I have always believed that one person’s freedom ends where another’s begins.
Freedom is not a one meaning word. There are several meanings, but two are very important at this moment, political and social freedom: the freedom of the individual in relation to other people and to the state.
Personal freedom actually ends where another’s safety begins. Safety has an extended meaning when considering health; it is a society issue not just an individual right.
When scientists first suggested world-wide social distancing as the only feasible way to suppress Covid-19, they were the first to admit that that might be difficult to work, in a so-called free society.
Anti-stay-at-home, anti-masks, anti-testing, anti-vaccine protesters base their arguments on their own individual rights not on the general rights of the people around them.
There is certainly a restriction on individual freedom. Same thing happens with the law requiring seatbelts to be used in vehicles and for motorcyclists to wear helmets. In both cases, fatalities and injuries decreased after the respective laws came into effect.
Wearing face masks is not just meant to save the wearer from the coronavirus. It is also meant to protect others from the germs or the virus of the mask wearer. Persons in the vicinity of a mask wearer are not protected from all the germs and/or viruses which the mask wearer possesses, but they are protected from the vast majority exhaled by the wearer.
There are persons in our society who are carriers of the Covid-19 virus and do not realise it. They are called asymptomatic carriers as they have the virus, but they show no signs or minimal symptoms of having the virus. However, when they are in close proximity to others, they spread the virus (usually unknowingly) when not wearing a face mask. Therefore, for the good of society and to help reduce health-care costs, these minimal restrictions on personal freedom are a smart step in the prevention of the spread of the virus and its consequences.
There is an old saying that says “your freedom to throw your fists about ends where my nose begins”.
And your freedom to not wear a mask ends when I am in your presence as I and the rest of society do not want our health to be impaired just because you think your personal freedom is being somewhat restricted.
The most relevant decision for today was issued in the Massachusetts Supreme Court in 1905. The constitutionality of a state law requiring compulsory vaccinations against smallpox was being discussed. The court declared, “Upon the principle of self-defense, of paramount necessity, a community has the right to protect itself against an epidemic of disease which threatens the safety of its members.”
The court explicitly rejected the claim that “liberty” under the Constitution includes the right of individuals to make decisions about their own health in instances where those decisions could endanger others.
The right to swing your fist certainly stops at another person’s nose. With coronavirus, your freedom stops when it endangers others by facilitating transmission of a highly communicable disease.
In the 19th century, it was argued that cities and towns had the authority to take necessary steps to ensure the communal “sanitary welfare” in terms of freedom, freedom from disease. They created the “harm principle”, which asserts that while individual liberty is sacrosanct, it should be limited when it will harm others.
“The sole end for which mankind is warranted, individually or collectively, in interfering with the liberty and action of any of their number, is self-protection,” Mill wrote in On Liberty in 1859.
In The Lancet in 1883, one author wrote “A man’s liberty is not to involve risk to others” and “We cannot see that there is any undue violation of personal liberty in the sanitary authority acting for the whole community, requiring to be informed of the existence of diseases dangerous to others”.
People are being faced with a choice between a rapid economic recovery and protecting the lives of vulnerable people. Curtailing personal liberties is sometimes necessary to secure freedom for everyone and guarantee better health and, as a consequence, a better economic situation.
Those who want to ignore social distancing, spurn masks, and crowd together might be making a statement in defence of personal liberty, but they are also undeniably endangering the freedoms of thousands of others.
And it is fundamental to speak about vaccine denial.
Vaccine refusers will come at a high cost for all of us, not only for health but also financially.
Even after the pandemic fades, millions of vaccine refusers could turn into hundreds of thousands of patients who need extra care, should they come down with the disease.
What are they thinking, these vaccine-hesitant, vaccine-resistant, COVID-sceptics? It is difficult to understand.
Many people are worried about future effects of the vaccines but do not seem to be worried about new variants of the Covid-19 which are more and more difficult to control.
The lingering effects of illness, both in the sick and in their families, will be an ongoing feature of the pandemic that will stay long after widespread vaccination. Society needs to be better prepared to care for the physical and mental problems that will persist.
Many say the coronavirus is extremely overrated and they trust their immune system to protect them. What if natural immunity is not enough to protect their grandmother?
It looks like it is more a Covid denial than a vaccine hesitancy, but this is a severe public-health problem as the vaccines are not only about building a defensive wall around young healthy people. We are also collectively building a wall around the more vulnerable members of society and … little holes in the wall can lead to unnecessary sad events.
Best health wishes,
By Dr Maria Alice
Dr Maria Alice is a consultant in General and Family Medicine. General Manager/Medical Director – Luzdoc International Medical Service. Medical Director – Grupo Hospital Particular do Algarve/ Hospital S. Gonçalo de Lagos