Compulsory, mandatory, involuntary

SEARCH FOR TRUTH - Ernesto P. Maceda Jr. - The Philippine Star

Secretary Harry Roque skirted the question on mandatory inoculation. With not enough vaccines, he decided to hedge rather than speculate. It’s a bridge he’ll cross when we get there.

Compulsory vaccination as a policy is a bridge we may have to cross sooner or later, given the continued public resistance to the vaccine. Gravity of the threat, mode of transmission, effectivity and safety of vaccines, proportionality of the penalty and risk-benefit analysis are a few of the basic factors to consider.

But beyond the question of should we is the issue of can we? Globally, a research spearheaded by Canada’s McGill University found that 105 of the 193 countries studied (54 percent) had mandatory policies. The most common penalty was the educational one. i.e., no vaccine, no enrollment. Next was fines and then, in 12 countries, jail time.

Italy is the first in Europe to make it mandatory for health workers. In Asia, Indonesia has imposed it for all, the punishment being the withholding of social assistance and also fines. Malaysia is weighing its options, though the law is already in place should authorities decide to forge ahead.

The Philippines already imposes a compulsory vaccination program here for our Armed Forces as announced last February. For the military, it is a duty and not an option. H.B. 9252 of Congressman Elpidio Barzaga would mandate vaccination for everyone to combat vaccine hesitancy and attain herd immunity. The penalty is a fine of P50,000 or imprisonment of not more than one year.

What’s at stake. Much has been written about the legality of these policies. As in past columns, the US rule is that state police power may restrict fundamental liberties on account of public health requirements, upon “the principle of self-defense, of paramount necessity.” In the enumeration of interests to be promoted when the state is permitted to interfere with individual rights, public health is always first on the list. This is followed by safety, morals and then the catch-all phrase “general welfare.”

In that 1905 case of Jacobsen v. Massachusetts, the mandatory vaccination for smallpox carried a fine of $5 for refusal (now approximately $100). This landmark decision is invoked to this day. Science and medicine may have developed exponentially and the mortality from the current pandemic is not as grave as the last one 120 years ago (the death rate of the pandemic faced by Jacobson, 1901-1903 in Boston was 17 percent) but the underlying rationale of state self-preservation remains ethically and legally sound.

In the European Human Rights Court (ECtHR), a landmark ruling this month backed Czech Republic mandatory vaccination policies (of pre-pandemic cases). ECtHR case law concedes that the involuntary medical treatment of compulsory inoculation interferes with the right to respect one’s private life. This includes integrity of a person’s mind and body. The ECtHR Grand Chamber held that the same can be justified in the interest of public health, noting that vaccination protects both those who receive it and also those who do not and are merely relying on herd immunity. This ruling will be critical in the coming COVID-19 vaccination challenges in Europe.

Sec. Roque actually agrees that the State has the authority to require vaccination. At present, we have adopted the WHO position of encouraging individuals to make their own voluntary and informed decisions.

Citius, Altius, Fortius... Insanus. Last year, the City of Tokyo and the International Olympic Committee had no choice but to postpone the scheduled quadrennial summer games.

Today, we are 83 days from opening. Continuing to host the Olympics in the midst of these cataclysmic events provokes powerful arguments on each side. For the hosts, the strongest impetus is the message that humanity defeats virus. Outside the offices of the Japan Olympic committee, however, the great majority are against it. Less than 24 percent of the Japanese people are in favor of the Games being staged. Only 1.6 percent of its population has been vaccinated (first shot), the slowest pace among wealthy nations.

It’s meant to be a symbolic moment: of Japan’s recovery from disasters and the world’s recovery from the pandemic. Symbolic as well of the notion of equality. Instead of inspiration, however, there is desperation. Where is the equality in the vaccine distribution? Among the athletes coming in, we will see a disproportionate skewing of vaccinated in the ranks of the wealthier nations.

The next few days will tell if the modern Olympics will have its fourth ever cancellation this year. The 1916 games were cancelled by the 1st World War. The 1940 and 1944 games by the 2nd World War. Should it play out that way, it will be a historic first ever peace time cancellation after the historic first ever postponement last year.

Import substitution. Alyja Daphne “Jaja” Santiago led the Saitama Ageo Medics to the championship of Japan V league. She is the first Filipina to do this in Japan. Santiago, playing blocker, was one of her team’s two imports. Her performance so impressed this volleyball powerhouse that she has been offered naturalization and the chance to try out for the Japanese national team.

As an individual player, the opportunity to compete at this stage is a rare gift. Much as Ms. Santiago is at the core of our local defensive crew, she will never get this same opportunity at world class exposure should she decline. For perspective, Japan is ranked 7th in the world and regularly competes against the likes of world volleyball titans Brazil, China, US and Italy. Our Philippine team is at a lowly 119.

Glossary of gloom. This week’s term is languishing, a.k.a. pandemic blues. It’s that “sense of stagnation and emptiness. It feels as if you’re muddling through your days, looking at your life through a foggy windshield... Part of the danger is that when you’re languishing... you’re indifferent to your indifference. When you can’t see your own suffering, you don’t seek help or even do much to help yourself” (Adam Grant, The New York Times).

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