Concluding Remarks

Comment by Andrew Donaldson

Dear Matt,

I read your HSF piece on vaccine mandates. You have covered a considerable body of philosophy with some eloquence.

Despite careful reading, I still haven’t got a clue why you think that vaccine mandates are wrong. Governments have, for centuries, imposed restrictions or mandates on people for public health reasons. This is an important part of what we call civilization. Without these intrusions in “freedom” life would be very nasty and for most people short. I cannot see where, in your written paper, you assess the unavoidable tension between choice and compulsion in the promotion of public health.

But that is not why I am writing. I don’t mind if you think vaccines should not be mandated, I don’t have particularly strong views on this.

I am writing because you characterise the views of those who favour mandates as motivated by a “disgust for the unvaccinated”.

This is a profoundly offensive view, and the offense is not tempered by the associated academic reference. Let’s examine the words you use. Narcissism is a clinically diagnosable personality disorder. Disgust is an emotional response to something reprehensible. Vaccine advocacy is a public policy position founded on scientific evidence. To conflate these things, as you have done, is a category mistake.

You might care to read the recent public comment of Graeme Meintjes, who as a WC Dept of Health public doctor speaks of the “daily reality” in Covid wards of people who are desperately ill and dying, most of whom would not be in hospital if they or their acquaintances had been vaccinated.

That he, and many others, regard vaccine mandates as sensible, has nothing to do with disgust, it is because they care about others.

With regards and respect,

Andrew Donaldson

Response by Matthew Kruger

Dear Andrew,

Thank you for your email, and for your kind words.

When I write, I never mean to offend. I regret that you feel that way. But, my writing is intended to make (the very few) people who read my work uncomfortable. To the extent that some of what you characterise as offensive is actually discomfort, then job done.

Now to the two main objections of substance:

1) The piece is not about whether vaccines should or should not be mandated. It is about the discourse and attitudes that seem to be driving members of our elite, who are otherwise violently opposed ideologically, to collectively support it. The blurb specifically makes this point: “Whatever the cold wisdom…” That same phrasing is used in the main text itself. This choice of wording was deliberate. But in retrospect, perhaps I should have been clearer.

Asking after discourse and attitudes is not an idle enterprise. Questions of policy and law are structured by a complex of concepts, categories, attitudes and emotions. The particular, prevailing complex of these opens up horizons of possible judgment. They make certain options seem obviously true, and others appear obviously false. Sometimes, they obscure options entirely. My aim was to try to disclose one aspect of this complex. This is important, I think, because it is only when the structuring complex is clear that we can meaningfully address the tension that you rightly identify. Until then, the field of evaluation is distorted. And consequently the judgments and actions that follow are illegitimate - or, at best, coincidentally right.

This is why, with all due respect to the extraordinary work that they do, a doctor’s view on this issue has no unique or higher authority than my own. Or any person’s. Doctors are experts in healing people. That is the limit of their authority. And even then, their job is only to inform us of the probable consequences of certain actions. Their views as doctors, as opposed to ordinary citizens, have no special weight when we, as a democracy, are deciding what to do.

2) Regarding disgust, I do cite academic authority for my claims. Obviously, the authorities do not concern Covid-19 itself. That is all too new. But look at the footnotes. Martha Nussbaum is cited. Even if you remain opposed to me, I could not recommend this book more highly. 

In the book cited, Nussbaum explains that emotions are "intelligent". What she means is that they have built in them evaluative judgments about objects or persons. Disgust is one such emotion. It is grounded, she argues, in narcissism, which on her account is rooted in the failure to overcome the infantile desire to control or dominate the world. But since this total control is impossible, she explains, life for the narcissist is characterised by two related emotions: shame and disgust. Shame is directed inwards, at the self, with the narcissist judging herself for her failure to effect the control that she thinks all-important. Disgust is directed outwards, at others or objects. For example, excrement is disgusting, she says, because it reminds us that we’re part of nature and therefore vulnerable (and so not in control). But likewise the narcissist can experience disgust of people, when these "others" threaten the narcissist’s sense of control. Given our country's history, this claim by Nussbaum hardly needs much argument to be persuasive. 

Now, this is what I think is driving much of the left and right. Over 18 months, our elites have instilled in Covid-19 an almost mystical power, possessing it with the ability to "engulf or destroy us all" (as the editor of News24 editor put it right at the start). But with effective vaccines available, they are transferring that fear from “the Virus” to “the Unvaccinated”. The term is not a coincidence: it serves to dehumanise a class of people. This class, we have been told, constitutes an existential threat. Because the nature of the threat is biological, the emotion accompanying their fear is disgust. 

Lastly, again, these are not idle, merely philosophical, speculations. For the policy to mandate vaccinations, when structured by narcissism and fear and disgust, is very different to one structured by your no doubt more tempered, humane standpoint. This matters. Because what happens when, to quote Biden from just last night, those with power "lose patience"? Will the "War on the Virus" become a "War on the Unvaccinated"?  My fear, perhaps overwrought perhaps not, is simply this: Whereas the natural response of the person who is ashamed is to hide from the world, the natural response of the person who is disgusted is to cleanse it.

Thank you again for taking the time to read my piece, and to write so thoughtfully in reply.

Best,

Matthew 

Comment by Anwar Suleman Mall

Dear Matthew,

I read your piece in the HSF newsletter with much interest, decrying the global hegemony of the U.S.A. or the ambiguity in the pronouncements of President Ramaphosa which, when carefully unearthed, seem to you to be a mere collaboration or capitulation to big business, with respect to the matter of mandatory vaccination.

You took this matter of the question of a mandatory vaccination policy and set it very nicely against the larger context of global attitudes and their influence in the way we do things. Such analyses have their value and create spaces for much intellectual discussion and debate in our institutions and public spaces. In fact, they are necessary to engage those destined for or who are in careers where policymaking is of crucial importance. Public education, in this regard, is important too.

Whilst we deal with the theoretical aspects of such issues, we have to be realistic and remember that the situation on the ground here in South Africa and the world is dire. Theorizing and philosophizing at this moment is not of much benefit! Your analysis seems to suggest that individuals have the freedom to make choices for themselves and to suffer the good or bad consequences, whatever they may be, and take responsibility for those choices. But freedom of choice in this instance could result in harm to others; our infectious diseases experts regularly remind us that the occurrence of a high level of infections in a large cohort of unvaccinated individuals will undoubtedly cause more dangerous variants to arise. Apart from maintaining the pandemic, there would be all kinds of deleterious effects on society at large through the focus on very many sick or dying Covid-19 patients, plus the continuing economic harm affecting large numbers of marginally surviving people.

People are dying daily from Covid-19, and an already severely battered South African economy is being further threatened, with consequences too horrible to imagine. The spectre of hunger, poverty, joblessness, and the vulnerability of a large sector of our (poorly literate or illiterate) population to misinformation, especially through social media, about the pandemic, are factors that must drive us to seeking practical solutions in the eradication of this pandemic. In fact, misinformation, and even outright stubbornness (should I say stupidity) has sometimes even overtaken those considered to be ‘educated’. Here I refer to a court application against the President in the early days of the pandemic by a group of professionals of a particular religious persuasion on the grounds that the lockdown regulations were violating their rights to congregational prayer! Perhaps we are also following the Americans in our ignorance, anti-intellectualism and anti-science attitudes?

As a scientist, I celebrate the prompt response of the western world in creating vaccines in so short a space of time. I am utterly grateful to those frontline health workers who have risked their lives and the well-being of their loved ones to serve the sick and dying. I support all efforts to get the proper information about this pandemic to all sectors of our society.

In the light of this I find your criticism against Ivo Vegter and Pierre de Vos to be in the extreme and unwarranted. All efforts to have at least the majority vaccinated is absolutely necessary. For those of us who have experienced the brunt of this pandemic through the loss of close relatives and friends, what we can hope for is a more efficient and faster vaccination rollout, and perhaps even mandatory vaccination, in specific instances and institutions, if found to be constitutionally sound, would be acceptable.

I would rely on the expertise of constitutional experts to guide me here.

Anwar Suleman Mall
Emeritus Professor
University of Cape Town

Interview with Matthew Kruger on BizNews Radio*

What drew you to this whole subject of mandatory vaccinations?

We are an extremely politically and ideologically diverse country. But what has struck me throughout, is the almost uniformity of response by individuals, by corporates, by NGOs, by media and by political parties. There’s been a near uniform response – a kind of party line, so to speak – that has been followed.

I’ve made written various pieces about that since the beginning. What struck me about this is that it seems, to me, to be taking up an especially dangerous form with the mandatory vaccines. It’s not so much the mandate itself or the proposed mandate itself. Let me make that clear. We can discuss the substance of that sort of decision, but rather the piece that I wrote is concerned with what strikes me as the framework through which we’re considering this question. I find that extremely worrying for a number of respects that I canvassed in that piece.

So, you don’t argue against the numbers for instance that President Ramaphosa put into his talk on the weekend where he illustrated that the vaccine is going to protect your life and we saw that relative to the unvaccinated. There was something that came out from Groote Schuur which made the same point. So that’s not the issue here, that vaccinations do save lives, there is something a lot more constitutionally involved. Just unpack for us.

There are two separate questions it seems to be, the one is the scientific question which I am constitutionally incapable of commenting on. I simply can’t speak to that and all the evidence seems suggests that they are overwhelmingly effective and that they are an extraordinary intervention. So I would never quibble with any of those statistics. They seem to be consistent with what must public health bodies around the world seem to be reporting.

But that facts are reported to us in a particular way doesn’t dictate our response to those facts. There is a difference between what the facts are that must shape our response and the values that structure how we confront those facts and then decide what to do. There is no - so to speak - following the science. There is no trusting the science in the sense that we must do what our doctors say and do what our scientists say. The authority extends to telling us what the facts are, not telling us what to do with the facts. The authority when it comes to deciding what we do with the facts are the Constitution and its normative framework and that is the framework in which me must analyse the facts and then from there determine what we should do.

Ok, so let me, I have just spoken with Piet Mouton, and he came out with an open letter yesterday where he was calling for mandatory vaccinations or at least an incentive for people who don’t, or disincentive for people who aren’t getting vaccinated. His mandatory vaccinations, he would say would be throughout the whole PSG group and that would include Curro - the school company, Capitec - the bank etc. His argument is how else are we going to get out of this pandemic, do you have a better idea let me know – I think we should be vaccinating everybody to do that. How would you respond to that kind of pretty logically approach to getting the economy going again?

There seems to me to be, and this is part of the conflation that I was speaking about at the outset it would of course be a good thing if. Let me rather start it this way, if our goal is to promote vaccine uptake and most people support that goal, and I support that goal, that is a question of what we should do. Then there is a question of how we should go about striving to realise that goal. And then that can be confronted or approached from two different perspectives. One, who is the party that is going to decide how we approach these sorts of issues. Are they going to be individuals as some people say, is it going to be corporates as other people say, is it going to be the state? Should we have a national legislation that mandates it. Should we leave it to the power of corporates to mandate it? Those are very different ways of approaching the issue. But no one seems to want to meaningfully engage that very important distinction. And I think that is extremely important and constitutionally necessary, essential to draw that distinction and decide who is going to mandate it, is it going to be corporate, is it going to be the state, is it going to be a third party, who knows?

If it is the state is it going to be done through Parliamentary legislation or is it going to be done through regulation, is it going to be an executive mandate or is it going to be a legislative mandate. But because it seems to me that people are so unified on the outcome of what should be done they neglect all these questions. Questions that we would never have neglected in any other context. But for some reasons, some of which I canvassed in that brief that I wrote, for some reason we have completely abandoned what are really first principle constitutional questions. And that is the question of who should be making these decisions.

Then there is the question of what reasons can legitimately function to structure those decisions. There is a difference between mandating a vaccine because we adopt a balanced, temperate constitutional perspective on it. Then there is, you can mandate a vaccine because you think the only thing that matters is profits and money, lives and livelihoods - so to speak. Or there can be what I think is often driving this – an increasing alienation or dehumanisation of a particular group of people – what we are now referring to as the “unvaccinated”. And I find that deeply worrying. Even if I were to agree that mandates were important and that they should be done, that doesn’t decide who should mandate and what the reasons for the mandating should be. And, again it is all collapsed into one.

The question I put to Piet Mouton, and he didn’t really have an answer for, and a similar one I would love to hear Adrian Gore’s view on given that he wants mandatory vaccinations for all 10 000 Discovery stuff – is although rare, I have heard of two direct issues where people have been vaccinated and died. So, if it were to occur that a corporate executive was to mandate vaccinations on all staff and a staff member died, please God it doesn’t happen, but it isn’t, because it has occurred before it is within the realms of possibilities. What are the issues there that start coming up, given that you have already said who should be making these decisions and if you do make a decision what would your responsibility be thereafter?

Well it is difficult to know because we have never dealt with this situation before. These are new times dealing with new issues and where we are trying to decide where the location of power ought to be and what the responsibility for the exercise of that power ought to be. But we haven’t really dealt with something like this before. And there is a way that our constitutional democracy deals with new issues. Our Constitution sets up certain processes and procedures, it has certain norms, rights and guidelines by which we need to make decisions. Yet we have for some reason abandoned that structure, abandoned that process.

Who has the responsibility is something that we have to debate openly, transparently through our Parliamentary structures. There has to be consultation with people, we need to do full justice to the representative and participatory character of our democracy. Yet we have had none of that of course, through the last 18 months. Since March last year we have had “family meetings” rather than Parliamentary discussions around these issues.

Just as Parliament ought to have designed legislation fit for purpose rather than rely indefinitely on the Disaster Management Act. Just as it ought to have done that, but has explicitly absconded from its role, it is now doing the same thing. It is now saying we don’t want to decide, we don’t want to debate this transparently. We don’t want to have participatory democracy. We don’t want our representatives and accountable parliamentarians to engage this issue. Rather we are going to through the ball to the corporates. And any problems that emerge, like the one that you have just raised, will ultimately be in there court. And that is inconsistent with first principles of our Constitution.

What would your message be to Adrian Gore and Piet Mouton? What are they missing in the approach that they take?

Our corporates and our companies know how to lobby government. Perhaps they should encourage government to take the lead. Mr Gore, in his open letter, spoke about leading bravely. While that’s admirable, what we need is Parliament to lead – not the President or Cabinet, Parliament. We need Parliament to take the lead on this question and not just on the question of mandatory vaccines. 

The pandemic is not going away and there will be new viruses. We cannot operate under the Disaster Management Act indefinitely. We need legislation that is fit for purpose. We need legislation and much the same way as we have equality legislation, environmental legislation and domestic violence legislation. We need pandemic legislation. We cannot continue to operate under the Disaster Management Act and Executive rule via a “family meeting”. This question is only coming up because Parliament has failed in its duty to design a legislative framework that can deal with these questions.

A link to the full interview can be found here.

*The interview has been roughly transcribed and does not appear in its entirety.

Matthew Kruger’s original brief can be found here.

Media Enquiries:

Francis Antonie
francis@hsf.org.za

Chelsea Ramsden
chelsea@hsf.org.za

The views of the Research Fellows, and others provided above, do not necessarily represent those of the HSF but are published under our auspices in order to enhance and broaden public debate, which is part of the mandate of the HSF.