Should spreading anti-vaccine misinformation be criminalised?
BMJ 2021; 372 doi: https://doi.org/10.1136/bmj.n272 (Published 17 February 2021) Cite this as: BMJ 2021;372:n272Read our latest coverage of the coronavirus outbreak
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Dear Editor
Should spreading anti-vaccine misinformation be criminalised?
No! But...
Freedoms of opinion and speech are important. Curtailing either will fuel the mistrust.
What is required for the whole of society, not just politicians, media or influencers, is making it mandatory to distinguish between objective, verifiable, documented information (sometimes referred to as facts) and opinion. Being required to compare and contrast opinion with such facts as are available would permit the emergence of balance.
This would reduce the cacophony that currently is displacing reasoned discourse.
Steve Ford
Competing interests: No competing interests
Dear Editor,
I agree with Melinda Mills when she says that misinformation about measles led to that disease's resurgence, and that it's an evil if people had to die due to misinformation.
But there's a far greater evil than that of spreading misinformation, and that evil is the assumption of unquestioned medical power of the state over the individual. So horrific and well-documented have abuses of medical authority been that I don't think I have to list any examples; eugenics by itself would yield countless examples.
We can remedy misinformation through teaching critical thinking and through refuting arguments, can't we? How do you remedy medical tyranny? Which is the greater evil, allowing people to state their opinions freely and to manage their own health, or shutting down opinions and medical decisions that disagree with the consensus view? Which has caused the most harm historically?
Let us never go down the road of medical tyranny or of censorship of open debate. Democracy is messy, while tyranny is straightforward and clean. Let us never lose sight of our humanity and our reason and our fairness, and let us not demonize those who hold opinions other than our own as imbeciles, morons, and idiots.
People who are opposed to the over-vaccination of our children have valid points. If they did not, intelligent, well-educated people wouldn't be agreeing with them. People who argue that we should have been using hydroxychloroquine long ago to fight Covid-19 have valid points. Calling something "misinformation" is one thing-- that's just a name. But giving our opinions the power of censorship is quite another, and is one more set of paving stones on the road to medical tyranny.
Competing interests: No competing interests
Dear Editor
As these days I'm more of a student of language than medicine, I noted Professor Mills' use of the term libertarian in association with anti-vacciners. An association whose juxtaposition leaves little doubt that condemnation of the one requires condemnation of both. Libertarianism, to remind readers, is a political philosophy that upholds liberty as a core principle and goes on to commit to freedom of choice, free association and political freedom. Dubious aspirations indeed and with those pesky consequences that some people hold views which others find unacceptable. Professor Mills does elswhere acknowledge that criminalisation of free speech can have drawbacks - she alludes to Russia - but feels that there are circumstances where what she might call countering misinformation but others might call censorship is justified.
It will be for lawyers to devise the legal framework for defining, policing and punishing disinformation. They may explore whether, for example, a throwaway remark querying the efficacy of the Astra Zeneca vaccine in over 65s meets the threshold of disinformation and, if so, merits a fine, an ASBO or 2 years in jail. Or whether arguing against compulsory vaccination in certain occupations is disinformation enough to attract a £10,000 fine, 10 years in jail or maybe a day of hate on Twitter. They too can consider the mechanism for bringing such incidents to the attention of the relevant body (staffed with the totally certain, of course). An app perhaps. I'd suggest the Systematic Transmission About Suspicious Information app. Stasi has a certain ring to it. I seem to recall hearing it before.
Clearly more thought is called for. Helpfully some preliminary thought on some consequences of putting public policy above personal freedom was carried out by Mr George Orwell. He would well recognise the inversion of language such that a concern for freedom becomes suspicious and where suppression of free expression become an aspiration. But no doubt he too was one of those libertarians.
Competing interests: No competing interests
Dear Editor
The analogy between a cancer running amok in an individual and the spread of Social media in today’s society is an apt one and certainly not a hyperbolic claim. The normal human body cell’s capacity to grow and repair is essential for human life. But when normal cell growth becomes excessive, unregulated and uncoordinated, cancer arises thereby destroying the individual from within. This is precisely what social media is doing to the society now.
From a benign technology helping people to connect friends and family, the social media has now grown rapidly and excessively with tentacles malignantly spreading to every part of the society. The inexcusable behaviour of Facebook against a democratically elected parliament in Australia, at the mere switch of a button, should be an urgent wake-up call to everyone in the world now.[1].
Social media hooks people and it is very difficult for anyone to completely wean themselves off Social media now. Social media companies know a lot about issues that trigger people’s emotions, drive traffic and engagement. Their algorithms are designed to rile up people, drive them to echo chambers and chain people to their ‘addictive dens’ much like a drug den.
Like the Tobacco companies, Social media companies should be forced by courts to divulge the treasure trove of psychological information they have amassed on people’s characteristics that drive their addictive behaviour.[2] [3]. This is essential so that psychological antidotes can be developed to prevent authoritarian takeover of the society in future.
Social media is here to stay as it permeates every aspect of society. Criminalising individuals would not work and does not deal with the underlying technology that gives megaphone to misguided and malicious individuals.[4][5]. So the long term solution is to regulate the social-media similar to essential services like Water, Gas and Electricity.
References
1 Facebook Australia: PM Scott Morrison ‘will not be intimidated’ by tech giant. BBC News. 2021.https://www.bbc.com/news/world-australia-56109036 (accessed 20 Feb 2021).
2 Velicer C, Lempert LK, Glantz S. Cigarette company trade secrets are not secret: an analysis of reverse engineering reports in internal tobacco industry documents released as a result of litigation. Tobacco Control 2015;24:469–80. doi:10.1136/tobaccocontrol-2014-051571
3 Harding A. Tobacco companies aimed to keep smokers hooked, court told. BMJ 2004;329:757. doi:10.1136/bmj.329.7469.757-a
4 Mills MC, Sivelä J. Should spreading anti-vaccine misinformation be criminalised? BMJ 2021;372:n272. doi:10.1136/bmj.n272
5 Wardle C, Singerman E. Too little, too late: social media companies’ failure to tackle vaccine misinformation poses a real threat. BMJ 2021;372:n26. doi:10.1136/bmj.n26
Competing interests: No competing interests
Dear Editor - given the appalling degree of polarisation that is presently dismantling the fabric of society, I was surprised that Melinda Mills and Jonas Sivelä would quite so readily make assumptions about criminal behaviours given the profound scientific uncertainties around a novel disease and even more novel vaccines. Criminality is typically determined in courtrooms based on legal judgments of evidence. We have yet to see any significant case law around vaccine hesitancy or misinformation. Dissent should not be conflated with criminality, and dissent has historically catalysed the discourse that ultimately facilities the emergence of scientific consensus. Let’s not judge until we have more facts, and let’s allow the courts to create criminals, not doctors, scientists or politicians.
Competing interests: No competing interests
Dear Editor
What is misinformation?
I say that merely because I have had one dose of Astra Zeneca, at the age of 88. I regard my vaccine status to be useless. No one should ask me for a certificate because it will NOT be proof that I am safe from the disease, nor that I am not a carrier.
Would the Pro-vaxcers want me to be hauled before the magistrate for poking fun at those officials who suggest that the vaccine is vital for the survival of Mankind?
Competing interests: No competing interests
Dear Editor
When conscientious members of the public carry out due diligence and discover that vaccine manufacturers themselves, in their Summary of Product Characteristics, make statements like, “The efficacy of Bexsero has not been evaluated through clinical trials” (1), or, “The effect of the HBsAg on foetal development has not been assessed. However, as with all inactivated viral vaccines one does not expect harm for the foetus”, or, “Information concerning the excretion into the breastmilk is not available. No contra-indication has been established”, or, “Engerix B has not been evaluated in fertility studies” (2), is it surprising that they begin to question the ubiquitous mantra, “Safe and Effective”?
Perhaps doctors themselves should be equally curious about the contents of their syringes?
(1) https://www.medicines.org.uk/emc/product/5168/smpc
(2) https://www.medicines.org.uk/EMC/medicine/24844/SPC/Engerix+B+20+microgr...
Competing interests: No competing interests
Dear Editor
Melinda Mills begins with the statement “vaccination is a miracle of medicine” [1] which surely falls short of scientific verifiability. Should she be allowed to say such a thing, and what is it founded upon? In the real world vaccines are just products which need to be tested for safety and efficacy, and what people should be able to do is discuss their merits and shortcomings without harassment or persecution. Nothing could be more disturbing, more disruptive of trust than trying to place a whole class of products beyond public scrutiny, and it does not demonstrate confidence in them if you want to do that.
Nor is it safe if you want to disregard - or silence - public experience. It is not surprising that the purveyors of these products should wish to turn off the voices of their critics [2], and it does not help if the Prime Minister resorts to abusive terminology like “nutjobs” (and before the United Nations General Assembly”) [3], but it also invites profound scepticism both for the products and for the motives of the people making such headstrong claims for them.
Should there really be a health bureaucracy deciding for the public what they may read? Last year a former editor of this journal, Richard Smith warned in his article ‘The Faults and Dangers of an Iatocracy’ [4]:
“Doctors have important roles to play in a pandemic—primarily in treating the sick and advising on prevention—but they cannot become rulers, and politicians cannot hide behind them. And we, the people, must never succumb to the idea that a world run by doctors would be a better world.”
It is about time we returned to the norms of civil discourse and public accountability, rather than discussing who we are going to ban next. We seem to have fallen far in the last year: at a time when government seeks to restrict people’s movements it can at least respect their views.
[1] Melinda Mills, Jonas Sivelas, ‘ Should spreading anti-vaccine misinformation be criminalised?’, BMJ 2021; 372 doi: https://doi.org/10.1136/bmj.n272 (Published 17 February 2021)
[2] John Stone, ‘ Regarding the Use of the Term "Anti-Vaxxer", 27 August 2020, https://www.bmj.com/content/370/bmj.m3099/rr-5
[3] https://www.gov.uk/government/speeches/prime-ministers-speech-to-un-gene...
[4] Richard Smith, ‘The Faults and Dangers of an Iatocracy’, 18 August 2020, https://blogs.bmj.com/bmj/2020/08/11/richard-smith-the-faults-and-danger...
Competing interests: AgeofAutism.com, an on-line daily journal, concerns itself with the potential environmental sources for the proliferation of autism, neurological impairment, immune dysfunction and chronic disease. I receive no payment as UK Editor. I also moderate comments for the on-line journal ‘The Defender’ for which I am paid.
Re: Should spreading anti-vaccine misinformation be criminalised?
Dear Editor
Of relevance to the debate as to whether spreading antivaccine misinformation should be criminalised I wish to draw attention to an unsolicited flyer which has recently been distributed in the area of Greater Manchester where I live. The text reads as follows:
"Caution!! The so called vaccines for corona-virus (in actuality a chemotherapy) are not effective and they are extremely dangerous. Hundreds of people died immediately after receiving the vaccine. High calibre doctors and scientists predict that more than 50% will die within 2-3 years after the vaccination. It is your responsibility to decline the vaccine for yourself and your family, irrelevant of your vulnerability to COVID -19. Remember that once you have taken it you can't undo it. Rather take Zink(sic), Vitamin D and lots of Vitamin C".
This must be regarded as disinformation as defined by Jonas Sivela - false information deliberately spread with the purpose of influencing public opinion - which can only be regarded as highly dangerous and therefore surely justifying criminalisation.
Competing interests: No competing interests