Vaccine passports are a 'huge ethical minefield,' says bioethicist
‘My question is: Is this justified? And I hope it is,’ says Kerry Bowman
There's no doubt vaccine passports will limit some people's freedoms and create a two-tiered society, says University of Toronto bioethicist Kerry Bowman. The question is: Is it worth it?
Bowman says vaccine passports are an ethical quagmire that could negatively impact some of the most vulnerable members of society. Whether it's justified will depend on how it's done, and whether it actually works to tamp down the fourth wave of the pandemic, largely driven by the delta variant.
On Wednesday, Quebec became the first in the country to require digital or paper proof of vaccination for most non-essential public activities, including restaurants, movie theatres, gyms, team sports, indoor pools and more.
Ontario just announced the details of its vaccine passport system, which will come into effect on Sept. 22. Manitoba will implement a similar system on Sept. 3, and B.C.'s takes effect on Sept. 13.
Here is part of Bowman's conversation with As It Happens guest host Peter Armstrong.
How big of an ethical minefield is Quebec entering today by requiring vaccine passports?
It's a huge ethical minefield, and, you know, after today's announcement [in Ontario], I would say it's even a little bit bigger than it was yesterday.
When I look to the Ontario rollout — and look, I'm not saying it's not justified; we're in a very difficult situation with delta — but having said that, looking at it now, starting off before the QR codes ... you're going to need photo ID ... plus your vaccination [receipt].
I know that's going to present a huge problem for people that already don't feel safe within a system, people that simply don't have photo ID due to poverty, homelessness, whatever it may be, [and] people that are new to the country. Photo ID is a lot.
When the QR codes come [to Ontario], will there be any element of data storage or surveillance to that? I don't know the answer to that, but there could be. And if there is, there's another ethical concern there.
And the big one is really freedom of movement.... Within a mature democratic society, freedom of movement is really an inherent part of how we live. And we're now laying down infrastructure through many provinces and throughout our country to really divide people.
But the heart of it is: With all of those concerns, do the benefits absolutely outweigh all of that? I'm not suggesting they don't. But I'm not an epidemiologist, so I'm going to leave that alone.
Let's let's dig in, then, on the freedom of movement thing ... because this isn't saying you can't move around. It's saying you can't go get a coffee or you can't go to the gym or go to the movies [without proof of vaccination]. Does that sort of divide [people] up into sort of subsets then?
Freedom of movement would imply that public spaces are available to all people, and we are now creating divisions within that.
Hopefully the system will get better, and hopefully the benefits will outweigh all of this.
But I would argue, Peter, that the discourse on this has not been wonderful. I mean, [people use terms like] carrots and sticks, no-brainer, slam dunk. I don't see this as something self-evident at all. And I would also argue the conversation on this has really been dominated by medical cultures almost exclusively. And we've heard very little from other people on this.
What might this mean, though, for the lives of people who, for whatever reason, have decided not to get vaccinated?
It would mean their lives are much more restricted. And that leads to an injustice. It leads to a bitterness as well.
When you look at the fact that, you know, you can't go for a coffee indoors [without proof of vaccination], but you could go to a barber or a salon … that kind of incoherence is not going to be lost on people, and that's going to erode trust as well.
I want to play a clip from CBC Toronto's morning show Metro Morning this morning. This was part of an interview with a woman who was interviewed at one of those pop-up vaccine clinics who still hadn't decided whether or not to get the shot:
"My concern is, [is my workplace] going to just enforce it at a certain point? So what do you do? You have to take it whether you're scared or not. I don't speak for every African-American, but I must say, a high percentage of the African-American community population are not taking it, not because [of] just the fear, [but] because it seems to them, and to me also, that it's been taking away our human rights. "
What do you make of what you just heard?
I myself have worked in the health-care system for decades, and there clearly is structural and systemic barriers and racism for certain groups…. There's no question about that. People that have been discriminated against are going to be far more hesitant to get the vaccine.
People say: "Well, we're still preserving autonomy. People don't have to get it. We're not forcing it in anyone's arm." I would argue that's actually not true because I literally know of people that are now taking the vaccine only to protect their livelihoods.
Again, my question is: Is this justified? And I hope it is. I think we're actually taking some very big steps here provincially and nationally, not small steps. And I hope this really brings our numbers down very quickly.
We know, though, that it's safe. We know that it saves lives. So is this worth it to try, as you say, to leave the carrot behind and move more towards the stick?
I hate the carrot and stick thing. You know, [a] carrot's a manipulation, and a stick is animal cruelty. It's actually the worst metaphor in the world, I think, to use in terms of public health.
But having said that ... whether we like it or not, it's here. And the question is, how do we do it fairly?
The unvaccinated — I'm not trying to make any excuses for them; I'm pro-vaccine, I'm fully vaccinated myself — but they didn't cause this pandemic either. And they're really, really being targeted. And some of them will be vaccinated. They just haven't been ready yet.
So we will see. We've got some strong consensus ... that vaccine mandates, passports, certificates, whatever you choose to call them, are the way forward. And we have jumped on board. And the question now is how do we make this as fair and as useful and as effective a process as we possibly can?
Written by Sheena Goodyear. Interview produced by Chris Harbord. Q&A has been vetted for length and clarity.