20 Mar 2014 UPDATED – Counterpoint: On Vaccines, State Power and Christian Living
Updated with Reader response below
UPDATE from author: I have had an incredible amount of interaction on this post, with many Reformed readers strongly opposed to my position for various reasons (for example, see the discussion on our Facebook page here). I have been very impressed with the overall tone and respect used in the dialogue. Those opposed to my arguments have shown much grace when interacting with what I wrote, which I really appreciate. I have in the past written about much less important issues in secular forums and have been verbally assaulted for my views, so I must say that I much prefer interacting with fellow Christians on very sensitive issues. Furthermore, because of the respectful tone, I am all the more compelled to rethink my position. I’m not sure yet if I’ll write more on this topic (I’m hardly qualified to do so from a medical perspective, although the more theoretical questions of public policy remain intriguing to me). Nevertheless, I want to republish a counterpoint to my counterpoint from one concerned parent. He wrote thoughtfully and thoroughly, carefully interacting with my arguments while exemplifying grace in his critique. Thank you! Please see appended below for the text of the counterargument. As always, we appreciate your feedback.
One final note of clarification: many have referred to “ARPA’s position” in discussing this issue. Please note – ARPA does not have a position on the vaccine issue. What is written below was the opinion of one staff member responding to the contrary position held by another staff member.
Earlier this week, my colleague posted an article about the ongoing measles vaccination controversy in southern BC. After outlining the two competing Reformed views on the issue, he concludes, “Although there are differing perspectives on the issue, we should be able to agree that it is a parent’s responsibility to make decisions about what is best for their child and that authority can only be interfered with in exceptional circumstances. It is good for Christians to respectfully challenge each other’s moral conclusions, as iron sharpens iron. There are huge consequences – including for our neighbours. But this is fundamentally a discussion for parents, families, friends, and churches – not the legal system.”
I accept his invitation to challenge his conclusion, as iron sharpens iron.
While I am in total agreement with the first three sentences in the concluding paragraph above, I have concerns with the concluding sentence. When we say that measles vaccination is “fundamentally a discussion for parents, families, friends, and churches – not the legal system”, I believe we have simplified the issue to our detriment. Indeed, in the discussions that surround this touchy issue, most who are against vaccinations make the error of lumping all vaccines together. But there is an enormous difference between a vaccine for a sexually transmitted disease (for example), and a measles vaccine.
To conclude that not vaccinating your child against the potentially fatal or crippling measles virus is “fundamentally a discussion for parents” would be like saying that a child caught stealing cookies could be punished by flicking his hand or by having his hand chopped off with a meat cleaver, since child discipline is all a matter of parental authority – “fundamentally a discussion for parents”. All our readers would agree that such a stance is indefensible. The reason is not because we think parents shouldn’t discipline their child for stealing a cookie. The reason is because we need to examine the nature of the disciplinary action, apart from the broader issue of parental authority in child discipline. So also, with an issue like vaccinations, we need to examine the nature of the vaccines and their corresponding diseases, and not just vaccines in general.
Now, I am not a medical doctor nor am I a medical ethicist. Yet I would dare to propose four criteria for when the government is not only justified in vaccinating its citizens, but in fact has an obligation to:
1. Where a disease is fatal or crippling, and
2. Where that fatal or crippling disease is highly communicable, (by air certainly, and possibly by touch) and
3. Where the vaccination has a proven history of effectiveness, and
4. Where the vaccine is not developed through immoral means,
Then, and only then, the government may insist on vaccinating its citizens in order to fulfill its obligation to protect the innocent, to maintain order and to govern rightly. (I’ll come back to this in a moment).
So, what types of vaccines would these criteria include and not include? I have no medical qualifications with which I could answer this question with confidence. However, I think almost everyone would agree that the four criteria were met with the vaccinations against smallpox. Other vaccinations that might meet these critia might include vaccines for polio or rubella and a few others. Smallpox (pictured above) has been effectively eradicated (as of October 26, 1977) by means of government vaccination programs. Smallpox, which killed 300-500 million people in the 20th century alone –more than Stalin, Hitler, Mao and Pol Pot combined – could only have ever been eliminated by means of State programs. No other means could have worked. Thank God for State intervention!
The four criteria listed above would not include vaccinations for sexually transmitted diseases like the HPV vaccine for young women (see criteria 1 and 2), vaccinations for seasonal flu (see criteria 3) or vaccinations developed using embryos or embryonic stem cells (see criteria 4). In the cases of these types of vaccinations, the decision should be left totally to the parents – the State has no right to interfere.
A final word on a biblical view on the role of the State in relation to vaccinations: Again, limiting this discussion to those potentially lethal viruses that are highly communicable, I think a clear case is made in Scripture for the State to exercise its role in good governance. Why did God institute the State? Paul says the civil government is to be “God’s servant for your good.” (Romans 13:4). Clearly, preventing an outbreak of a lethal virus on its citizens would fall into this category. Indeed, the State would fail in its role if it had the means to contain such a virus and did not do so. Still not convinced? Consider the alternative by turning the argument on its head: which of the three divine institutions (church, family or State) is the appropriate and most effective institution for such a task?
In our eagerness to make sure the State does not overstep its bounds by interfering with parental authority, we must be cautious that we not throw the baby out with the bath water. God instituted the State. It has a role, though not an absolute one. But the authority of parents is not absolute either. With a controversial issue like vaccinations, let’s take the time to dig deeper, and appreciate the nuances of the positions we take.
* I found the blog of One Christian Dad to be very helpful. You can access it here. I also think the “love your neighbour as yourself” aspect can be more fully explored. With highly communicable diseases, the second greatest commandment kicks in with full force. Are we certain that we are doing all we can “to promote my neighbour’s good” when we refuse to vaccinate against deadly viruses?
Your turn! What do you think of the arguments above? We’d love to hear from you.
COUNTERPOINT TO THE COUNTERPOINT:
You’ve asked for thoughts regarding the arguments in your article Counterpoint: On Vaccines, State Power and Christian Living. Despite my hesitation (especially in public forums) to discuss this sensitive issue for fear of offending others or making other parents second guess themselves, in this situation I feel compelled to respond.
First off, I would like to mention that while generally I really appreciate the way that you reach conclusions with logical premises in your articles, I’m somewhat disappointed that you (and ARPA collectively) chose to wade in on this issue that I am not so sure is an issue appropriate for the legal and/or political forum. Even more so, I’m extremely disappointed at the implications of your article and the oversimplification of this issue, and I feel the need to (humbly and respectfully) highlight a few glaring weaknesses in the arguments in your article.
In your first paragraph you note that most parents that are against vaccines ‘make the error of lumping all vaccines together.’ While I would agree that this is certainly an error, I’m not convinced that most against vaccines make this error. We have numerous friends and family members that are not entirely for vaccines but are for delayed schedules or selective vaccines, and many of those that are against vaccines are extremely well-informed. In fact, in our case, most family and friends that are against vaccines have done significantly more research than those that are entirely in favour of vaccines. Given your arguments, I would suspect that your child(ren) is or will be vaccinated, and I would never venture to suggest you aren’t doing what you think is most beneficial for your child(ren), however given some of your information I am not convinced you have completed a thorough study of vaccines or more specifically the measles vaccine. (Please understand that I don’t mean to be rude by saying that.)
In your next paragraph, you make the argument about the child stealing a cookie. One of the critical facts in that argument lies in the point that everyone would agree that a child should be disciplined for stealing a cookie, that discipline is a ‘positive’ tool, yet still needs to be administered correctly. That’s where, in my opinion, your argument fails. If indeed the measles vaccine was a 100% positive, proven and effective tool, then the logic would follow, however that’s what forms the entire issue for many parents. Do the benefits of the measles vaccine outweigh the risks of the vaccine or even contracting the disease itself? Does the vaccine actually confer 100% immunity, not to mention lifelong immunity? Why have boosters been repeatedly added to the vaccine that was initially believed to be 100% effective? Are the contents of the vaccine safe for my child? The science is certainly not settled with this vaccine, or many others. Understand that many parents that choose to decline the measles vaccine for very specific reasons. In the minds of many well-researched parents, the measles vaccine is not necessarily a positive tool, making its use a ‘discussion for parents.’
The next issue here is in your four criteria that a government might use is justifying vaccinating its citizens. In the first criterion you point out ‘where the disease is fatal and crippling.’ Measles is hardly a fatal and crippling disease, and in most children manifests itself with symptoms similar to a cold or a flu. Yes, approximately 1 in 1000 (studies suggest in well-nourished, healthy populations 1 in 10,000 or 1 in 100,000 – I can get you the information if you’d like) develop severe complications such as encephalitis, however I’m not sure one can argue 0.1% and the regular course of infection for measles justifies a title of ‘fatal and crippling’ disease, or a ‘lethal’ virus as you point out later in your article. The virus is in fact more dangerous for children or pregnant women, which I do understand, however I think it would be fair to argue that I have a primary obligation to do my best to keep my own children and family, also encompassed under ‘my neighbour’, safe.
Criterion number three argues ‘where the vaccine has a proven history of effectiveness.’ The measles vaccine certainly does NOT meet these criteria. A look at graphs in the UK or the US (available on Wikipedia, or I can provide you the official CDC information) will show the rapid decline of measles prior to the discovery and implementation of the vaccine. Like many communicable diseases, rates were declining rapidly as sanitary measures such as hand-washing were discovered. The vaccine has also had boosters added on several occasions because of ineffectiveness, does not confer 100% or lifelong immunity, and there are newer studies (again, I can provide you the information if you like) suggesting the need for adult boosters. Many adults, not just ‘unvaccinated children,’ may actually be carriers for the disease. Studies also suggest that vaccinated persons may also serve as carriers for the disease for several weeks after immunization. As the disease is generally not terribly debilitating in healthy children, and infection confers genuine lifelong immunity, is the vaccine actually the most ‘effective’ route? You point out the lack of effectiveness of the flu vaccine as an example of not meeting this criterion, and the same case could be made for numerous other vaccines.
Towards the end of your article, you provide ‘a final word on the biblical view on the role of the State in relation to vaccinations.’ Essentially, using Romans 13, you argue that the civil government should step in for the greater good of its citizens as part of its role in good governance in preventing a ‘lethal’ virus (which again I’m not sure I would agree fits the measles virus). Following this train of thought, can the government step in to tell parents what to feed their children to prevent obesity, the number one risk factor for cardiovascular disease? Can the government make smoking, the number one risk factor for lung cancer (among many other diseases), illegal in seeking to be a ‘servant for your good?’ I realize that tobacco use is not ‘contagious’ in the sense of the virus (although the negative effects of second-hand smoke inhalation, which many children are exposed to, is well-documented), however the issue here is about the government seeking to be ‘a servant for your good.’ The link between smoking and lung cancer, a disease with an over 80% fatality rate, is just as clear as that between measles and a ‘lethal virus’, however I’m not sure many would be in favour of the government stepping in as part of its role in ‘good governance’ in these cases.
In conclusion, to be clear, I would never attack other parents for vaccinating their children. Personally, I am vaccinated, and I would never, ever hold that against my parents, despite my position. I think it’s safe to say that most parents, especially those in our Reformed circles, are active in promoting what is best for their own children. While I am not in favour of all vaccines, there are some that I may still seek out for the ‘best interests’ of my children. Children need parents to be advocates for their safety, and parents that are against vaccines, delaying vaccines, or just simply doing their fair share of research are advocating for their children. It was only a few years ago that I became aware of some of these issues and became active in research. I would agree that in many, or even most instances, no adverse reaction will occur from vaccines, however the same could be said of many of the diseases for which we vaccinate against, which is why I would venture to say parents have the obligation to be well-informed in this issue, however that’s the key word: parents. To make the vaccine issue a Biblical issue, or calling it a ‘violation of the 6th commandment’ like I’ve read in other so-called ‘Christian’ articles has inappropriately far-reaching implications. To make this issue a political and/or legal issue creates implications for a number of different areas of our lives, fundamental human rights, and our freedoms as (Christian) parents. I sincerely appreciate the work that ARPA, and especially you on behalf of ARPA are involved with in advocating for Reformed Christians in the political landscape, however I would agree with your colleague that this article extends beyond that scope. Your colleague is entirely correct in stating that ‘this is fundamentally a discussion for parents, families, friends, and churches – not the legal system.’
Blessings in your continued work, especially in the upcoming Loyola case.
A concern Reformed Christian parent
And now for a non-religious counterpoint to the counterpoint to my counterpoint to the original article: see this article titled, Dear Parents, You Are Being Lied To.