Public Health

Guest Post: JABBING, PLAYING, AND PAYING – HIGH SEASON ON ANTI-VAXXERS

Christopher Chew
Monash University

In the strange, upside-down world of the Southern Hemisphere, cold and gloomy Winter is quietly slinking away, and raucous Spring in all his glory begins to stir. Ah, Spring! The season of buds and blooms and frolicking wildlife. One rare species of wildlife, however, finds itself subject to an open hunting season this Spring – the anti-vaxxer.

In April this year, the Australian Federal Government announced a so-called “no jab, no pay” policy. Families whose children are not fully vaccinated will now lose subsidies and rebates for childcare worth up to almost AUD$20,000 per child, except if there are valid medical reasons (e.g. allergies). Previously, exemptions had been made for conscientious and religious objectors, but these no longer apply forthwith.

Taking things a step further, the Victorian State Government earlier this week announced an additional “no jab, no play” policy. Children who are not fully vaccinated, except once again for valid medical reasons, will additionally now be barred from preschool facilities such as childcare and kindergartens.

I should, at this point, declare my allegiances – as a finishing medical student, I am utterly convinced by the body of scientific evidence supporting the benefits of childhood vaccination. I am confident that these vaccines, while posing a very, very small risk of severe side-effects like any other medicine, reliably prevent or markedly reduce the risk of contracting equally severe diseases. And finally, I believe that the goal of universal childhood vaccination is one worth pursuing, and is immensely beneficial to public health.

Despite my convictions, however, I still find myself wondering if the increasingly strict vaccination regime in Australia, and every-increasing punishments for anti-vaxxers, is necessarily the best means to go about achieving a worthy goal. It’s not clear, to me, that the recent escalation will have significant positive effects beyond a mere simple political stunt.

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Is this really me? Parasites and other humans’ cells in our brains change our psychology

Many people are suspicious about being manipulated in their emotions, thoughts or behaviour by external influences, may those be drugs or advertising. However, it seems that – unbeknown to most of us – within our own bodies exist a considerable number of foreign entities. These entities can change our psychology to a surprisingly large degree. And they pursue their own interests – which do not necessarily coincide with ours.

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Is the NHS surcharge just?

Not long ago the UK implemented an NHS surcharge – an extra fee that non-EEA nationals (Australia and New Zealand are also exempt) applying for leave to remain in the UK must pay. It costs £200 per year, and must be paid up front. So, for example, if you are applying for a work visa for 3 years, and you have a family of three, you must pay £1800 to cover the surcharge for you and your family (on top of other visa costs).

It is difficult to find much public discussion in the UK regarding this surcharge, outside of a few articles that recently noted that the surcharge is unlikely to do what we were told it would do – namely, benefit the NHS. (See here)

Is the surcharge a just policy? Continue reading

Strange brew: opiates from yeast

A recent series of papers have constructed a biochemical pathway that allows yeast to produce opiates. It is not quite a sugar-to-heroin home brew yet, but putting together the pieces looks fairly doable in the very near term. I think I called the news almost exactly five years ago on this blog.

People, including the involved researchers, are concerned and think regulation is needed. It is an interesting case of dual-use biotechnology. While making opiates may be somewhat less frightening than making pathogens, it is still a problematic use of biotechnology: millions of people are addicted, and making it easier for them to get access would worsen the problem. Or would it?

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What’s Wrong With Giving Treatments That Don’t Work: A Social Epistemological Argument.

Let us suppose we have a treatment and we want to find out if it works. Call this treatment drug X. While we have observational data that it works—that is, patients say it works or, that it appears to work given certain tests—observational data can be misleading. As Edzard Ernst writes:

Whenever a patient or a group of patients receive a medical treatment and subsequently experience improvements, we automatically assume that the improvement was caused by the intervention. This logical fallacy can be very misleading […] Of course, it could be the treatment—but there are many other possibilities as well. Continue reading

Is Sexual Offending Genetic?

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Do genes make sex offenders? Are rapists and child molesters driven by biology or environment?

An article published last week in the International Journal of Epidemiology provides compelling evidence for a genetic component to risk of sexual offending.[1] The study found that sons or brothers of convicted sex offenders are 4 to 5 times more likely than randomly selected males to be convicted of a sexual offence. Half-brothers of sex offenders, in contrast, are only twice as likely as controls to be convicted of such offences. The study estimates on this basis that genetic factors contribute about 40% of this variability in risk of offending. Environmental factors shared between siblings, such as parental attitudes, were estimated to contribute only 2% of this variability. Continue reading

Brain size and socioeconomic status

A new drug, Numarol, is currently being trialled which increases the surface area of the brain in children. Numarol causes children to have bigger brains, do better in cognitive tests and generally improves their life prospects. One critic of Numarol recently pointed out it would be very expensive, and only the rich would be able to afford it. Its release would likely create a significant difference in brain size between the highest and lowest socioeconomic groups. Numarol would create a world in which biological inequalities are forged from economic ones.   The rich would not only have bigger houses, better cars, and better healthcare than the poor, their children would also have bigger brains. Such a world would be abhorrent.

But we already live in this world.  Numarol is fictional, but the rich do have children with bigger brains than the poor.   Social inequalities have already been written into our biology.  Continue reading

Smoking, Ice-Cream and Logical Progressions: Why We Shouldn’t Ban Smoking in Outdoor Public Places

It’s a beautiful warm sunny day, and you have decided to take your children to join a group of friends for a barbecue at the local public park. The wine is flowing (orange juice for the kids), you have managed not to burn the sausages (vegetarian or otherwise), and there is even an ice-cream van parked a conveniently short walk away.

An idyllic scenario for many of us, I’m sure you will agree; one might even go so far as to suggest that this is exactly the sort of thing that public parks are there for; they represent a carefree environment in which we can enjoy the sunshine and engage in recreational communal activities with others. Continue reading

Oxford Uehiro Prize in Practical Ethics: May the state limit the free speech of individuals who advocate against vaccines intended to combat infectious disease? by Miles Unterreiner

This essay, by Oxford graduate student Miles Unterreiner, is one of the two finalists in the graduate category of the inaugural Oxford Uehiro Prize in Practical Ethics. Miles will be presenting this paper, along with three other finalists, at the 12th March final.

May the state limit the free speech of individuals who advocate against vaccines intended to combat infectious disease?

Freedom is the most contagious virus known to man.

-Hubert H. Humphrey

 

Philosophical arguments concerning freedom of speech have traditionally focused upon which types of expression the state apparatus may justly limit, and under which circumstances it may do so. The state has therefore been the locus of history’s most celebrated works on the subject, including John Milton’s Areopagitica (1644), chapter 20 of Spinoza’s Tractatus Theologico-Politicus (1670), and perhaps most famously J.S. Mill’s On Liberty (1859). Mill’s argument in favor of the free exchange of ideas remains today the most lasting and the most relevant, and his formulation of the “harm principle” – that “the only purpose for which power can be rightfully exercised over any member of a civilized community, against his will, is to prevent harm to others” – continues to undergird significant components of law and policy in industrialized democracies today.[1] Continue reading

Does religion deserve a place in secular medicine?

By Brian D. Earp

The latest issue of the Journal of Medical Ethics is out, and in it, Professor Nigel Biggar—an Oxford theologian—argues that “religion” should have a place in secular medicine (click here for a link to the article).

Some people will feel a shiver go down their spines—and not only the non-religious. After all, different religions require different things, and sometimes they come to opposite conclusions. So whose religion, exactly, does Professor Biggar have in mind, and what kind of “place” is he trying to make a case for?

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