Morning Ethics Warm-Up, 1/29/19: Sick Room Edition

I hope you’re feeling better than I am.

1. Sick Ethics. Being sick on the job is always an ethical conflict, and riddled with bias. My father’s approach, so characteristic of him as someone who insisted on going into the Battle of the Bulge as an officer with a mangled, recently-repaired foot that was still oozing blood, was to ignore the illness and soldier on. There are two problems with that, however. First, you are working at diminished capacity, and second, you risk infecting others. The problem is a bit easier when you have a home office like I do, but there is still a trade-off issue: if I “soldier on” like my father, do I risk a longer illness and reduced capacity for far longer than if I just took a day or two off to recuperate? In my case, this is always a tough call: I am very vulnerable to bronchitis and pneumonia following chest colds (that’s what I’ve got, big time, starting last night), and when the stuff I cough up starts attacking me through the Kleenex, I’m in big trouble that has sometimes lasted for months. There is also a bias problem when you feel rotten. Right now, I would love to lie down. I can’t think of anything I would like more. I bet I can rationalize air-tight reasons why I should lie down, despite all of the very valid reason not to.

2. And speaking of sick...All 50 states require vaccinations before children to attend school, but 47 of them  (California, Mississippi and West Virginia are the exceptions) allow parents to opt out of vaccines if they have religious beliefs against immunizations. Eighteen states also allow parents to opt out of vaccines if they have personal, moral or philosophical beliefs against immunizations, including beliefs that they can think straight when they are in fact idiots and get their medical advice from Jenny McCarthy and other hysterical anti-vaxxers. Oregon and Washington are among the states that allow for a parent’s personal beliefs to exempt their kids from being immunized, along with Arizona, Arkansas, Colorado, Idaho, Louisiana, Maine, Michigan, Minnesota, North Dakota, Ohio, Oklahoma, Pennsylvania, Texas, Utah, Wisconsin and Vermont.

You know. Morons.

Guess: which Western state now has a major measles epidemic? (You have 18 guesses.) Why is that, do you think?

Last week, Washington Gov. Jay Inslee declared a state of emergency after 35 confirmed cases of measles and 11 suspected cases in his state. Since then, there’s been another confirmed case in Washington, and one case in Oregon.The American Academy of Pediatrics position since 2016 is that personal and religious exemptions should not be allowed

“It’s really a no-brainer,” said Dr. Yvonne Maldonado, chair of the AAP’s Committee on Infectious Diseases. Well, yes, we knew that, since the people who claim without any evidence that vaccinations cause autism have no brains. The AAP supports  medical exemptions only for children undergoing chemotherapy and with other immunity system problems.

Your right to protest ” government in America [forcing]  its fellow citizens to risk injury or death without their voluntary, informed consent”—quoting anti-vaxxer cant— ends where it threatens the health of my children. Eschew vaccinations,  home-school your children, and let everyone they coming into contact with that they haven’t been immunized. [Source: CNN]

3. Sick, but funny! You know why this story would appeal to me: A former Marshalltown, Iowa, prosecutor named Benjamin Stansberry had his  license tp practice suspended indefinitely after he pleaded guilty to misdemeanor theft and trespassing .He also paid more than $200 in fines and court costs and resigned from his job in the Marshall County Attorney’s Officeas  his position as a member of the Marshalltown Community School District board. His offense? Stansberry’s was arrested  after a co-worker found a pair of her underwear in her driveway just after Stansberry had been alone in the woman’s house. Confronted, he confesses to stealing her undies. What he did with them, I don’t know, and I don’t want to know.

4. And now for something completely different! Billionaire financier Meshulam Riklis died, but it was his obsession rather than his occupation that made him famous. In 1977, he married Pia Zadora, a petite, standard-issue night club performer of no great beauty or talent, and set out to make her a major celebrity and star. He was 53, she was 24. In this quest he was following in the tragic, if fictional, footsteps of Charles Foster Kane in “Citizen Kane,” who tried to make his untalented wife a singing star. (The model for Kane, William Randolph Hearst, actually did aide his wife’s show business career, but then Marion Davies was a genuine comic talent.) Riklis could make Pia famous but not special—she was okay.  Her name became a synonym for celebrities who were famous for being famous; I think of her as a someone who leaped over more deserving singers and actresses using money and her husband’s influence rather than merit. It is unfair, but, perhaps, no more unfair than the advantages bestowed on Jack Kennedy, the Rockefellers, George W. Bush, Hillary Clinton and too many others to count.

Fittingly, Pia Zadora’s last significant appearance was spoofing herself in the third “Naked Gun” film. I have to say, she was pretty good:

27 thoughts on “Morning Ethics Warm-Up, 1/29/19: Sick Room Edition

  1. I’m sorry you’re sick. I hope you feel better soon.

    2. Is it ethical for the state to force the children to get vaccines? It sounds like Utilitarianism, but this school of thought has never set well with me.

    • I really am wary of them removing the religious exemption. To begin with, the only religions that seem to have a problem with it are the Church of Christ, Scientist (~100,000 members and the Dutch Reform Church (that seems to hav very few members). Muslim groups object that MMR contains pig proteins, but they are not currently objecting to vaccination with the agreement that halal vaccines be produced in the future. So, a religious exemption is not going to cause a real problem with the ‘herd immunity’ that vaccination tries to produce. Secondly, once the government can steamroll over one religious belief, when will they stop? The US Government forced the Mormons to abandon polygamy and discrimination against blacks. Although distasteful, I don’t see why these beliefs and practices were any worse than polygamy, slavery, discrimination against blacks, and sexism in Islam. When and where does the government’s ability to pick and choose religious doctrine end?

  2. Last week, Washington Gov. Jay Inslee declared a state of emergency after 35 confirmed cases of measles and 11 suspected cases in his state. Since then, there’s been another confirmed case in Washington, and one case in Oregon.The American Academy of Pediatrics position since 2016 is that personal and religious exemptions should not be allowed

    “It’s really a no-brainer,” said Dr. Yvonne Maldonado, chair of the AAP’s Committee on Infectious Diseases. Well, yes, we knew that, since the people who claim without any evidence that vaccinations cause autism have no brains. The AAP supports medical exemptions only for children undergoing chemotherapy and with other immunity system problems.

    How deadly is measles?

    • ME – Not sure if you are implying that death is the only measure here.

      The excerpt below is from the CDC website, where it says 1-2 in every 1000 children die:

      Severe Complications

      Some people may suffer from severe complications, such as pneumonia (infection of the lungs) and encephalitis (swelling of the brain). They may need to be hospitalized and could die.
      •As many as one out of every 20 children with measles gets pneumonia, the most common cause of death from measles in young children.
      •About one child out of every 1,000 who get measles will develop encephalitis (swelling of the brain) that can lead to convulsions and can leave the child deaf or with intellectual disability.
      •For every 1,000 children who get measles, one or two will die from it.

      Measles may cause pregnant woman to give birth prematurely, or have a low-birth-weight baby.

    • From Wikipedia:

      Measles affects about 20 million people a year,[3] primarily in the developing areas of Africa and Asia.[6] No other vaccine-preventable disease causes as many deaths.[11] In 1980, 2.6 million people died of it,[6] and in 1990, 545,000 died; by 2014, global vaccination programs had reduced the number of deaths from measles to 73,000.[8][12] Rates of disease and deaths, however, increased in 2017 due to a decrease in immunization.[13] The risk of death among those infected is about 0.2%,[5] but may be up to 10% in people with malnutrition.[6] Most of those who die from the infection are less than five years old.[6]

    • It used to be a killer, but we have evolved and adapted after living with it over the centuries so that we have had a collective resistance to the disease. That is probably fading, as large numbers of children no longer routinely come down with this disease, but it is a very slow process both ways.

      As I recall, measles was one of the infectious diseases that plagued the American Indian population when the Europeans came over here. The child mortality rate in past centuries used to be extremely high in good part because of the so-called childhood diseases such as measles, mumps, whooping cough and many others. Smallpox was something that affected the entire population. If you look at causes of death in the 19th century, the leading causes were all infectious diseases such as influenza, tuberculosis and a host of others.

      We’ve largely eradicated the big killers in Western civilization and over the decades we have become complacent. There is a certain critical mass of the population which, if unvaccinated, will allow for an epidemic of this sort of disease to become established. I understand that in some states we are nearing that percentage — we’ll see what happens.

      While there might be a certain poetic justice if the people who oppose vaccinations were the ones to come down with the disease in an epidemic, unfortunately it is not them but their children who will suffer. They were probably vaccinated in their childhood and are safe.

      Ask them if there had been an influenza vaccine in 1919 — would they look at the wagons going down our streets collecting the dead and refuse to be vaccinated then? Hah!

  3. #2 We do have a few cases where we have compelled duty as citizen. You have to report for jury duty. Males are subject to selective service, and even conscientious objectors must still serve even if not in a combat role.

    We should be treating vaccinations the same. It’s a duty to society to not be a vector of infection.

      • HPV is a bit unique. First of all, it isn’t a required vaccination (at least where I live).

        It’s also one that has a method of transmission other than casual contact so avoiding it should be easy. The big but, though, is the fact that it is estimated that 80% of adults in the US have been infected by one of the four main strains.

        • FWIW, all three of my children over 13 have completed or are completing the series for HPV, regardless of gender.

          My wife and I discussed this with them and allowed them to choose. We made sure they were properly informed and they all choose to proceed.

  4. Without doing an internet search…
    How many cases of measles result from the vaccination? Live virus?
    How far does the government get to go in regards to what is mandated?
    Where was patient zero from?

  5. I was curious about religious doctrine opposing vaccination in the USA: Apparently the only groups that discourage it are Christian Scientists and some Dutch Reformed Congregations. The easy solution for members of these groups is to home school their kids although there are some problems with this. In my opinion, no school district should be forced to admit children or teens that haven’t been vaccinated by any state law.

  6. … Eighteen states also allow parents to opt out of vaccines if they have personal, moral or philosophical beliefs against immunizations, including beliefs that they can think straight when they are in fact idiots and get their medical advice from Jenny McCarthy and other hysterical anti-vaxxers. Oregon and Washington are among the states that allow for a parent’s personal beliefs to exempt their kids from being immunized, along with Arizona, Arkansas, Colorado, Idaho, Louisiana, Maine, Michigan, Minnesota, North Dakota, Ohio, Oklahoma, Pennsylvania, Texas, Utah, Wisconsin and Vermont.

    You know. Morons.

    You do them an injustice. It is quite possible – on the information we have before us – that their objections actually do work out in their own children’s best interests.

    That is partly because the experts are in fact lying, in the interests of a collective good, so we don’t actually have accurate information about just where we are on the scale of individual costs and benefits. And it is partly because we are in Tragedy of the Commons/Prisoner’s Dilemma territory here.

    Dealing with the last point first, I will leave it as an exercise for the reader to see why and how the best public health vaccination policy for one child is that all the other children should be vaccinated, but not that one – even for tiny individual risks from vaccination (for completeness, I should mention that this is not necessarily the case when vaccination is itself an infection source – but that works against a simple full vaccination goal). Then I will ask the reader to consider past and known to be dangerous immunisation practices, such as smallpox infection and salting cattle against Rinderpest (which killed roughly a third, and cost the rest their tails) – and then reflect that experts are always using collective good as a test, and would definitely lie to advance even those practices if those were all they had. In support of this pattern of routine lying, we know that they routinely present absence of evidence as evidence of absence, e.g. whenever they assert that mercury based vaccine preservatives present no health risk (they run no risk in not providing studies that really do exonerate these products, so they don’t even try even if they could).

    In the light of all that, parents who know they don’t know the risks would be rational in holding their own children out of vaccination. That doesn’t mean either that the unknown data really would back that, or that it would be ethical to risk other children by prioritising their own children, it means that there is an arguable case there. Remember, we must also wonder whether it would be ethical to risk their own children by prioritising other people’s children.

    You may pooh pooh the risks. But we don’t know the truth of the matter, because of the well meaning liars who are ceaselessly at work. And, of course, there may well be people who have indeed reached their positions moronically.

    Please note, I am not advocating any utilitarian or ethical position here either way, I am trying to inform the analysis.

    • Not lying, PM. I ran the database on lawsuits involving vaccinations for the plaintiffs bar.The risk of an adverse reaction to vaccinations is minuscule, and the causation when it does is weak.But juries love sticking it to Big Pharma, and those adoptable kids irresistible. All the lawyers who exploit this get their kids vaccinated.

      • You misunderstand me. I am not referring to any stopped clock issue of whether any single statement of theirs is accurate. I am referring to their routinely never subjecting their public assertions to that test, rather than to whether they are furthering the collective good. I gave a concrete illustration of that, too.

        The result is that we don’t know, rather than knowing them to be wrong.

  7. {Dons editor hat}
    On #3 –
    – “license tp practice” should be “license to practice”
    – space on the wrong side of the period after “trespassing”
    – “Officeas his position” I think should be “Office and his position”

    I completely understand. A couple of months ago I was sick and sent out a company wide email 3 times before I got the day, date, and time correct (and the event was the next day). I summarily packed it up and went home.

    One more aspect of taking a sick day – in IT, I can negatively affect everyone’s productivity if an illness addled brain causes me to screw something up (shutdown email, the internet, main file server, etc).

  8. There are two kinds of polio vaccine: the oral vaccine (Sabin), which uses a live virus that has been attenuated, and the injected Salk vaccine, which uses an inactivated virus. The attenuated live virus in the oral vaccine can mutate into something that actually causes paralysis. So there is a small (very small) risk of getting polio from the oral vaccine. That is why, in 2000, doctors in the US stopped giving the oral vaccine and switched to the Salk vaccine. You know there is a problem when a disease has been eradicated in a country, except for a small number of children who contract it from the vaccine intended to protect them from it. My children were born before 2000 and I asked my wife to raise this issue with the pediatrician who wanted to give the oral vaccine. The doctor insisted that he knew best and that the oral vaccine was appropriate. My wife acquiesced but was angry that I didn’t go to the doctor’s office myself. Thank heavens everything worked out alright, but I thought about this when it was announced in 2000 that they wouldn’t be using the oral vaccine anymore in the US. The powers that be finally saw the issue as I did. The reason our doctor liked the oral vaccine from a public health perspective is that the attenuated live virus passes through the patient’s digestive tract and can be picked up by caregivers who, say, change the patient’s diapers. By vaccinating the baby, you have a chance of also vaccinating all of the people who take care of the baby. That’s a powerful thing when there is a need to expand the “herd’s” immunity in the face of an active outbreak of disease. But it comes at the risk of a small number of people actually getting polio. The judgment in 2000 was that that risk was no longer defensible given the eradication of polio in the US. This is a clear example of a vaccine related situation in which the interests of the individual are not aligned with those of the broader community.

Leave a Reply to Alizia Tyler Cancel reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s

This site uses Akismet to reduce spam. Learn how your comment data is processed.