Tuesday, August 17, 2021

Masking Up and Getting Vaccinated: My Rights vs What's Right

The Rise of the Delta Variant

Earlier today I read an article by the by the chief of the Pathology and Laboratory Service for the Central Iowa VA Health Care System. Dr. Stacey Klutts. He is a health care expert, and his expertise is not just in medicine generally but in the very area of medicine that gives one a deep understanding of the virus, the vaccines, and the benefits of masks. He explains clearly why it is so, so important both to get vaccinated and to wear a mask as the Delta variant of the SARS-COV-19 virus surges across the country. He has no political agenda. He simply wants to help keep people alive and healthy.

In briefest terms, his point is this: the COVID vaccines offer robust protection against serious illness and death, but does not prevent the virus from getting an initial foothold on the surface of the throat mucosa. This means that a vaccinated person might be infectious for a couple of days (significantly shorter than the infectiousness of the unvaccinated), but is unlikely to get very sick (or sick at all) since the virus meets a primed immune system as it tries to spread beyond that initial infection point. Beyond this, his focus is on the Delta variant, which is many times more infectious than earlier strains--as infectious as the measles, meaning it is as infectious among humans as any disease we know. This Delta variant is sweeping through the south and heading north fast. He likens it to a tsunami, with vaccination as the high ground of safety. Getting as many people to safety as possible is critical--and mask use by everyone, vaccinated and unvaccinated, helps disrupt the rate of spread enough that we can get more people to safety.

Individual vs Collective Decision-Making

The question is what we should do, individually and collectively, with this information. And here, I want to focus on the phrase "individually and collectively." The first question is about what is the right thing for me to do, what is the right thing for you to do, what is the right thing for all of us as individuals to do granted this information. The second question is about public policy--and questions about public policy are generally about what we as a society will require and what we will permit.

These are different questions. When we are talking about public policy, individual rights loom large and often clash with matters of public welfare. The aim of public policy is to promote the public welfare, but individual rights impose constraints on how we do so. But how much do they constrain? How important does the public good at issue have to be in order to justify a constraint on liberty? These are hard questions, and they are the questions that become front-and-center when our conversation turns to mask mandates and vaccination mandates: does the individual have a right to refuse to wear a mask or get a vaccine, or does the state have the authority, given the urgent public health needs during a pandemic, to require these things?

My purpose in this blog post is to set aside those collective questions altogether and focus on the individual question: "Given the medical information currently available and the situation we are currently facing, what ought you and I to do?" That individual question often gets obscured or lost amidst the debates over the collective, public-policy questions.

What I Have a Right to Do vs. What is Right for Me to Do

In most of my moral philosophy classes, at some point I have to talk about the distinction between what we have a right to do and what is the right thing for us to do. Suppose I'm planning to go to a philosophy conference but learn that my sister will die without getting a liver transplant, meaning she needs a piece of someone else's liver--someone who's compatible. Let's suppose I'm a compatible donor, and it will be very hard to find another in time to save her if I don't volunteer. But if I do volunteer, I'll miss my conference.

I have right to refuse, given that it's my body. But what is the right thing for me to do? That I have a right to refuse really just tells other people what to do. It tells them they can't make me go under the knife to save my sister's life. It means, probably, that it would be wrong for the government to legally require me to donate a piece of my liver to my sister. So, it probably follows that is it wrong for the state to implement public policies that in any way, even with certain constraints, require people to donate organs to dying relatives.  But that doesn't settle what I should do. Should I miss a conference to save my sister's life? Absolutely I should. Her life matters more than a philosophy conference.

Sometimes the question of what we have a right to do is clear, but the question of what's the right thing to do is muddy. Sometimes it's the other way around. Sometimes--as in the case above--both questions are easy to answer: because it's my body I have a right to refuse even if it means my sister's death; and if I exercise that right by heading off to the conference and letting her die, I've done something seriously morally wrong. You'd be justified in thinking less of me. Doing that would, morally speaking, make me a pretty bad guy--even though I have a right to do it. Because the right thing for me to do in this case is clear as day: I should forego the conference and save her life. That's the right way for me to exercise my rights.

So let us assume that the information in the linked article is correct. There's excellent reason to do so. The author, Dr. Klutts, is an expert on precisely the matters at issue. He has studied all the evidence and explains it clearly. And he appears to have no reason to lie. Furthermore, what he's saying is endorsed by every competent physician whose expertise and character I trust--even if a few stray physicians in fields other than epidemiology and virology, whom I otherwise know nothing about, express a contrary view on YouTube videos. (I looked at one such video a few months ago and was able to google some of the claims as I was listening to uncover research studies that flat-out refute what she was saying and, in one case, makes it obvious that she was confused about some key distinctions--Thanks, Google Scholar!)

If you assume this, then the question of what we should do, what's the right thing to do, is pretty darned clear even if the question of what we have a right to do is a matter of major ongoing public debate. The question of whether the government can mandate vaccination and mask-wearing pits public health against individual liberty in ways that can make things muddy very quickly. But that doesn't mean that the question of what each of us should do is equally muddy.

The No-Brainer Moral Question

If the information contained in this article is correct, there isn't a lot of room for controversy about what the best choice is based on concern for your own health and the health of your loved ones, your neighbors, your fellow citizens, and the health care workers who are exhausted and, in many cases, at an emotional breaking point. Getting vaccinated promotes your own health and makes you less likely to infect others. Wearing a mask promotes your own health to some extent, and to a greater extent makes you less likely to infect others. The Delta variant is so transmissible that it will sweep through the unvaccinated population very quickly unless we slow it down with masks and other mitigating measures. Slowing it down gives us more time to get more people vaccinated--and the more people who are vaccinated and the slower the spread, the more likely it is that our healthcare system will be able to handle in the influx of seriously ill COVID patients.

In the light of this information and looking at things from the standpoint of consequences, masking and getting vaccinated are pretty clearly going to have better consequences than not. Of course, something might be immoral even though it has good consequences if doing it violates someone's rights. But my getting vaccinated doesn't violate others' rights. My wearing a mask doesn't violate others' rights. So if we're looking at the question of what I should do, the better consequences of masking and vaccinating win the day. The same is true if we look at things from the standpoint of the ethics of care: If I care about myself, about my loved ones, about the people in my community and the health care workers who treat them, I will want to show that by taking steps to make their lives better. Masking and vaccinating do that. 

When our focus is on the question of what is the right thing for individuals to do, rather than what the law can rightly mandate, there's little room for moral argument. It is one of those no-brainer cases where it's hard to come up with an argument against masking and getting the vaccine. 

My Plea

So here is my plea: Please don't let the controversies about the morality of health care mandates get in the way of seeing what's the best choice for each of us to make as individuals. I understand why people are concerned about legal mandates to get vaccines (and, to a lesser extent, mask mandates), even though I also believe that there is a legal place for public health-related mandates. But that's a debate about what people have a right to do or not do and what the government has a right to require. The question of what's the right thing for you and me to do is a different question. And while there is some variability in answers based on individual life circumstances (I know someone for whom mask-wearing triggers tachycardia), for most of us the question of what's right to do in this situation is far less muddy that the question of rights and government authority, at least when we think clearly enough to separate out the two questions.

So if you think the government shouldn't mandate masks or vaccines, by all means make that case in the public sphere (and be prepared to engage honestly with arguments for the opposing views). But don't confuse that argument with the question of what is the right thing for you and me to do.

In other words, it makes perfect sense to wear your masks, get your vaccine, defend the right of your neighbors to refuse to do likewise...while arguing that the right thing for them to do, the right way for them to exercise their rights, is to follow your example and get vaccinated and wear masks.

And whatever you do, please, please don't do something that hurts you and your loved ones and your neighbors and your community and the health care workers we all depends on just as a way to assert your right to do it. We have a right to do things we shouldn't do. But in making decisions, it's the "shouldn't do" part that defines our moral character.

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