Our Default State: Compulsory Vaccination for COVID-19 and Human Rights Law

Table of Contents

1. Qualifying Human Rights
2. Sectioning the Public
3. Future Legislation
4. A Living Laboratory
5. Pathologising Dissent

Addendum: Why did so many German doctors join the Nazi Party early?

On Monday, 14 December, in response to a petition signed by 325,797 people asking the Government ‘to prevent any restrictions being placed on those who refuse to have any potential COVID-19 vaccine’, 6 Members of Parliament debated the issue for just over an hour. At the end, Nadhim Zahawi, since 28 November the Parliamentary Undersecretary of State for COVID-19 Vaccine Deployment, repeated word for word the Government’s initial response to the petition on 11 September:

‘There are currently no plans to place restrictions on those who refuse to have any potential Covid-19 vaccine.’

I won’t go into the discussion between the MPs, which was as empty, uninformed and meaningless as all the other debates about coronavirus-justified policy held in Parliament. Indeed, the greater part of the hour was devoted to the MPs promoting the benefits of vaccines, affirming their own intention to take one as soon as it is available, repeating factually inaccurate statements about the threat of the coronavirus and the effects — both known and unknown — of the COVID-19 vaccine, and almost entirely ignoring the petition or the issues it raises. All agreed that compulsory vaccination was not ‘British’ — or ‘Irish’ in the case of Jim Shannon of the DUP — and all were appeased by Zahawi’s bland assurance. No-one questioned what ‘currently’ might mean for the future.

I’m going to take a look myself, therefore, at what that future might be; for the question of whether and how the UK Government will make a vaccine for COVID-19 compulsory has been around almost since this crisis started. On 22 July, in response to an open call by the Joint Committee on Human Rights for evidence on the ‘The Government’s response to COVID-19: human rights implications’, four academics from the Oxford Uehiro Centre for Practical Ethics, Dr. Lisa Forsberg, a Postdoctoral Fellow in the Faculty of Law, Dr. Isra Black, a Lecturer in Law at the University of York, Dr. Thomas Douglas, a Professor of Applied Philosophy and the Director of Research and Development at the Centre, and Dr. Jonathan Pugh, a Senior Research Fellow, together submitted a response under the same title. Although only 1 of 226 responses published by Parliament, it is this text I want to discuss, for its authors’ extraordinary proposal is that the legislation under which a vaccine for COVID-19 could be made compulsory in the UK is the Mental Health Act 1983.

1. Qualifying Human Rights

Their strategy is to address the justification and proportionality for interference with Article 8 of the European Convention on Human Rights (ECHR) — the ‘right to respect for private and family life’ — entailed by compulsory vaccination, and in particular how it accords, in the Guide on Article 8 issued by the European Court of Human Rights, with Section B, ‘Physical, psychological or moral integrity’, subsections 3, ‘Forced medical treatment and compulsory medical procedures’ and 5, ‘Health Care and treatment’. The authors do this by what they call two ‘parity’ arguments, in which they draw equivalents between powers in already existing legislation and the power to make a vaccine for COVID-19 compulsory.

First, if the restrictions on persons, things and premises known as ‘lockdown’ are compliant with human rights under Sections 45B and C of the Public Health (Control of Disease) Act 1984 and Schedules 18 and 19 of the Coronavirus Act 2020, then it is arguable that compulsory vaccination is too. They call this the ‘lockdown parity argument’. However, neither the Public Health Act nor the Coronavirus Act grant the Government the power to mandate vaccination. In fact, as the authors point out, Section 45E of the Public Health Act and Schedules 18 and 19 of the Coronavirus Act specifically rule out provisions requiring medical treatment, including ‘vaccination or other prophylactic treatment’. From this the authors conclude that ‘a policy of compulsory vaccination would thus require primary legislation’, which is to say, a new Act of Parliament.

Second, however, if non-consensual treatment under Section 3 of the Mental Health Act 1983, (c) ‘for the protection of other persons’, is also compliant with human rights law, then it is arguable that compulsory vaccination is too. They call this the ‘mental health parity argument’. Under Section 63 of the Mental Health Act, the consent of the patient, even those with the capacity to make decisions, ‘shall not be required for any medical treatment given to him for the mental disorder from which he is suffering.’ This derogates from the common law requirement that individuals must give consent in order for treatment to be lawful. From this the authors conclude that:

‘Mental health law permits the detention of a person for treatment for the protection of others, and permits compulsory medical treatment of a person so detained.’

Now, under Article 8 (2) of the European Convention on Human Rights:

‘There shall be no interference by a public authority with the exercise of this right except such as is in accordance with the law and is necessary in a democratic society in the interests of national security, public safety or the economic well-being of the country, for the prevention of disorder or crime, for the protection of health or morals, or for the protection of the rights and freedoms of others.’

The European Court of Human Rights has established that medical treatment without consent constitutes an interference with Article 8, with case law (Pretty vs. United Kingdom, 2002) stating:

‘The imposition of medical treatment, without the consent of a mentally competent adult patient, would interfere with a person’s physical integrity in a manner capable of engaging the rights protected under Article 8(1) of the Convention.’

And since vaccination is defined as medical treatment for the purposes of the Public Health Act, compulsory vaccination is likely to constitute such interference for people who would otherwise refuse.

Article 8, however, is a qualified right, meaning such interference may be justified in pursuit of the aims listed above, which include ‘public safety’, ‘the protection of health’, and ‘the protection of the rights and freedoms of others’. From this the authors conclude that:

‘The most important element of the evaluation whether a measure constitutes a violation of article 8 ECHR is the analysis of its proportionality.’

From this conclusion they develop what they call their ‘strategy’, which is that since interference with the rights protected by the European Convention on Human Rights are ‘commensurable’, it is possible to ‘evaluate the degree of different kinds of interference with human rights on a comparable basis’, including the qualified rights in Article 8 of the ECHR. From this proposed standard for measuring the degree of violation of our human rights that is permissible, the authors jump to a series of assumptions about what they deem comparable. They do this by liberal use of the word ‘seems’:

‘Even accounting for any harms associated with non-consensual administration, the interference with an individual’s private life that compulsory vaccination entails seems proportionate in light of the seriousness of COVID-19 risks and impacts.’

‘A policy of compulsory vaccination seems less burdensome on the interests the ECHR protects than “lockdown”; that is, the degree of interference with bodily integrity entailed in compulsory vaccination seems less than the degree of interference with liberties from lockdown.’

In both these comparisons, the authors judge that forcibly sticking a needle into someone and injecting them with a foreign substance against their wishes is proportionate with the risks and impacts of COVID-19, and less of a burden to the so-enforced public than the loss of our civil liberties under lockdown measures. By this argument, the very extremism and disproportionality of lockdown measures in response to the deliberately exaggerated risk of COVID-19 to the general public becomes the basis for the equivalent extremism of compelling British citizens to take a vaccine against their will for a disease that presents no risk to 99.8 per cent of us, and to an even higher percentage of those under 60 years of age. From this leap of equivalence, the authors are brought to their chilling conclusion:

‘In the event that a policy choice between “lockdown” and compulsory vaccination were coterminous, it would in our view be strange to opt for lockdown over compulsory vaccination. The absence of the legal power to require individuals to undergo vaccination is hard to explain.’

2. Sectioning the Public

After this response was published by Parliament on 21 September, the public response was such that the authors, on 9 November, issued a statement to the effect that their concern was merely to investigate the possible policy options available for making vaccination compulsory under existing legislation, and that they were ‘not endorsing a policy that imposes COVID vaccination in the UK’. As the conclusion in their original response makes plain, this is pure sophistry, issued by collaborators in the implementation of the UK biosecurity state who have been caught in the glare of publicity for their abhorrent proposals. Indeed, they opened their initial response with the statement that:

‘Our chief conclusion is that, as and when a vaccine becomes available at scale, the Government should give serious consideration to compulsory immunisation as a means of reducing the impacts of Covid-19.’

If this isn’t an endorsement I don’t know what is. In reality, the Oxford Uehiro Centre for Practical Ethics is actively promoting compulsory vaccination. On 25 November, Dr. Alberto Giubilini, a senior researcher at the Centre, wrote in the The Conversation that it should be mandatory, with ‘penalties for failure to vaccinate, such as fines or limitations on freedom of movement’; while on 2 December the Centre’s Director, Professor Julian Savulescu, made a case for mandatory vaccination at the Imperial College Union Debating Society. The authors of this conclusion may find it ‘hard to explain’ why the legal power to force rational individuals to undergo medical intervention against their will doesn’t already exist, but the reason they do becomes all too apparent when they go on, in the rest of their response, to challenge the rationality of individuals who refuse to comply with any future policy enforcing the violation of their bodily integrity.

All four authors of this response are involved in research on the ethics of consent to medical interventions, but Dr. Forsberg and Dr. Douglas are also researchers on neurointerventions. The former is currently leading on a project titled ‘Changing One’s Mind: Neurointerventions, Autonomy, and the Law on Consent’; and before that she worked on the project ‘Neurointerventions in Crime-Prevention: An Ethical Analysis’, for which Dr. Douglas, the Centre’s Director of Research and Development, was the lead. The project was funded by the Wellcome Trust — whose CEO, Jeremy Farrar, sits on the board of SAGE — and looked at the ethics of neurointerventions. These are medical interventions that act directly on the brain and alter some of its functions, for example, through drugs administered to attenuate desire in sex offenders, treat addiction for repeat drug offenders or reduce aggression in violent criminals. In particular, the project looked at making such treatments a part of a criminal sentence and — more pertinently for the ethics of making a COVID-19 vaccine compulsory — a condition of parole.

On the one hand, such neurointerventions throw up images of the Beethoven-loving hero of Anthony Burgess’s (and Stanley Kubrick’s) A Clockwork Orange being trained through drugs to associate violence with feelings of nausea; but there’s another, much darker comparison, whose influence on medical ethics was discussed by Giorgio Agamben in his 1995 study of biopolitics, Homo Sacer: Sovereign Power and Bare Life. At the Doctors’ Trial held in Nuremberg in 1947, German doctors who had compelled prisoners in concentration camps (Versuchspersonen, ‘human guinea-pigs’, drawn initially from camp criminals) to undergo medical experiments, argued that there was an equivalence between their studies and those conducted on prisoners and persons sentenced to death in medical experiments in the early Twentieth Century — and in particular in the USA, the country from which most of the Nuremberg judges came. Not only that, but that the benefit of such tests to German soldiers forced into extremes of cold, altitude, injury, disease or pain to defend their country and its people made them proportionate to the costs to the individuals subjected to such tests — and, indeed, dozens of studies of hypothermia, for example, have since cited their research. ‘From this point of view’, Agamben writes, ‘the inhumanity of the experiments in the United States and in the camps is, therefore, substantially equivalent’.

Equivalence and proportionality have ever been the excuses of dictators seeking to justify the means of their present dictatorship by the purported ends it serves, and these arguments for what the authors of this response euphemistically call the ‘harms’ of compulsory vaccination are no different in kind, if they are in degrees of violence. Behind their claims to address compulsory vaccination as an abstract question of law, the neuro-interventionists at the Oxford Uehiro Centre for Practical Ethics are in the line of those doctors and judges who, not so long ago, prescribed chemical castration for homosexuals, lobotomies for social misfits and sectioning for women who didn’t obey their husbands. The exact degree of violence, however, to which the authors of this response are prepared to find equivalence, proportionality and benefit only becomes clear when they go on to argue the second of their parity arguments. This is the equivalence they make between mentally unstable patients unable to consent to medical treatment and British citizens who refuse a vaccine for COVID-19.

Section 3 of the Mental Health Act, they argue, empowers the state to detain a patient suffering from a mental disorder not only for their own protection and the protection of others, but also in order to administer medical treatment for both these purposes. Importantly, Section 63 of the Act permits treatment without consent to persons so detained, ‘even if they possess decision-making capacity’. As Agamben observes, it was this granting of consent, even in the conditions in which its withholding meant continued imprisonment or a sentence of death, that the Nuremberg judges cited as differentiating the ethics of medical trials on prisoners by US doctors from the lack of consent in the concentration camps. The authors of this response 70 years later, however, appear not to be concerned with such fine distinctions, and from this legislative authorisation of medical treatment without consent they conclude:

‘Mental health law provides an example where the law permits — exceptionally — compulsory interference with a person’s bodily integrity for their own protection and that of others when the nature and degree of their circumstances gives warrant.’

It’s important to note that, under Section 63 of the Mental Health Act, treatment without consent is only authorised ‘for the mental disorder from which [the patient] is suffering’, and not for this blanket interference with our bodily integrity assumed by the authors of this response. This too they ignore. But drawing on the case law compiled in the Guide on Article 8 of the European Convention on Human Rights and published by the European Court of Human Rights, they argue that this establishes that compulsory treatment in this context may be compatible not only with Article 8 but also with Articles 3, ‘No one shall be subjected to torture or to inhuman or degrading treatment or punishment’. I’ll merely note here the hypocrisy of citing such a right in a country which continues to hold Julian Assange in solitary confinement in a high-security prison, where he is strip-searched several times a day, without a criminal charge having been laid against him under UK law; but from this assumed compatibility of compulsory medical treatment with human rights the authors draw yet another equivalence between their violations:

‘We can argue by analogy from the compatibility with ECHR of compulsory treatment in mental health law to the human rights law compliance of compulsory vaccination.’

Finally, the authors end their response with a statement which encapsulates the medical and legal basis of the biosecurity state:

‘In the context of highly infectious disease, every person is at risk of infection and a potential threat to the life and health of others — a person’s default state is of a nature and degree to warrant immunisation.’

This decisive statement, which asserts that we are born into a defective biological state of which it is the right and duty of the state to cure us, reveals, if nothing else, the religious basis to the UK biosecurity state, in which the Church, as Giorgio Agamben has written in his own commentaries on this crisis, has been replaced by medicine, the ‘fallen’ nature of Christian Man by our newly-deficient biology, and the priests who sold us salvation (or at least purgatory) are now the salesmen of Big Pharma, having exchanged their dog-collars for stethoscopes. According to this biopolitical fundamentalism, our ‘default state’, in both nature and degree, is a threat to the life of others, and must therefore be sectioned, detained, contained, monitored, treated, cured, chastised, immunised, purified and regulated in perpetuity for evidence of apostasy. ‘Stay alert!’ is its ethical motto. ‘Live in fear!’ is its religious instruction. ‘Obey our laws!’ is its threat of retribution.

3. Future Legislation

This is probably the most terrifying document I’ve read in a year of unremitting terrorism. That it has been written by middle-class academics who have accorded themselves the right to judge the degree of the state’s power over the bodies of its citizens only makes it more chilling. In summary and effect, these Oxford doctors of medical law and ethics have advised the UK Government to equate anyone who refuses to take the COVID-19 vaccine voluntarily with someone with a mental health disorder. Under the Mental Health Act, which creates an exception to the common law requirement that medical treatment is only lawful with an individual’s consent, this would allow the Government to enforce ‘treatment’ without our consent, for our own protection and the protection of others. Anyone dissenting would, by definition, be regarded as mentally unbalanced, and therefore subject to enforced vaccination without their consent. This, effectively, answers the question Agamben poses about how compulsory medical experiments are justified by the greater good:

‘If it was theoretically comprehensible that such experiments would not raise ethical problems for officials and researchers inside a totalitarian regime that moved in an openly biopolitical horizon, how could experiments that were, in a certain sense, analogous have been conducted in a democratic country?’

If we believe such sweeping powers in violation of our bodily integrity and albeit qualified human rights couldn’t be made into law under a single Section of the Mental Health Act 1983, we should recall that, as of the time of publication, 80 coronavirus-justified Regulations in violation of our civil liberties have been made into law by an equally contentious interpretation of a single Section, 45C, of the Public Health Act 1984.

As I said, the publication of this response didn’t pass without comment. On 5 November, Rosalind English, a former lecturer on law and genetics at the University of Cambridge and currently part of the editorial team of the UK Human Rights Blog, wrote:

‘Even assuming an entirely safe and effective vaccination, it is something of a step to proclaiming the entire population of a country is on a par with mental health patients who have been deemed enough of a danger to themselves and others to warrant medical treatment under detention. Compulsory interference with a person’s bodily integrity is not something that a democratic society will tolerate without detailed regulations and specialist tribunals in place.’

Unfortunately, the repeated failures of both Parliament and civil society to question, oppose or stop coronavirus-justified restrictions to our human rights and civil liberties throughout 2020 and into 2021 have demonstrated very clearly that we do not live in a democratic society, but rather one that is moving, to use Agamben’s phrase, ‘in an openly biopolitical horizon’. Ms. English, nevertheless, concludes that, notwithstanding the Mental Health Act:

‘Vaccination without consent would be prohibited by the criminal law on assault, and even grievous bodily harm, if the consequences of the treatment are serious.’

In this she appears to take comfort from the conclusion the authors draw from their first parity argument, that new and primary legislation would be required for the Government to make a vaccination for COVID-19 compulsory. But given the almost total acquiescence of both Houses to each and every Government Regulation and Act made into law on the justification of nothing more than unproven assertions about the threat of the coronavirus to public health, can it be long before such primary legislation is brought before Parliament?

This is the legislative context in which Nadhim Zahawi, the Parliamentary Undersecretary of State for COVID-19 Vaccine Deployment, told the 6 MPs debating restrictions on those refusing vaccination that there are ‘currently no plans to place restrictions on those who refuse to have a COVID-19 vaccination’. Zahawi, however, has considerable knowledge about the financial benefits of changing legislation. Following the Health and Social Care Act 2012 he helped push through Parliament, Zahawi’s former company, SThree, which specialises in the pharmaceutical and biotechnology sector, provided staff for clinical commissioning groups benefiting financially from the privatisation of healthcare services. And in June last year Zahawai founded a new company, Warren Medical Limited, which is registered in his wife’s name and whose two directors are his sons. Doubtless the company will soon find itself awarded numerous untendered Government contracts for vaccine distribution. To this end, just four days after allaying the fears of these 6 MPs, on 2 December, the market research company, YouGov, which was also founded by Nadhim Zahawi, its former CEO from 2005-2010, asked 5,351 adults in the UK:

‘Would you support or oppose the Government making it legally compulsory for all people in Britain to be vaccinated against COVID-19?’

37 per cent of respondents supported this proposal; 44 per cent opposed it; and 18 per cent said they didn’t know. Then on 17 December, YouGov held another survey:

‘And, once a vaccine has been found, would you support or oppose the Government prosecuting and fining people who do not get a vaccination against the coronavirus?’

Interestingly — and worryingly for our future — the results of this survey have not been published on the YouGov website, which presumably did not want the public to know they had even asked such a question. But this is how close we are getting to the UK Government enforcing vaccines produced by Pfizer, AstraZeneca, Moderna, GlaxoSmithKline, Johnson & Johnson, and any other multinational pharmaceutical company it cuts a deal with, on us and our families.

4. A Living Laboratory

The UK enters the New Year with 68 million people under house arrest and the expansion of the biosecurity state being offered to us — like criminals offered neurointerventional treatment — as a condition of the freedom the Government now holds in its hands like a prisoner governor. This gives it the freedom to do whatever it wants, and it hasn’t been slow to take advantage. The Government has now announced that the vaccination of the UK population will be conducted on a new timetable. Instead of the 3 weeks between the two doses at which the BioNTech/Pfizer vaccine has been tested, the Department for Health and Social Care, the four Chief Medical Officers, the Scientific Advisory Group on Emergencies, the Joint Committee on Vaccination and Immunisation, the Medicines and Healthcare products Regulatory Agency, Public Health England and the National Health Service have all agreed that the doses will now be administered 12 weeks apart. This, apparently, is to offset either a shortage of supply or a lack of administrative capacity or both, depending upon who’s making the excuse. Not only that, but with the Oxford/AstraZeneca vaccine authorised by the MHRA for use in the UK as of 30 December, the Government has now suggested, in its Green Book for Vaccinations, that it is ‘reasonable’ for the vaccines to be mixed — with, for example, a first dose of Pfizer’s vaccine and, 12 weeks later, a second dose of AstraZeneca’s or any other COVID-19 vaccine developed by Moderna, which has been authorised for use in the UK on the evening I publish this, or GlaxoSmithKline, or Johnson & Johnson, or some other pharmaceutical company.

Now, first of all, there have been no trials of such a vaccination programme, the results and consequences of which are therefore completely unknown. Even Pfizer, which has a long history of mis-administering their products with fatal consequences, has issued a joint statement with BioNTech declaring that:

‘Pfizer and BioNTech’s Phase 3 study for the COVID-19 vaccine was designed to evaluate the vaccine’s safety and efficacy following a 2-dose schedule, separated by 21 days. The safety and efficacy of the vaccine has not been evaluated on different dosing schedules as the majority of trial participants received the second dose within the window specified in the study design. There is no data to demonstrate that protection after the first dose is sustained after 21 days.’

Indeed, even the World Health Organisation, which more than any other organisation is responsible for inventing the ‘pandemic’ and then authorising the testing-programme that assures its continuation as medically meaningless ‘cases’, has expressed its reservations at the UK’s arbitrary changes to the dosing programme. Perhaps this is just another way to indemnify pharmaceutical companies and the vaccine producers even further from liability for the effects of their hastily fabricated and authorised products. But to suggest that the BioNTech vaccine, which uses experimental mRNA (messenger ribonucleic acid) technology that encodes the viral protein spikes with synthetic genetic material and has never been approved for use on humans before, is compatible with the Oxford vaccine, which uses adenovirus-vectored technology that carries a gene from the protein spikes that triggers an immune response, sounds at best like medicine bowing to political and economic expediency, and at worst like playing Russian roulette with British lives. Even Public Health England says there is ‘no evidence’ of their interchangeability; while the Centers for Disease Prevention and Control has stated flatly that different mRNA vaccines are ‘not interchangeable’ even with each other, let alone with vaccines using different technologies.

What we do know, thanks to Belgium’s Budget State Secretary, is that the AstraZeneca vaccine (€1.78) is a fraction of the price of either Pfizer’s (€12.00) or Moderna’s (€18.00), which presumably is the Government’s motivation for substituting it as the second dose; and that in the New Year all three are being included in trials to ‘mix-and-match’ their effects. The obvious question to be asked when presented with this witches’ brew is: why are these trials not being conducted, and their long-term effects studied, before we start experimenting on the UK population? At the time of writing, some 1.3 million people in the UK have had their first dose of the Pfizer vaccine, most with the expectation of a second dose of the same vaccine being administered in the time frame in which it was trialed. But the fact the entire UK medical establishment has unhesitatingly signed up to this medical experiment — ‘effectively turning the UK into a living laboratory’, as one US news website described it — is evidence of one thing: that all its bodies and their representatives are now following Government directives rather than any recogniseable scientific procedure, and in doing so have reneged on their Hippocratic oath to care for the best interests and medical safety of the UK population.

5. Pathologising Dissent

In saying so, however, I have identified myself as suffering from ‘vaccine hesitancy’, a term that has gained popular acceptance and use in the UK with worrying ease and speed. Defined by the World Health Organisation as ‘the reluctance or refusal to vaccinate despite the availability of vaccines’, behind this branding of a choice as a pathology there lies the additional accusation of a conspiracy, which the authors of the Oxford Uehiro Centre for Practical Ethics response are quick to conjure into reality:

‘Vaccine hesitancy in respect of COVID-19 may arise because of the influence of anti-vaccination movements, the uneven demographic distribution of Covid-19 morbidity and mortality risks, or the mistaken belief that COVID-19 immunity has already been acquired.’

All these statements, however, are contestable at best, and at worst deliberately misleading. Reservation about taking a vaccine produced in such an unfeasibility short time by an industry synonymous with corruption and law suits from which only its vast profits allow it to escape prosecution, for a disease to which 0.23 per cent of the population is at risk even after being infected (and only 0.05 per cent of those under 70 years of age), does not immediately qualify the person holding these reservations as the member of an ‘anti-vaccination movement’. And since there is no evidence that any of the COVID-19 vaccines on the market do anything to stop transmission of the coronavirus, questioning why the other 99.77 per cent of the population (99.95 per cent of those under 70) not at risk from infection should take it is not only entirely rational but a question the authors attempt to brush over with this accusation of ‘vaccine hesitancy’. Finally, numerous eminent epidemiologists, immunologists, biochemists and disease modellers from across the world have argued precisely that a large percentage of the population already had or has since acquired immunity to SARS-CoV-2, and the authors of this report provide no justification for their casual dismissal of this vastly important point — on which rests the very basis of mass-vaccination, compulsory or otherwise — and the empirical data on which it is based. Indeed, perhaps the greatest reason for what they dismiss as ‘vaccine hesitancy’ is the presence of such unquestioned suppositions in a document by academics and lawyers advocating compulsory vaccination — that, and the seeming ease with which these Oxford doctors of medical ethics jump to the violence consequent upon their recommendations:

‘Should a Covid-19 vaccine become available at scale, we cannot expect sufficient voluntary uptake. It is necessary for the Government to consider a policy of compulsory vaccination, with appropriate exceptions.’

This, unmistakably, is the voice of the petty bureaucrat drunk with the power of the policeman’s truncheon. And they’re not alone. I have written previously about the growing number of medical reports that equate refusal to comply with coronavirus-justified regulations with mental deficiency and sociopathic behaviour. But whether it’s the Oxford Uehiro Centre for Practical Ethics advocating sectioning the UK public to enforce compulsory vaccination, the Scientific Advisory Group for Emergencies terrorising the nation with predictions shown to be deliberately misleading, or the Academy of Medical Sciences justifying the current lockdown of the UK back in July with a worst-case scenario predicting a quarter of a million UK deaths by June 2021 — scientists, academics and lawyers collaborating with an authoritarian government to justify the implementation of a biosecurity state that removes our human rights and civil liberties in order to ‘protect’ us from an imaginary threat is neither new nor normal.

One of the most prominent doctors put on trial at Nuremberg was Wolfram Sievers, the Director of the Institute for Ancestral Heritage (Ahnenerbe), an SS think-tank composed of over 100 professors and scholars whose anthropological theories and medical experiments between 1935 and 1945 were used by the NSDAP Government to justify its eugenicist and biopolitical policies, which like today were implemented under Regulations made without parliamentary approval under a permanent State of Emergency that in Germany’s case lasted 12 years. Prior to his trial, Allied officers produced a report on this Institute in which they concluded with this warning about how even the most educated minds can be used to justify barbarity:

‘It cannot be too strongly emphasised that this was not a crackpot organisation. These were men of the highest calibre, professors from the leading universities, men of the calibre of the atom-splitters and the V-bomb designers, engaged in a project to rewrite the record of the past, in order to influence the future course of history.’[1]

Addendum: Why did so many German doctors join the Nazi Party early?

Extracts from an article by Omar S. Haque, Julian De Freitas, Ivana Viani, Bradley Niederschulte and Harold J. Bursztajn, ‘Why did so many German doctors join the Nazi Party early?’, published in the International Journal of Law and Psychiatry, Vol. 35, Issues 5-6 (September-December, 2012), pp. 473-479.

‘During the Weimar Republic in the mid-Twentieth Century, more than half of all German physicians became early joiners of the Nazi Party, surpassing the party enrolments of all other professions. From early on, the German Medical Society played the most instrumental role in the Nazi medical program, beginning with the marginalisation of Jewish physicians, proceeding to coerced “experimentation,” “euthanisation,” and sterilization, and culminating in genocide via the medicalisation of mass murder of Jews and others caricatured and demonised by Nazi ideology. Given the medical oath to “do no harm,” many post-war ethical analyses have strained to make sense of these seemingly paradoxical atrocities. Why did physicians act in such a manner? Yet few have tried to explain the self-selected Nazi enrolment of such an overwhelming proportion of the German Medical Society in the first place.

‘This article lends insight into this paradox by exploring some major vulnerabilities, motives, and rationalisations that may have predisposed German physicians to Nazi membership. Professional vulnerabilities among physicians in general (valuing conformity and obedience to authority, valuing the prevention of contamination and fighting against mortality, and possessing a basic interest in biomedical knowledge and research), economic factors and motives (related to physician economic insecurity and incentives for economic advancement), and Nazi ideological and historical rationalisations (beliefs about Social Darwinism, eugenics, and the social organism as sacred). Of particular significance for future research and education is the manner in which the persecution of Jewish physician colleagues was rationalised in the name of medical ethics itself. Giving proper consideration to the forces that fuelled “Nazi Medicine” is of great importance, as it can highlight the conditions and motivations that make physicians susceptible to misapplications of medicine, and guide us toward prevention of future abuse.

‘In addition to sheer membership, the systematic planning and actions of physicians greatly contributed to Nazi power and functioning. Possible reasons for the behaviour of these German physicians are often difficult to comprehend in today’s medical and legal environment, where explicit consent from patients and subjects is mandatory, and where any intentional, even accidental, harm inflicted by physicians is publicly condemned and brought before the law.’

‘One theory for Nazi doctors’ abandonment of the ancient and most basic tenets of ethical medicine is that medical doctors tend to have an authoritarian personality, characterised by a strong adherence to rules and a weak ability to control more primitive, “id-driven” impulses. Such personality traits would presumably account for Nazi doctor’s propensity to follow Hitler’s orders with little or no argument. This theory may also explain how these physicians were easily persuaded to follow newly established, barbaric rules of conduct. Other possible explanations have been rooted in theories of practitioner narcissism. They include an inflated sense of self-importance in shaping the future of the nation and a desire for career advancement and public praise.

‘One factor that stands out in the context of current professional and societal concerns is the use of “ethical” claims or considerations to rationalise unethical acts. Thus, this study of Nazi doctors can contribute to ongoing research and education as a case study in the misuse of medical ethics. 

‘Physicians may have been especially predisposed to assent to the authority of the Nazi regime because there were many abstract and practical objectives and orientations that the regime appeared to share with the medical profession. These commonalities included: instilling a culture of conformity and obedience; preventing contamination; and providing a partial solution to the dread of helplessness in the face of existential problems (death, disability, humiliation, loneliness); and an interest in biology, science and research, and biomedical knowledge. In a sense, the medical society had risk factors for acquiring Nazi ideology.

‘Due to the importance of conformity and obedience to authority in medical training and practice, physicians — when contrasted with members of other professions (e.g. lawyers or businessmen) — may have been especially vulnerable to the influence of Nazi ideology. The principle of conformity has always been a central one in medicine, in which great emphasis is placed on following rules and protocols for the delivery of efficient, high-quality health care; equally important is a principle of obedience to authority. It is not unusual for the medical students transitioning into the clinic from his or her preclinical courses — where they “why?” questions are valued and encouraged — to have “why?” questions concerning clinical care be curtly dismissed in the midst of triage-like hospital settings where limited physician time confronts limitless patient needs.

‘The strength of certainty was celebrated by Nazis, while doubt, questioning, and awareness of uncertainty were disparaged as shameful, harmful, and worthy of marginalisation as Jewish cultural artefacts, and so were punished and expunged. 

‘As a means of preventing illness and disability, the Nazi Party framed the extermination of the Jewish population as a health necessity in its own right, a sure way to ward off contamination (and death). Given the core value that prevention of contamination plays across almost all strata of medical practice, this kind of mission would have been particularly salient to members of the German Medical Society. This could even be cast as a way of doing good — a fulfilment of ethical imperatives.

‘A key tactic Hitler employed to simultaneously heighten the perceived threat of contamination and assign responsibility for this threat to one ethnic group was the moralisation of disgust. Made out to be unclean by Nazi propaganda, the Jewish population was framed as a constant danger to the average German citizen’s health, inspiring disgust as an aversion response. A clear divide was therefore formed between the German Jewish “other” as disgusting and dangerous, and the Gentile German “us” as pure and clean. Hitler employed varied tactics to instil this essentialising, discriminatory distinction into the psyche of the German population, thus maliciously recruiting the basic human revulsion of filth and pestilence into a force for dehumanising Jews.

‘Members of the German Medical Society would have been particularly sensitive to the way this threat was framed and propagated, given the all-encompassing mission of physicians to prevent contamination in order to preserve health.

‘At the core of the psychological allure of the Nazi regime was the promise of a form of immortality. The regime’s promise to relieve helplessness and anxiety surrounding mortality overlapped with the very goals that made the medical profession alluring to physicians. Compared to other professionals, physicians may have been most open to this desire to transcend — both in symbolic and literal terms — our species mortality, having already subscribed to the preservation of mortal life through medicine. Saving or prolonging life is, after all, central to medicine’s clinical and ethical mission.

‘Compared to other professional, physicians are more directly dependent on the objective use of scientific information specifically, in the diagnosis and treatment of illness. This interest in and respect for biomedical knowledge and research would have made physicians especially sensitive to Nazi ideology. The Nazi Party motivated its objectives by drawing upon scientific theories that were popular at the time, lending Nazi philosophy the semblance of empirical exactitude. The critical purpose that science plays in all areas of medical understanding and practice would have made Nazism — which imagined itself as a scientific ideology — attractive to medical practitioners, accustomed as they are to benefitting humanity through the application and advancement of scientific research.

‘After the German loss of World War I, there remained a widespread desire for renewed pride. As elites in German society, physicians may have felt this shame more than other citizens at the time. After WWI, physician salaries were very low and unemployment was rising.

‘Many medical practitioners were attracted to Nazism as a means of alleviating the feeling of powerlessness prevalent at the time. The helplessness and grief that were so much the rule in German society after the losses of World War I may have been particularly poignant for physicians, at least some of whom were attracted to medicine by a combination of false promises. One such promise was economic security and empowerment through a “war” on deadly illnesses, particularly the post-WWI scourges of influenza, typhus, and tuberculosis. Such war metaphors and false hopes were integrated easily with interwar-Germany’s capitulation to the historical tendency of depressed nations to mobilise prejudice as a means of relief from feelings of societal impotency.

‘Examining Nazi ideologies through the looking glass of German medical practitioners of that era calls attention to factors that may have made physicians especially open to and interested in Nazi rationalisations. Through a Social Darwinist ideology, Nazism explicitly framed its methods and aims in biological terms. As Hitler’s deputy, Rudolph Hess, claimed: “National socialism is nothing but applied biology”.

‘The Nazi medical experimentation, with its veneer of a research program progressing to benefit the nation — and, by extension, all of humanity — was an easy subsequent step for the regime to implement. A eugenic movement provided a direct means of conducting the kinds of research that could address these problems while cutting the efficiency costs that typically accompany humane treatment of experiment subjects.

‘The self-righteous persecution and marginalisation of Jewish physicians by early Nazi members of the German Medical Society were greatly facilitated by caricaturing Jewish physicians as unethical. This was an important, perhaps essential, move in the process of rationalisation, since a conception of ethics — of doing good — has animated the profession of medicine since antiquity.

‘The prominence of physicians among early joiners of the Nazi Party exemplifies the fact that the defence mechanisms, which prevented post-World War II Germans from fully grasping the reality of the Holocaust, were also operating before Hitler came to power. The German Medical Society was a pre-existing organisation, not one created by the Nazis to serve its ends. Nonetheless, the Society’s involvement in the inhumanity of the Nazi regime was not one of mere acquiescence in the face of coercion. Rather, the Society and the profession it represented were instrumental in both the planning and implementation of the multifarious atrocities that would finally be tallied in the Nuremberg trials.

‘The causes of the brutalities committed by the Nazi doctors with such self-righteous, methodological efficiency— acts that have reverberated for years since — continue to elude many historians and psychologists. Nevertheless, identification and analysis of the vulnerabilities and other factors that fuelled this behaviour can guide us toward prevention of future abuse by highlighting the conditions that make physicians susceptible to misapplications of medical research, medical practice, and medical ethics.  

‘Such analyses also provide vital case studies for teaching medical ethics more effectively. To the extent that we can understand and teach about the context and motives that surrounded physicians’ abandonment of the Hippocratic Oath in favour of Nazi ideology and inhumanity, the teaching of bioethics can cultivate essential practical insight. Such insight is necessary to identify one’s own vulnerability to seductions of abandoning the Hippocratic Oath, as well as principles such as beneficence and respect for the autonomy of the “other”. Alas, such seductions arise with some regularity in the ever-changing biopsychosocial (not to mention economic) landscape of clinical practice.

‘Moreover, thorough analysis of these vulnerabilities and factors provides lessons in what has been termed ethicogenesis, i.e., harm caused under the banner of self-righteousness, in the name of such ethical values as public health or even medical ethics itself. Unimaginable as the medicalisation of genocide may seem today, the perversion of ethical principles is no more confined to the historical past than are demoralisation, economic insecurity, a need to belong and conform, and the search for a quick fix to existential problems. George Orwell’s admonition in 1984 that “He who controls the past, controls the future” is well worth remembering, so that education in medical ethics will not omit the pitfall of invoking ethics themselves as a rationalisation for perpetuating crimes such as those that were enabled by the German Medical Society.’

Simon Elmer
Architects for Social Housing

1. This is a transcript taken from Michael Wood’s documentary film, Hitler’s Search for the Holy Grail, which was first screened in 1999 as a Secret History Special on Channel 4. I have written to Professor Wood to ask for the exact source of the quote, which he reads at the conclusion of the film, and which I have been unable to find in the court documents from the Nuremberg Trials or in the National Archives and Record Administration; but the research notes for the film are in storage and inaccessible under the ongoing lockdown of the UK. He assures me, however, that the quote is accurate. I should make it clear that I did not tell Professor Wood why I wanted to identify this quote, or the comparison I would be making between the role of intellectuals in implementing the respective biosecurity states of the Third Reich and the UK Biosecurity State, and no inference of his support for this thesis should be made.