The opinion of the Bioethics Committee on compulsory vaccination: one more step towards the dissolution of the ethics of fundamental rights

Part 2
(see Part 1)

The arguments of the Bioethics Advisory Committee, built on a flawed scientific basis as shown in the first part of this text, are easily refutable. In the text below, we have refuted them one by one in order to highlight the lack of scientific and ethical basis for the government’s position. A tedious exercise, but an edifying one! The Committee’s arguments have been numbered I through X and our objections 1) through 42).

I. Among the justifications for mandatory vaccination, the Advisory Committee’s opinion sets out the principles of « non-harmfulness » and « reduction of risks and harm to the most vulnerable ». It considers that, although every individual has the fundamental right to refuse treatment, this freedom could be limited if it involves a risk to others, provided that this measure is proportionate and necessary in terms of public health. However, these various conditions are clearly not met.
Indeed:

1) people who are not vaccinated against covid-19 may become infected at some point and pose a risk to others, but so may people who are vaccinated. In relation to the question of risk to others and transmission, it is therefore wrong to present the vaccination of all as necessary in terms of public health;

2) if vaccination is only effective in reducing the number of severe forms of covid, vaccination of people who are not at risk of developing severe forms of the disease (i.e. the majority) cannot be presented as necessary in public health terms either;

3) the anti-covid « vaccines » are experimental (they are in phase 3 of testing), and it is illegal to force a person to take part in an experimental treatment;

4) these « vaccines », like any treatment, are not without risks of serious side effects and contraindications: studies to better define these risks (short, medium and long term) and contraindications are still underway;

5) The risks of vaccinating against HIV after being infected are still being studied;

6) therefore, to put a healthy (and non-consenting) person at risk, without any guarantee of benefit in individual terms or in terms of transmission, is an unjustifiable measure: the Bioethics Committee will not be able to contradict this principle, which puts forward the concern for « risk for others »; as a collective stresses, this risk « would constitute a serious infringement of the ethical principles of precaution and non-maleficence, in a democratic system which confers on the State an obligation to protect all its subjects whatever their state of health »⁽¹⁾ ;

7) At this stage, the efficacy of vaccines on the omicron variant and on future variants is not clear: it is therefore not justified to force vaccination with products developed for old strains;

8) In terms of severity and mortality, covid is not polio, yellow fever or smallpox. The mortality of omicron has yet to be determined but appears to be extremely low. Whether it is the original strain, which is already not very lethal (0.2%), the delta variant or the omicron variant, it is not proportionate to put young people who are not at risk of severe forms of covid at risk from vaccination;

9) these « vaccines » are not vaccines because they do not protect against contamination or disease. At best, these are treatments for severe forms (not all of which are preventable). Every individual has the right to consent to the treatments proposed to him or her. Reversing this fundamental principle would open a Pandora’s box that would allow the State to impose any treatment, vaccine, medicine, medical device, etc., in the name of what the institutions (Belgian, European, international, public or private) or the majority will consider as being in the public interest;

10) However, the power of the State over an individual must have limits: the right to respect for bodily integrity is a safeguard and its violation would lead to a world where the bodily integrity of each individual could be violated whenever the decision-making bodies so decide;

11) Liberal democracy is not the dictatorship of the majority: respect for minorities and fundamental rights are inherent principles;

12) while voluntary vaccination of people at risk is legitimate, mass vaccination in times of pandemic is considered by some scientists to be a medical error that, on the one hand, would deprive younger people of the acquisition of a broader natural immunity that could protect them from future variants and contribute to herd immunity and, on the other hand, would be likely to exert selection pressure on the variants

II. The opinion contrasts two fundamental values: solidarity and respect for individual freedom.
Gold:

13) these two values do not have to be opposed nor hierarchical but must be sought simultaneously;

14) Vaccines are not solidary since they do not prevent transmission;

15) the meaning of the term solidarity is deviated here because it is a question of making people who are reluctant to be administered these « vaccines » take potentially serious or even vital risks, but the forced sacrifice is not part of the field of solidarity;

16) the argument of the lack of solidarity could be returned to those who put pressure on the non-vaccinated and do not show any solidarity towards young people (sometimes their own children or grandchildren) likely to be endangered by possible serious side effects of the « vaccines »;

17) real solidarity would be based on the construction of solid health structures (hospitals, caregivers, primary care, prevention) and this is a political issue (see below).

In the same vein, the opinion stresses that, in general, individual freedom can be limited to preserve the public interest. In this case, he makes « the immunity acquired within the population » (one imagines that he is referring to vaccine immunity) « a kind of common good ». Gold:

18) The public interest and the common good also lie in the natural immunity of the young and of those not at risk, which can contribute to a certain collective immunity;

19) on the other hand, in preserving the health of children and people not at risk by not forcing them to administer experimental products;

20) and finally in the preservation of fundamental rights, including the right to informed consent and the right to bodily integrity;

21) on the ideological level, the opinion clearly gives precedence to the notions of solidarity and the common good as redefined by the decision-making bodies over consent and bodily integrity, which evokes more the language of a Chinese-style regime than that of a liberal democracy.

In the same vein, the opinion sets out the idea that solidarity takes precedence over individual freedom with a view to reducing the risks associated with severe forms of the disease and their social costs, the stress on carers, fragile people and the circulation of the virus which creates variants. Gold:

22) If vaccines work and really prevent severe forms, this is the case whether or not there are non-vaccinated people;

23) non-vaccinated people assume their choices and the choice of their medication and accept the risk of severe forms;

24) the social costs linked to the serious forms of covid of the non-vaccinated are not higher than the social costs linked to the pathologies caused by cigarettes, drugs, junk food, obesity, risk behaviors, etc. (yet no constraint of behavior or treatment is imposed on these patients), nor to the social costs generated by the so-called « sanitary » measures (confinements, isolation, closure of certain economic sectors, disruption of the educational and sports sectors, etc.);

25) non-vaccinated people contribute like others;

26) Fragile people must be protected (prevention, early care), but also protect themselves (we are responsible for ourselves before being responsible for others);

27) finally, the circulation of the virus creates variants, but, as we have pointed out above, mass vaccination during a pandemic, according to some scientists, could also exert selection pressure on the variants.

III. The opinion expresses the idea of a « general vaccination obligation, a factor of equality ».
Gold:

28) this is a real nonsense from a medical point of view: in terms of health, whether it is a matter of treatment or even vaccination, each individual must be considered on a case-by-case basis. The opinion mixes here two levels of discourse: an ideological discourse and a medical discourse.

IV. With regard to acquired (vaccine) immunity in the population, the opinion states: « the circulation of the infectious agent is so impeded that the probability of a susceptible individual being contaminated is very low ».
Gold:

29) In view of the outbreaks of infection, including in the countries that have vaccinated the most, it is difficult to argue that the circulation of the virus has been impeded by vaccination.

V. In the Committee’s view, the use of a population-based vaccination strategy is scientifically established.
Gold:

30) the use of generalized anti-covid vaccination with the currently proposed vaccines during a pandemic is a strategy that is far from being unanimously approved scientifically.

VI. According to the opinion, one of the justifications for compulsory vaccination is to preserve hospital capacity, to avoid postponement of care and « to avoid greater expenditure that would be necessary if an epidemic broke out ».
Gold:

31) on the one hand, the end does not justify the means;

32) on the other hand, what is expected of a bioethics committee is to state ethical arguments, not political or economic arguments: these are political objectives that should not be based on an individual constraint to vaccination: it is the responsibility of the government, to whom financial means are allocated, to ensure that hospital capacities correspond to needs, and it is well known that capacities have been reduced for several decades; similarly, the postponement of care is the consequence of political decisions. Increasing hospital capacity and improving primary care are policy issues that have been culpably neglected. The saturation of hospitals, which has been seasonal for years, should not be attributed to scapegoats.

In the same vein, the opinion states: « the financial burden of the epidemic is difficult to absorb by a public health system with limited resources and it goes beyond the health system to other sectors of society ». Gold:

33) the economic consequences are more due to the sanitary measures (confinements, curfews, shutdowns of certain sectors) than to the virus itself;

34) the opinion rightly mentions limited resources that should not be wasted, but do we need to remind ourselves of the number of billions granted for the purchase of « vaccines » that leave something to be desired and for aid to sectors that government measures have devastated?

VII. The opinion states the following justification: « By being vaccinated, they contribute to the protection of the right to life and the right to health of others. On the contrary, it is the government and society that would adopt such a vaccination obligation that could be accused of denying the right to health and the right to life to certain citizens.
Indeed:

35) by refusing experimental injections that are not without risks, as the pharmacovigilance data strongly suggest, and by invoking freedom of care, the non-vaccinated are also claiming their right to health;

36) similarly, by refusing the non-vaccinated the right to work (a right refused to caregivers, and tomorrow perhaps to all employees), society is in a way refusing them the right to subsist, that is to say the right to live.

VIII. The opinion goes on to state the following rationale: « Some vaccinations may cause serious side effects in rare cases. One could conclude that it is therefore not justified to administer these vaccines. However, similar complications may be observed in persons who develop the disease with a frequency (…) greater than that following administration of the vaccine (…) The much higher frequency of complications due to the disease is a decisive factor in this assessment to vaccinate anyway.
Gold:

37) this paragraph misleadingly fails to make clear that the serious effects of covid and vaccines do not affect the same people. Indeed, people at risk of covid make, at the time of vaccination, a free benefit-risk calculation that is their responsibility. But it would be neither acceptable nor proportionate to force people who are not at risk of covid or who are not afraid of facing these risks to take an unconsented risk, and for some, greater than that to which the disease exposes them, by forcing them to vaccinate;

38) it is therefore not appropriate to weigh benefits for one class of population (at risk of serious covid) against risks for another class of population (younger and not at risk of serious covid). To date, the benefit-risk balance between covid and vaccine differs for each person depending on their age, immunity, co-morbidities, and health history, and it is up to them to make this calculation themselves;

39) To date, studies on pharmacovigilance have not been sufficiently developed and the institutions that should be conducting them have raised doubts about their independence.

IX. According to the Committee, « Western democracies value respect for the physical integrity of the individual, a position that is reflected in the requirement of informed consent (…). However, this principle is not absolute. In certain circumstances, it may be necessary to make vaccination compulsory in order to prevent an imminent risk of serious disease. The opinion thus calls into question the principle of respect for the bodily integrity of the individual and the principle of informed consent to prevent an imminent risk of serious illness.
Gold:

40) any disease can be serious for people at the end of their lives or for those who are frail: this reasoning in favour of generalized compulsory vaccination could therefore be applied to any pathology. However, it is not applied to influenza, colds or gastroenteritis: should we expect it to be in the future? And why would this development be justified?

41) as we can see, overriding the right to respect for bodily integrity and the principle of informed consent is tantamount to opening the Pandora’s box mentioned above, since these two fundamental principles (as well as all the others) can then be placed in parenthesis simply by invoking, by the decision-making bodies, the « general interest », the « common good » or « solidarity ».

X. The opinion states that compulsory vaccination could be justified provided that the state compensates for the damage caused by possible undesirable effects.
Gold:

42) such a condition would not be sufficient to justify compulsory vaccination and the risk it imposes on a part of the population, particularly the youngest, who are not at risk of serious covid. Accepting the possibility of serious side effects following vaccination in a single child, a single non-consenting person, for a benign disease, as evidenced by the low mortality rate, is ethically unacceptable: a serious pathology or death following the forced administration of a treatment is akin to poisoning or homicide, and compensation does not make up for the moral fault. It should be noted that if the vaccination obligation takes the disguised form of a vaccination pass, the authorities will be able to invoke their lack of responsibility since the principle of compulsory vaccination will not be enshrined as such in law.

The common good, the big loser

The only acceptable points in the Bioethics Committee’s opinion on mandatory vaccination are:

- it recognizes that it is unethical to refuse care, whether urgent or non-urgent, to a non-vaccinated person (contrary to what a part of the population in favour of compulsory vaccination says it is ready to consider, among other discriminatory measures, which may even infringe on the rights of non-vaccinated persons);

- that solidarity (social security) should not depend on vaccination status (contrary to certain discriminatory measures envisaged by certain countries, such as exclusion from unemployment for non-vaccinated persons, who are already deprived of their right to work);

- that « any physical coercion to subject an individual to vaccination » would be ethically unacceptable; however, it is regrettable that the opinion does not recognize that moral and economic coercion are equally unacceptable acts of violence!

On the following points, on the other hand, instead of denouncing profoundly unjust practices, the Committee pretends to propose an ethical framework (presented as) for compulsory vaccination and, in so doing, endorses the principle:

- the Committee indicates that removing the possibility of being tested to maintain the health pass could only be justified on a scientific basis. Even if it is difficult to see how this scientific justification for the suppression of the tests could be provided, one would have expected an independent ethics committee to denounce the lack of scientific basis of the health pass (given that the vaccinated can also be contaminated);

- the Committee states that a mandatory vaccination strategy should explain the need for vaccination, explain the negative consequences, and be free of commercial considerations. Again, one would have expected an ethics committee to denounce the fact that these three conditions are not, in fact, met, and only bad faith could lead to ignoring these obvious commercial interests;

- instead of denouncing the idea of sanctioning people who refuse to be vaccinated, the Committee endorses the principle, proposing sanctions that are « appropriate and fair » and that « do not allow a limited proportion of the population to afford a right not to be vaccinated that would not be available to others. Such consequences could include a very significant financial penalty;

- the Committee adds that the government should demonstrate « how the use of voluntary vaccination is insufficient to ensure the preservation of the public interest and of vulnerable individuals. Once again, even if it is not clear how this demonstration could be made scientifically, one can only regret the « prudence » (and therefore complicity) of the Bioethics Committee, which seems to have refrained from criticizing, contesting or denouncing the government’s ethical choices during this crisis.

*The first part of this article has benefited from the reflection and advice of a multidisciplinary group