UNTIL THE YEAR 2021 bodily autonomy and integrity were not controversial concepts. They were fundamental human rights, enshrined in national laws and international charters, such as the Nuremberg Code. Created in 1947 with the aim of ensuring the excesses of coerced health care and medical experimentation during the Nazi era would never be repeated, the Nuremberg Code sent a clear message to the world’s global citizens: your body is your own from a medical standpoint and it’s your choice what medical interventions it is subjected to and what goes inside it.
Its first clause states that “the voluntary consent of the human subject is absolutely essential” for any medical intervention to satisfy moral, ethical, and legal standards:
This means that the person involved should have legal capacity to give consent; should be so situated as to be able to exercise free power of choice, without the intervention of any element of force, fraud, deceit, duress, overreaching, or other ulterior form of constraint or coercion; and should have sufficient knowledge and comprehension of the elements of the subject matter involved as to enable him to make an understanding and enlightened decision.1
Bodily autonomy refers to the right to make decisions over one’s own life and future. It is about being empowered to make informed choices. Bodily integrity is the right of each human being, including children, to self-ownership and self-determination over their own body. Together, the two principles mean that doctors, scientists, and researchers do not have the right to administer any medical treatment or procedure without the patient’s informed consent.
Vaccine mandates and vaccine passports violate both principles, since they seek to compel or coerce people to take an experimental medical product against their will. By doing so, they threaten to cancel the very notion that human beings have agency over their own bodies.
“Not only is bodily autonomy a human right, it is the foundation upon which other human rights are built.” These are the words of the United Nations Population Fund (UNFPA), a UN agency whose mission is to improve reproductive and maternal health worldwide. If, as UNFPA claims, the principle of bodily autonomy is the foundation upon which other human rights are built, then taking it away will also have huge implications for those human rights. In its report “My Body Is My Own,” published in April 2021, UNFPA underscores the importance of bodily autonomy—specifically in relation to women’s decision-making power over their sexual and reproductive health. But many of its statements are couched in general terms (emphasis my own):
Bodily autonomy is about the right to make decisions over one’s own life and future. It is about being empowered to make informed choices. These are universal values. Governments everywhere have committed, in a variety of international agreements, to protecting autonomy. Respect for autonomy is a core tenet of international medical ethics.
Your body is yours and yours only. And so are any decisions about your body.
Collective decision-making is common across cultures, societies and governments. But group decisions cannot circumscribe the rights of individuals.2
Yet that is exactly what is happening right now in countries all over the world. The decisions of large groups of people—including governments, public health agencies, supranational organizations, and global corporations—are circumscribing the basic rights of individuals who don’t want to have a medical product injected into their bodies. The administration of those vaccines—and their accompanying passports—hinge not on the informed consent of the individual but on mandatory adoption, or in many cases coercion (threatening to deny people the ability to earn a living or access basic services is textbook coercion).
The classic counterargument to this is “your rights end where my safety begins.” In other words, while people have a right to bodily autonomy, they can enjoy that right as long as they are not threatening the bodily autonomy of others. This is the way the issue has been framed by the legacy media and public health authorities. Because COVID-19 threatens the safety and bodily autonomy of others, there must be limitations to its application that did not pertain to medical experimentation during the Nazi era.
While this is a legitimate argument, it places vaccine mandates and passports among the most important legal and ethical questions that a society can ever grapple with—on a par with issues like abortion, the death penalty, or the right to die. All of which means that vaccine mandates and passports should be under discussion at the Supreme Court, in parliament, and every dinner table in every country in the world—not simply a fait accompli pronouncement that everyone in the world is expected to adhere to without question.
Instead of having that debate, governments are using emergency laws to bulldoze vaccine mandates and passports into force. In the United States there still isn’t an official government document, whether in the form of legislation, law, or regulation, that grants a legal basis for President Biden’s mandate. In early November 2021, the US Occupational Safety and Health Administration (OSHA) did release its COVID-19 Vaccination and Testing Emergency Temporary Standard (Vaccine and Testing ETS), which would require that companies with 100 employees get regularly tested for COVID-19 or take the vaccine. But within days the US Court of Appeals for the Fifth Circuit had already paused the implementation of the vaccine requirements, which the court described as a “a one-size-fits-all sledgehammer that makes hardly any attempt to account for differences in workplaces (and workers).”3
In December 2021, the US Sixth Circuit Court of Appeals in Cincinnati overturned that ruling, meaning that the vaccine-or-test requirement for workers at companies with 100 or more employees could once again take effect. OSHA said the vaccine mandate would come into effect on January 10, 2022, but just days later the United States Supreme Court placed a temporary block on the vaccine-or-test requirement.4
A similar tack was taken by the UK government. When it realized the full extent of backbench opposition to its draft vaccine passport legislation, it decided to shelve the proposed legislation. Two days later, it announced what it called “Plan B” contingency measures, which included mandatory vaccine passport rules.
Here is the contradiction: While bodily autonomy is enshrined in international law, vaccine mandates are legal in many jurisdictions. A study published last year in Vaccine, an open-access journal published by Science Direct, titled “Global Assessment of National Mandatory Vaccination Policies and Consequences of Non-compliance,” analyzed this issue in 193 countries. The study found that over half (105) of the countries have some kind of nationwide mandatory vaccination policy in place. Of those, 62 countries imposed one or more penalties for noncompliance, mostly financial or educational (such as refusing school enrollment).5
Given the huge threat that infectious diseases can pose to public health, vaccine mandates are, at times, legitimate and justifiable. But they must be proportionate to the threat posed by the virus as well as the efficacy of the vaccines being mandated. As I argued in chapter 1, the penalties for noncompliance with the COVID-19 vaccine mandates are disproportionately punitive, a major ethical violation when you’re asking people to forfeit their right to bodily autonomy.
In the United States, vaccine mandates are legal but they have been used sparingly, especially at the federal level. Neither Dwight Eisenhower nor John F. Kennedy nor Lyndon Johnson ever resorted to threatening US citizens with the loss of their jobs during their administrations’ inoculation campaigns against polio and smallpox.
Even President Joe Biden himself said he wouldn’t impose a vaccine mandate, before doing just that in September 2021.6 Rather than relying on persuasion or calls to civic duty, as Eisenhower, Kennedy, and Johnson had before him, he “hectored, demonized, shamed, politicized, and threatened,” wrote Charles Lipson, a professor of political science at the University of Chicago. “That has become his routine, along with his refusal to answer the public’s pressing questions.”7
Many of those questions concern long-term vaccine safety. Given the severity of short-term adverse reactions to the COVID-19 vaccines—including menstrual irregularities, Bell’s palsy, blood clots, heart attacks, strokes, and sudden death—concerns about long-term health risks are not only reasonable but responsible. In September 2021, two top scientists at the Federal Drug Administration (FDA)—the Director and Deputy Director of the Office of Vaccines Research Marion Gruber and Philip Kause—resigned as the Biden administration sought to fast track the rollout of COVID-19 booster shots. Although neither Gruber nor Kause gave a reason for their departure, they were among 18 vaccine experts who two weeks later signed a letter to the medical journal Lancet cautioning about administering boosters too soon or too frequently:
Although the benefits of primary COVID-19 vaccination clearly outweigh the risks, there could be risks if boosters are widely introduced too soon, or too frequently, especially with vaccines that can have immune-mediated side-effects (such as myocarditis, which is more common after the second dose of some mRNA vaccines, or Guillain-Barre syndrome, which has been associated with adenovirus-vectored COVID-19 vaccines). If unnecessary boosting causes significant adverse reactions, there could be implications for vaccine acceptance that go beyond COVID-19 vaccines. Thus, widespread boosting should be undertaken only if there is clear evidence that it is appropriate.8
Since the publication of this letter, both the FDA and the US Center for Disease Control (CDC) have authorized booster shots manufactured by Pfizer BioNTech, Moderna, and Johnson & Johnson. This despite growing concerns about the risks the vaccines may pose, especially to teenage boys and young men. As doctors in the United States began administering Moderna’s booster jab to people of all ages, health authorities in Sweden indefinitely extended a moratorium on giving the Moderna vaccine to anyone under the age of 31. Finland, Iceland, and Denmark took similar steps while Norway is encouraging males under 30 not to get the shot. In early January 2022, the European Medicines Agency went a step further, cautioning that regular booster shots of any COVID-19 vaccine could undermine the immune response.9
In October, Italy’s government, led by former European Central Bank chairman Mario Draghi, introduced a law that made it impossible for anyone without a vaccine passport to work in the public or private sector. Italy’s “no jab, no job” rule applies to workers of all kinds, including the self-employed, domestic staff, and even people working remotely. Unvaccinated workers were given the option of showing proof of a negative test every two days. But that could cost as much as €50 each time—well beyond the means of most workers—and was withdrawn as an option anyway in early December.10 Any worker who refused to get vaccinated faced unpaid suspension as well as a fine of up to €1,500. At the time of its entry into law, there were 3.8 million unvaccinated workers in Italy—more than one and a half times the total number of those who were officially unemployed.
The Italian government’s new legislation is a mandate in all but name. Workers must submit to receiving a vaccine against their will or face unemployment. As the Italian journalist Thomas Fazi pointed out, this kind of discrimination is in direct violation of the EU’s own regulations on vaccine passports (2021/953), which states that “[t]he issuance of [COVID-19] certificates … should not lead to discrimination on the basis of the possession of a specific category of certificate,” and that “[i]t is necessary to prevent direct or indirect discrimination against persons who are not vaccinated, for example because of medical reasons … or because they have not yet had the opportunity or chose not to be vaccinated.”11
Italy’s “no jab, no job” rule also contravenes the Nuremberg Code, which while not officially accepted as law in any country, is widely considered to be the most important document in the history of clinical research ethics.12 The Code was specifically drafted to address medical experimentation but has since served as a blueprint for many of today’s legal and ethical standards, including the Helsinki Declaration of 1964, which in turn has been codified in national or regional legislation and regulations. The Declaration built on the 10 principles first stated in the Nuremberg Code. Crucially, it also tied them to the Declaration of Geneva (1948), a statement of physicians’ general ethical duties.13 Those statements include the following: “I WILL RESPECT the autonomy and dignity of my patient.”
The rule also violates the EU’s Charter of Fundamental Rights, which holds that “everyone has the right to respect for his or her physical and mental integrity. In the fields of medicine and biology, the following must be respected in particular: the free and informed consent of the person concerned, according to the procedures laid down by law.”14
Both the Nuremberg Code and the EU’s Charter of Fundamental Rights are in agreement: forcing medical procedures upon someone who doesn’t want them contravenes an individual’s basic right to bodily autonomy and integrity. This violation is particularly flagrant and unjustifiable in the case of a vaccine that was authorized, in the case of the EU, only on a fast-track basis, meaning that the vaccine manufacturers are protected from legal liability for any harm they may cause, or a vaccine that does not confer immunity.
Don’t take my word for it, though. That was the conclusion of Switzerland’s National Advisory Commission on Biomedical Ethics. In a public statement issued in February 2021, the Commission said that unequal treatment of vaccinated and nonvaccinated people via a vaccination certificate could only be justified if the vaccination in question guaranteed protection against virus. It also averred that a general vaccination obligation in Switzerland would interfere “disproportionately with fundamental rights,” and that mandatory vaccination for certain groups of the population, such as health care workers, should be avoided.15
Public health authorities should instead focus on making vaccines available to everyone who wants to take one, the Commission said. For those who don’t, alternatives such as regular, rapid testing should be made available. The Commission also warned of the broader societal and economic harms the vaccine mandates and passports could cause, such as exacerbating the current shortages of skilled workers—precisely what’s happening in many countries, including Italy, France, the UK, and the United States.
Unfortunately, most governments—including Switzerland’s—have ignored these recommendations. At the end of November 2021, a clear majority of 62 percent voted in a referendum to keep the government’s COVID-19 laws in place, including the vaccine passport.
One result of all this is that millions of frontline workers all over the world who were hailed as heroes in 2020 are now losing their jobs due to their refusal to get vaccinated. They include countless thousands of doctors, nurses, and care workers whom our governments lionized for putting themselves in harm’s way, often with inadequate protective equipment, to treat COVID-19 patients in the first waves of the pandemic.
These workers know better than anyone the damage COVID-19 can cause yet they still refuse to get vaccinated. The Wall Street Journal reports that some believe the vaccines were rolled out too quickly and are concerned about the possible long-term adverse effects on their health.16 Some may have already seen first-hand the short-term harm the vaccines can cause. Many of them already have natural immunity from the virus, which more and more studies show is broader and longer lasting then the immunity provided by the vaccines.17 Yet most vaccine mandates do not exempt those who have already had a SARS-CoV-2 infection. Now many nurses, doctors, and other health care workers face dismissal for exercising their right to bodily autonomy. And health care systems around the world face even worse staff shortages than during the early waves of COVID-19.
For some governments, stripping workers of their ability to work does not go far enough. In Canada the Employment Minister Carla Qualtrough said that those fired for refusing the vaccine should not receive employment insurance (EI). In other words, not only will they lose their livelihood but also all access to other forms of income, including the employment insurance they have contributed to over the course of their working lives.
“It’s a condition of employment that hasn’t been met,” Qualtrough said in an interview with CBC’s Power & Politics. “And the employer choosing to terminate someone for that reason would make that person ineligible for EI. I can tell you that’s the advice I’m getting, and that’s the advice I’ll move forward with.”18
Qualtrough’s comments elicited a sharp rebuke from some legal experts. Paul Champ, an employment lawyer in Ottawa, told CBC:
I think it’s very arguable about whether employees terminated for not getting the vaccine requirement is just cause for termination. I think it’s reasonable that some employers may and will terminate employees for not being vaccinated—I don’t take issue with that—but it’s different to say that it’s just cause, meaning you pay them nothing.
To suggest an employer can order an employee to be vaccinated is pushing it, Champ says: “That interferes with bodily integrity and at least my opinion—and I think the consensus among most employment lawyers right now—is that it’s not just cause for an employee to refuse that, at least in most circumstances.”
Nicholas Wansbutter, a Canadian criminal defense lawyer, believes that the vaccine passports being rolled out by the Trudeau government are not only an affront to a free and democratic society but are also a clear assault on patients’ rights:
Medical treatment is an assault if it is not done with not only the consent but the informed consent of a patient. Consent given under fear or duress is ineffective. Consent given under fear or duress is not consent.
The implementation of a vaccine passport is absolutely the exercise of authority. If a person receives a vaccine only because of that use of authority, and because they want to be able to live a normal life, they did not consent to medical treatment, and in my view that is a clear assault. And it is an assault that any physician is a party to that takes part in. The Hippocratic Oath requires that physicians do no harm. Assault is harm. A vaccine passport is absolutely offensive to a free and democratic society.19
In the United States and Canada, universities have even begun to fire or suspend professors of ethics and bioethics—the very people who should be helping us to navigate the thorny ethical issues thrown up by advances in biology, medicines, and technology—for questioning or refusing to comply with their employer’s vaccine mandates. Those professors include University of California Irvine’s director of medical ethics, Dr. Aaron Kheriaty, who was placed on “investigatory leave” after he challenged the constitutionality of UCI’s vaccine mandate in regard to individuals who have recovered from COVID-19 and therefore have naturally acquired immunity. UCI has banned him from working on campus or working from home.
In a blog post, Kheriaty writes: “How can I continue to call myself a medical ethicist if I fail to do what I am convinced is morally right under pressure?”20
Dr. Julie Ponesse, an ethicist at Huron University College in Ontario, lost her job for refusing to abide by her employer’s vaccine mandate and made headlines after filming a tear-filled statement:
… My employer just mandated that I must get a vaccine for COVID-19. If I want to keep working in my job as a professor, I have to take this vaccine. Here’s my conundrum: my school employs me to be an authority on the subject of objective ethics. I hold a PhD in ethics, an ancient philosophy. And I’m here to tell you it’s ethically wrong to coerce someone to take a vaccine. If it happens to you, you don’t have to do it. If you don’t want a COVID-19 vaccine, don’t take one, end of discussion. It’s your own business.
But that is not the approach of the University of Western Ontario, which has suddenly required that I be vaccinated immediately or not report for work. So, with the school year beginning in a few days, I’m facing imminent dismissal after 20 years on the job because I will not submit to having an experimental vaccine injected into my body.
My job is to teach students how to think critically, to ask questions that might expose a false argument. Questions like: Says who? Who is the authority giving this order? Should I trust them with control over my body? As a professor, I don’t have to watch the news to find out if the COVID vaccines are safe. I read medical journals and I consult my colleagues who are professors of science and medicine. I’ve learnt from doctors that there are serious questions about how safe these vaccines really are. There are questions about how well they work. Nobody is promising that I won’t get COVID or transmit COVID if I get the vaccine.
But ultimately none of that matters to me, because I’m a professor of ethics and I’m a Canadian. I’m entitled to make choices about what does and does not enter my body regardless of my reasons. If I’m allowed back into my university, it is my job to teach my students that this is wrong. I’m hired to teach them that it is ethically wrong to impose an experimental medical procedure as a condition of employment. This is my first and potentially last lesson of the year.21
The video ends with the written message: “Dr. Ponesse was dismissed from her position on September 7, 2021.”
One of the most worrying aspects of the vaccine mandates and passports—and one that many vaccinated people are only now beginning to fully appreciate—is their ratcheting effects. The government of Israel, the first country to launch a vaccine passport nationwide, told Israeli citizens in February 2021 that all they needed to do to qualify for the so-called Green Pass and all the privileges it confers was to take two jabs of the Pfizer vaccine. The majority of adults and children over the age of 12 complied. But in September the government reneged on its commitment. After the effects of Pfizer’s leaky vaccine began to wane over the summer, Tel Aviv announced that to remain eligible for the Green Pass, Israeli citizens would need to take a booster shot five months after the second dose, otherwise, their Green Pass would be deactivated.
Unlike traditional passports or traditional vaccine certificates, these are living digital documents, meaning they can be activated and deactivated at any time. This is what makes them such a dangerous tool, especially in the wrong hands. With the click of a mouse or the stroke of a key, they can be turned off if a user no longer meets the requirements. And governments can change those requirements at any time.
By mid-October 2021, the United States was embarking down the same path as Israel. In a press conference CDC Director Dr. Rochelle Walensky said that booster shots may become mandatory in order for people to be considered fully vaccinated:
We have not yet changed the definition of fully vaccinated. We will continue to look at this. We may need to update our definition of fully vaccinated in the future.
Yet as already mentioned, vaccine experts including two former top FDA scientists have already warned of major risks if booster shots “are widely introduced too soon, or too frequently, especially with vaccines that can have immune-mediated side-effects.”
Changing the definition not only puts pressure on people to get a booster; it serves two other nefarious ends. First, it opens the door to even tighter control of citizens. As the British journalist Kit Knightly writes, “forcing people to jump through hoops just to ‘get back’ rights they once took for granted creates an atmosphere that normalizes state tyranny.”22 Second, it makes it more difficult to ascertain the extent of breakthrough cases. After all, anyone who is double-jabbed but has not received a booster shot will be considered unvaccinated. If infected with COVID-19 before receiving the booster or in the two weeks after receiving the booster, they will not be considered a breakthrough case.
By the end of 2021, this had already begun to happen in the UK. As Omicron raged, pushing the country’s COVID-19 case numbers to record highs, Prime Minister Boris Johnson issued a statement claiming that “up to 90 percent of the people in ICU are not boosted.” Yet when asked by Kate McCann, a political correspondent for Sky News, to clarify the figure, the prime minister’s spokesperson said it was based on anecdotal evidence from “some NHS Trusts.”23
The lesson from this is clear and urgent. When you give up your basic fundamental rights to bodily autonomy and bodily integrity in return for the promise of government-granted privileges, you are on a slippery slope to a dark place. You no longer have control over what goes into your body; the government does. If you have an adverse reaction to the first, second, or third booster shots and you decide that you don’t want to have any more, you will be considered unvaccinated. You will lose your privileges. As we are now seeing, governments do not have to honor the promises or commitments they make. But if you want to maintain your temporary privileges, you will be required to do exactly as you are told.
But as you will learn in the next chapter and chapter 5, all citizens are not affected equally by this. When it comes to the vaccine mandates and vaccine passports, some people are more equal than others.