I’ve previously said here that mass vaccination is a crucial tool in disease control, but that enforced vaccination has some problems. The first five I’m just listing, because I think everyone should be aware of them. I know some are controversial, but I’m not planning to discuss them here. The last one is IMO the most interesting.

Misc issues, not the subject of this post

• civil rights - forcing medical treatment on people is normally a serious crime, but for whatever reason people seem to make an exception for vaccination.

• utility - politicians usually don’t think so, but people generally make better decisions for themselves than politicians will make for them

• fragility - when everybody is forced to do the same thing at the same time, and problems with it are immediately big problems. Like when the CDC mandated one covid test kit, but the kit was defective, and hospitals were prohibited from using different non-approved kits. It’s better for people to have access to several options, in case the mandated one has some flaw.

• incentivisation (1) - a government which cannot enforce a rule has to convince people to follow the rule. So it has an incentive to make high quality rules. You can then measure whether the rule really works for people by measuring the compliance by demographic.

• incentivitation (2) - many people will resist or ignore a command from an authority. They are much more likely to obey good convincing advice from an authority.

The real subject of this post

• trolley problem

You can guess that a novel vaccine will have unexpected side effects and will kill some number of people. You should, because every medical intervention has a non-zero mortality rate, with very rare exceptions like acupuncture.

So the vaccine will save X deaths and cause Y deaths. Nobody can know what X and Y are, except that X is much bigger than Y. This sounds like the trolley problem.

I used to think that providing access to vaccines is good. People can make their own decisions to take the risk, based on their personal risk profiles and doctor’s advice. But if the president or minister forces people to do something that kills Y people, the president/minister is responsible for those deaths. The only question would be what level of culpability he would have.

So my question.

Does instead framing it as a trolley problem hold water? If so, does that debunk the criminal argument? Or is there maybe a hybrid perspective or a different one, that’s even more solid?