognized then that any public health mandate is an infringement on individual liberty, which matters greatly, and we argued that vaccine mandates therefore must have strong ethical justification. Moreover, we knew then that a vaccine mandate had the potential to backfire among some people. Thus, both respect for autonomy and pragmatic considerations made it necessary to provide robust ethical as well as scientific justifications for vaccine mandates, and these concerns informed our earlier statement. For instance, we did not endorse forcible vaccination or imprisonment of those refusing vaccination even as we argued that other coercive methods, such as fines, could be ethical. Furthermore, we did not argue that a COVID-19 vaccine mandate should remain in effect in perpetuity; rather, we expected that our position should change if and when circumstances with COVID-19 changed sufficiently.
Today, some contextual features from 2021 persist, but several have changed in significant ways, which prompted our reassessment of the ethics of vaccine mandates now. Illness from COVID-19 is still common, and vaccinations remain effective at diminishing the possibility of serious illness and death. But recent variants have had milder clinical outcomes across the population, due to a combination of widespread vaccination, infection-related immunity, better treatments, and changes in the biology of the virus. Hospitalization rates for COVID-19 have declined dramatically since fall 2021, and US health systems are no longer at imminent risk of collapse from being swamped with severely ill, unvaccinated COVID-19 patients. Meanwhile, the benefits of vaccination for reducing transmission to contacts have also been dropping. For instance, recent data suggest that vaccination against Omicron might reduce secondary transmission by only 31 percent (compared to 96 percent against Alpha and 87 percent against Delta strains) and that prior infection provides comparable levels of protection against forward transmission. Since nearly everyone now has been infected, vaccinated, or both, the marginal benefit of vaccination in terms of preventing onward transmission to the community is much lower today than it was in 2021.
Ethically, these changes to societal risk are key. It is widely held that “my right to swing my fist ends where your nose begins” (to quote John B. Finch). In other words, people should be able to do what they like, until others are affected. Limits on the permissibility of putting others at risk are commonly justified and often required. Speed limits, stop signs, cleanliness standards for restaurants, safety requirements in factories, and many other laws and regulations that protect third parties’ health and well-being are widely accepted. Some individuals might not like following public health and safety measures, but most appreciate that these measures are reasonable and regularly abide by them.
Another important factor now looms comparatively larger: the potential for mandates to backfire and increase vaccine resistance. While universal vaccination with updated vaccines remains desirable, it is increasingly difficult to know if vaccine mandates can help to achieve this. For the minority of people who remain unvaccinated today (more than 80 percent of US adults have received at least one dose), a mandate might be ineffective or even counterproductive. For instance, some vaccination holdouts with false convictions that the pandemic is merely an excuse to assert control over the population might choose to be vaccinated only if they feel uncoerced into doing so, that is, after mandates have been lifted. Only then might they be able to accept that vaccination is in their best interests.
Changing an ethical recommendation does not always mean that one has changed values or reconsidered their comparative weights. The main ethical values that need to be balanced in considering vaccine mandates are the liberty interests of individuals versus our responsibility not to harm one another. Today, although the benefits of updated vaccination to individuals remain considerable, the relative value of universal vaccination against COVID-19 for achieving safety for others seems considerably lower than it was in fall 2021. This is why the APBD now supports policy decisions to lift most COVID-19 vaccine mandates but continues to call for freely available access to updated vaccines against COVID-19. We also recognize that vaccine mandates could again become ethically justifiable should circumstances change.
Critics of the COVID-19 response sometimes mock what they perceive as the “flip-flopping” of experts on policies ranging from vaccine mandates to masking to social distancing to addressing pediatric risk. But evolving recommendations can be a sign that experts are doing exactly what’s expected of them—modifying their responses as data emerge and the situation evolves, and not tethering themselves to dogmatic thinking or ideology. Indeed, the harshest critics of the COVID-19 response have sometimes been those who grasped a theory of the pandemic early on and have been seemingly unable to adjust their views. Those who still believe that ivermectin is a “miracle drug” against COVID-19, despite reams of recent data to the contrary, have become exemplars of the perils of being unable or unwilling to integrate new information into one’s recommendations.
While we believe that universal vaccine mandates are no longer ethically justified, it does not follow that no mandates are justifiable for any group. In particular, some ABPD members support preserving COVID-19 vaccination mandates for at least some who work in health care, given the responsibilities tied to their professional roles and the extreme vulnerability of some patients. It also bears emphasis that updated vaccines against COVID-19 remain highly effective at protecting individuals against serious illness and long COVID. As long as vaccines are in good supply, governments are ethically obliged to provide free and equitable access to vaccination for children and adults. Finally, our revised guidance on the ethics of mandating COVID-19 vaccination does not lead to revised views on other vaccine mandates with very different science and social context. Routine childhood vaccinations, for instance, provide enormous ongoing benefits to children and communities, and mandates are well-known to be effective at achieving and sustaining near-universal vaccination in that unique population.
In conclusion, the ABPD believes that most COVID-19 vaccination mandates should be lifted now, but this does not mean they weren’t justified before nor that they might not be justified again in the future. Science, public health policy, and ethical analysis are and should be topics of ongoing learning, especially in a rapidly moving pandemic—which means that all three should be expected to change as the context and knowledge base evolve.
All the authors are affiliated with the Association of Bioethics Program Directors (ABPD) and a policy on this topic is the subject of this article. During COVID-19, Eyal served on a group of advisers to the New Jersey Department of Health. Dr. DeBruin served as a member of the Minnesota Department of Health’s COVID-19 Vaccine Advisory group (which provided recommendations on allocation, but not mandates, and did not have power to set policy itself), and she co-led the Minnesota COVID Ethics Collaborative (MCEC) (which developed ethics recommendations on various issues related to COVID-19 response in the state—MCEC was advisory only, it did not have power to set policy, and it did not provide recommendations on vaccine mandates). The campus where Wynia works adopted a mandatory COVID-19 vaccination policy, which was largely rescinded in July 2023. Dr. Eberl is president-elect of the ABPD.
True.
But it IS an indicator that the Authority Figure is FOS.
And, FWIW, irony is lost on one of the authors. Wow…
And that it’s against international law via the Nuremberg trials to force any individual any medical treatment without their express permission. So there’s that.
One cannot unring the bell.
This reads as an excellent example of “how not to do ethics”.
It was not a secret before, during, or now.... despite the “novelty” of covid.....it was very much like a flu. The flu comes and goes every year. Vaccines sometimes work sometimes dont. Natural immunity is a vital part of moving though a pandemic. However the ethics involved in lying about causes of deaths, lying about natural immunity’s value, lying about the effectiveness of the vaccine, lying about alternative treatments, lying about the origins of the virus all escape me.
Medical community now ranks up there with politicians, lawyers and the media as far as trust goes. That of course renders opinions like this guys useless and truthfully ,laughable.
Nuremberg 2.0. Justice
lbie wrote: “And that it’s against international law via the Nuremberg trials to force any individual any medical treatment without their express permission. So there’s that.”
First of all, that’s incorrect.
Second, the Nuremberg conventions are not US law.
I couldn’t read the whole thing it was so disgusting. It’s worse than a flip flop, it is self serving swill.
Modern Vaxes are highly effective against Cold-19? Perhaps they should tell the truth about the mask?
https://www.youtube.com/watch?v=Vic9vfkxVsI&t=2990s&pp=2AGuF5ACAcoFOUJyZWFraW5nISBUaGV5IFBMQU5ORUQgdGhlIHdob2xlIHRoaW5nIHllYXJzIGluIGFkdmFuY2UuIA%3D%3D
In other words, you are still an idiot.
wjcsux wrote: “In other words, you are still an idiot.”
The ‘idiots’ are the members of the anti-vaxxer conspiracy cult.
“The ‘idiots’ are the members of the anti-vaxxer conspiracy cult.”
The evidence against you Branch Covidians is stacking up by the day. Your gaslighting days are rapidly coming to a close.
wjcsux wrote: “The evidence against you Branch Covidians is stacking up by the day. Your gaslighting days are rapidly coming to a close.”
The fact that the anti-vaxxine folks can only respond with personal attacks, that they avoid factual responses, only proves you are wrong.
its not a vaccine and does not confer immunity from covid and never has, CDC changed the defanition of a vaccine.
OH and prove me wrong.
markman46 wrote: “its not a vaccine and does not confer immunity from covid and never has, CDC changed the defanition of a vaccine.”
No vaccine has ever confered immunity to a disease. There are always breakthrough cases. Regardless of the minor changes in definition, the covid vaccines are still vaccines.
if you believe that you are so very wrong
smallpox, polio etc vax’s do confer immunity.
and no the covid vaccine do not stop you from getting or passing on covid period.
markman46 wrote: “if you believe that you are so very wrong
smallpox, polio etc vax’s do confer immunity. and no the covid vaccine do not stop you from getting or passing on covid period.”
You do realize that you can still get smallpox or polio after you’ve been vaccinated? Just like the COVID vaccines, neither the smallpox or polio vaccines prevent infection in all cases. IOW, no vaccine ‘confers immunity’ if you mean that one cannot become infected after vaccination.
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