Where do you draw the line? On vaccination and freedom of speech

I was skimming my Facebook feed this afternoon, and I had to take a second glance at one of the articles when my brain eventually caught up with what was on the screen.

Australian nurses who spread anti-vaccination messages will now face prosecution”, it said.

My first reaction was, “Wow … that was unexpected.”

So unexpected, in fact, I initially thought it was a hoax.  Then I noticed the story was being reported by several sources, some of which looked reputable.  Perhaps this wasn’t a viral meme after all.  I went to the Australian Health Practitioner Regulatory Authority’s website to get direct confirmation, and sure enough, it was no joke—AHPRA and the Nursing and Midwifery Board of Australia (NMBA) recently issued a statement saying exactly what was reported.

“The NMBA has become aware that there are a small number of registered nurses, enrolled nurses and midwives who are promoting anti-vaccination statements to patients and the public via social media which contradict the best available scientific evidence. The NMBA is taking this opportunity to make its expectations about providing advice on vaccinations clear to registered nurses, enrolled nurses and midwives.”

“The NMBA expects all registered nurses, enrolled nurses and midwives to use the best available evidence in making practice decisions. This includes providing information to the public about public health issues.”

“Any published anti-vaccination material and/or advice which is false, misleading or deceptive which is being distributed by a registered nurse, enrolled nurse or midwife (including via social media) may also constitute a summary offence under the National Law and could result in prosecution by AHPRA.”
~ http://www.nursingmidwiferyboard.gov.au/Codes-Guidelines-Statements/Position-Statements/vaccination.aspx

Vaccination is a pet subject for me—I’m a strong advocate for immunisation and I detest those who would misconstrue the science of vaccines to suit their own twisted agenda.  I think there’s a special place in hell set aside for Jenny McCarthy and Andrew Wakefield.

That said, I’m still a teensy bit uneasy about this new approach by AHPRA, because as much as I hate hearing about people mislead by anti-vaxxers, I want to protect freedom of speech.

Muzzling free speech is a two-edged sword.  Yes, you might stop slimy crack-pots like Wakefield from spreading their malicious fiction, but you also run the risk of stifling legitimate debate.

There’s no evidence that vaccines have toxic levels of mercury or aluminium, or that vaccines cause autism or cancer.  To suggest otherwise is unscientific, and I have no problems in categorically stating that vaccination opponents are currently wrong.  But … what if a legitimate concern about a vaccine arises?  I’m not suggesting the evidence for vaccination is unsettled, but rather, what if a new vaccine is developed that does have unforeseen complications?  Will gag laws prevent a whistle-blower from coming forward for fear of being tarred as “anti-vaccination”?  I wouldn’t put it past the developing drug company from using such a tactic if they wanted an easy way to defend their product.

The other aspect to consider is broader—is this the thin end of the wedge?  If we start gagging health professionals from speaking out against the consensus on immunisation, then what’s next? Abortion law reform? Euthanasia? Climate change?  Each of these issues remains controversial and each side of each issue claims to have science on its side.  Should the side with the perceived ‘consensus’ have the authority or the right to suppress debate from their opponents?

Besides, the problem of anti-vaccination propaganda goes way beyond nurses making comments on social media.  AHPRA’s power only extends to registered health practitioners in Australia.  It doesn’t stop naturopaths or “nutritionists” from promoting anti-vaccination views, and it seems it hasn’t stopped certain chiropractors from subverting the rules either.  It doesn’t stop alternative-health hawkers overseas.

Despite my misgivings, I’m still in favour of AHPRA’s move.  It’s a step in the right direction, and it’s being done for the right reasons—to protect patients from rogue operators that would betray their trust—although this edict might need further discussion before extending it to all AHPRA health practitioners.

Perhaps we should focus on promoting the truth instead of trying to suppress the lies.  For every anti-vaccination blog, there should be a hundred promoting the science behind vaccines.  For every anti-vaxxer celebrity that gets thirty seconds of air time, there should be thirty minutes of air time for reputable scientists and vaccination advocates.  Anti-vaxxers should be able to say what they want even if it’s pseudoscience, but they should be prepared to be pilloried by real scientists using proven facts.

Perhaps that’s a better way to protect all the rights of the community.

What do you think?  Feel free to leave your comments below.

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5 thoughts on “Where do you draw the line? On vaccination and freedom of speech

  1. Agree. Freedom of speach is a fundamental right that can too easily be incrementally eroded. Once reduced, you may as well kiss it goodbye. Society needs clear communicators of the good rather than draconian limits on the foolish. Let fools be revealed by their own foolishness. However, advocates of unsafe practice (such as anti-vaccinators) should be held accountable before the law for their published advocacy. Sue the buggers!

  2. I think there are 3 key things that need to be identified in this type of thing:

    First of all, there should not be legal prosecution happening from anyone. The nurse has the right to freedom of speech, and thus no “suing” or criminal or civil charges should occur. This is a muzzle on those that would speak out if they did find something wrong in the future, as you said.

    Secondly, I DO think that as a health care worker, you have a duty to be “above” others. In this, if you are found telling patients not to get vaccines, that undermines the patients’ safety and health, which is absolutely inappropriate. No matter what you believe, a health care worker must be held to uphold the knowledge from controlled empirical studies. If they do not, then they are not suited for that job. Just as a police officer is expected to hold a higher moral and ethical compass, the police officer should be removed from duty if their beliefs are interfering with their job. If they believe there is seriously something wrong in their job then they must separate themselves and go on the offensive in a different avenue. The debate here happens with the question “should what these people say on social media – which is a different avenue than their work – be held to scrutiny?” I think the answer is yes, because just like police officers, health care workers are held to a high standard, and are in a POSITION OF AUTHORITY, whereas nutritionists and homeopathy and naturopathy do not hold specific titles that this authority comes from.

    And finally, I do believe that the nurses in question should be let go(fired). If they are purely expressing their thoughts and feelings on social media as a person, that’s ok. However, once they use their title to stop people from getting vaccines, then they are representing health care in their country and should be stopped. If Nurse Nancy goes on facebook and links to some anti vaccine as “Nancy” then that’s her freedom of speech. But once she identifies herself as a health care professional, it is not longer just personal. There are better ways to debate these things than to just identify yourself as a professional and telling people what to think.

    • Hi Ben,

      Thanks for the comment. You raise some very good points.

      One thing I disagree with is that, while nutritionists, homeopaths and naturopaths don’t have the knowledge/training required to give accurate and authoritative advice, they still think they do and people listen to them like they do. And while I haven’t gone and checked every website, it certainly appears that the vast majority of on-line information comes from wholly unreliable sources – this is impossible to regulate. AHPRA’s decision is justifiable but even if every anti-vaccine nurse and midwife curtailed their social media posting, there would be no appreciable difference to the level of pseudoscientific bovine excrement regarding vaccines that still clogs the internet.

      But otherwise, I agree with you. Thanks for sharing your insights.

      All the best.

      • Good point. I’d have to agree. I think that the government, or whatever hands out health care titles in one’s country should absolutely be more stringent with their titles. If they are not, then they should penalize these naturopaths who claim ridiculous things.

        In Canada, for instance, you must have a VERY specific educational background, passing specific tests and interviews, along with submitting empirical studies, to call yourself a psychologist. It is illegal to do so otherwise. On the other hand, absolutely anybody at all can call themselves a therapist. Now, in the medical, neuroscience, psychology worlds, this distinction is obvious and clear. However, for the vast majority of average citizens, the distinction is not clear between these two things. In fact, some people believe that a therapist has more education than a psychologist. So the government and regulation places need to do either one of two things.
        1. They need to strip the titles naturopathy, therapist, etc” from these people, and not allow any Adjectives to be used, to separate the good from the bad. It’s not inherently wrong that people believe the poor stuff from naturopaths, etc, it’s that these “professionals” are only receiving this trust from the populace BECAUSE of the misinterpretation of the title. The populace believes that these naturopaths and homeopaths are professionals with high levels of education. And unfortuantely none of these people have to clarify that they do not.
        2. Or, the government can look at these people and say “if you are going to carry a title that has the connotations and expectations of high degrees of education and yearly reviews (or whatever) then you must abide by the rules set forth by the countries health code. Which includes not spitting bovine excrement 😉 ”

        Thanks for the response again.
        -Ben

      • Absolutely! You’re preaching to the choir here 🙂 I think titles should be registered and exclusive to specific degrees to avoid the confusion of the public. The oxymoronic juxtapositions of ‘osteopathic physician’ or ‘doctor of chiropractic’ are cases in point. Unfortunately governments the world over aren’t really interested, and the genie’s out of the bottle.

        Cheers!!

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