Risk – A Definition

Risk is the possibility that something bad or unpleasant will happen. It is measured as a matter of statistics, given in averages and probabilities. Life is inherently risky, and requires decision-making based on risk assessment. Most of this occurs subconsciously, or more accurately, without much effort and based on precedence.

For example, I never cognitively considered the risks of brushing my teeth with a toothpaste which had an ADA label on it because I have previously determined the risk to be very low, even though the determination of that risk was not based on scientific evidence, but rather what was passed down to me as a child and a baseline trust in the ADA. While I could have used more reliable methods to determine that risk when I got older, I did not, because I did not have the time to use my cognitive powers to weigh all risks scientifically, and experience told me that this particular risk was not a high priority for me. However, a few years ago I developed a tooth sensitivity. I did a risk assessment on store-bought toothpaste and determined that using glycerin (a common additive to commercial toothpastes) on my teeth was causing my problem. I started using homemade toothpaste and the sensitivity went away. Now I avoid commercial toothpaste because my experience tells me that it is risky, but I do not advocate that everyone make the switch because my risk is based on a specific set of variables — including my development of sensitive teeth — which cannot be extrapolated to all individuals.

Risks are variable. Their assessment depends on natural conditions, ourselves, and the actions of others. For our purposes, we will name these three categories of risk as natural (existing in nature), medial (derived from one’s self), and lateral (determined by the actions of others).

Nearly all risks fall into more than one category. Driving on the freeway, for example, is both medial (your personal driving skill and decisions) and lateral (the skill and decisions of others), with a little natural (a boulder could roll onto the freeway and crush you). Flying in a plane is mostly lateral (the pilot and maintenance crew of the plane), with some natural (ice, birds) and very little medial (you did choose to fly that day). Free-climbing a mountain face is mostly natural (gravity), with quite a bit of medial (your personal skill level), and very little lateral (the maker of the ropes).

Risk Measurement

Risks, as probabilities, are usually represented in numerical form. These can be given in fractions, portions, or percentages.

Regardless of the way the risk is written, the measurement of a risk is complicated. Averages of current events can be determined for populations, but even these are no more than statements of current conditions and not an actual prediction of risk. For examples, citing an average of 10.7 car accident deaths per 100,000 people (2012), does not mean the average risk of dying in a car crash is .011%, because the variables which caused the numbers reported in 2012 are not the exact variables present right now. This said, we can reasonably assume that the average risk will be somewhere in that ballpark, so long as that average has stayed roughly constant in the years preceding and succeeding 2012.

Personal risks are much harder to determine because of the number of variables involved. Your personal risk of dying in a car crash might vary drastically from the average. Some of these variables include age, gender/pregnancy, pre-existing disease, mental health, genetics, behavior, socio-economy, geography, education, and skill. While one may attempt to measure personal risk for a given event, only a very rough estimation can ever be scientifically derived.

Under these conditions, perceived risk becomes a determining factor in our decision-making process. Our biases and our education weigh heavily on perceived risk. Confirmation bias convinces us that previously held risk-assessment opinions are more valuable than more current information. Availability bias convinces us that the really scary recent death we just saw on the news makes something inherently more risky, though the statistics have not changed. Ignorance on a given subject make it even more likely that our perceived risk will be weighted more heavily by our biases, and even scientists and experts are susceptible to these biases.

The very nature of scientific experimentation lends itself to considerable uncertainty. There are variables which distort results, biases which distort data, and even disagreements on extrapolation applications, models, and parameters. In some cases, experimentation can get pretty exact, and is easily replicable, and a consensus is reached. However, even in these cases, there is rarely unanimity of analysis and conclusion. In most cases, experimentation isn’t exact, includes too many variables, is experiential at best, or has even been manipulated with bias, and the uncertainty of the general conclusions is too high to use in decision-making.

As we can see, the measurement of risk can be very complicated, in particular at a personal level. The best we can do is determine averages and then try to assess our personal risk with as little bias as possible.

Acceptable Risk and Practical Legal Issues

Given that life is inherently risky, acceptable risk is the amount of risk which is acceptable to an individual or a population, or the threshold of risk which will not sway us from a particular action. The determination of acceptable risk plays a large role in legal issues.

In our interactions with others, we often have a duty of care. This means we have a responsibility to do what we can to make sure our actions are not injuring another party. For example, if we make toothpaste, we have a duty to make sure we are not including ingredients that will harm others. When determining negligence and fault in a personal injury case, one must determine whether the event in question occurred under conditions of acceptable risk or if there really was a breach of duty.

In our toothpaste example, there is an acceptable risk that if I use a particular toothpaste, I might have a personal reaction to that toothpaste which is not common to the general populace. Determining what is common and what is not is a measurement of acceptable risk. This is nearly impossible to arrive at numerically, as there are a number of factors at play. Scientifically-based assessments cannot be attained because “acceptable” is not a scientific degree of measurement. Publicly-based assessments, such as what is called current toleration, of acceptable risks are fraught with bias and ignorance.

Therefore, acceptable risk is almost always a case-by-case assessment. It is roughly measured by a judge in a court of law when a determination of breach of duty is rendered. Judges will often cite acceptable risk in their determinations, but never define what that is numerically because it is impossible to assess numerically. We rely on these judgments to protect the honest efforts of producers in our society and to protect individuals from true acts of negligence.

For toothpaste, I would find great difficulty in getting a judgement against a company for breach of duty because I personally experienced a sensitivity to glycerin. This is either because so few people have this same complaint or because very few people associate their sensitivity with glycerin. Should enough people find that their sensitivity was due to glycerin, then perhaps we might have a case. This is the purpose behind class-action lawsuits. The threshold of acceptable risk must be crossed in order to actually determine negligence.

In addition to a breach of duty, causation must also be proved. As a commercial toothpaste user with sensitive teeth, the burden of proof would be on me to produce evidence that the glycerin is the cause of my problem. This would be difficult to do for this particular case, but in other cases, causation is not as hard to prove. This concept of causation when judging negligence is not related to risk, but will be useful to remember later.

Types of Risk, Natural Rights, and Law

To further understand the applications of risk in our society, we need to understand these risks in light of truths which we already know. In the United States, it is generally believed, though not generally practiced, that there are natural rights which must be held inviolate. We cannot rightfully pass a law that limits our rights to life, liberty, and property, unless the exercise of our rights in a particular case actively infringes upon the rights of another. If I am found in violation of this principle, legal action can be taken against me either civilly or criminally.

Going back to the three types of risk — natural, medial, and lateral — it is important to note the degree of control which we have. We have complete control over medial risks. We are perfectly free to educate ourselves, increase our skill levels, or lock ourselves in a padded clean room.

We have limited control over natural risks. We can brace the mountainside with netting in an effort to prevent rock-slides, but we cannot say with certainty we will never be crushed by a rock.

It is with lateral risks where things get tricky. The mountainside has no inalienable right to not be braced, but people do. If someone gets in their car to drive to work at the same time that I do, they are making my drive more risky. However, I do not have a right to say they cannot drive on the road when I do just to minimize my risk. In the case of lateral risks, the risk is trumped by the rights of individuals because an increase in risk is not the same as an actual injury.

This is an important concept to understand. Risk is not an absolute. It is abstract, incredibly variable, and does not, in and of itself, define reality. As we outlined earlier — risk is possibility, not reality. The control of lateral risk can only happen through the control of others, just like the control of natural risks can only happen through the control of nature. We have rules regarding our ability to control others, however, and we can only legislate regarding events and actual occurrences, but not possibilities. Given that risk is not reality, and is only possibility, it cannot be legislated. At least not constitutionally (which “constitutionality” derives all of its power based on real and actual natural rights, and not on abstract possibilities).

Unfortunately, we have legislated risk in a number of cases, which has set a very dangerous precedence. Our laws, which can only relate to events — actual occurrences — are sustained in societies with attached consequences, and must be built on unchangeable principles or they have no foundation at all. The argument for these risk laws are based on the concept of acceptable risk, or what a majority of people consider to be an unacceptable risk.

As we showed earlier, however, acceptable risk is much too variable to give us real numbers to base general decisions on, let alone laws which must be grounded in reality. When governments seek to pass legislation based on the abstract, the process is reduced to bargaining. The models of bureaucratic bargaining, stakeholder inequality, and principal-agent relationships are real phenomena and have been outlined in a number of accepted economic reviews. It is beyond the scope of this paper to discuss practical political theory as it applies to publically-based risk assessment and current tolerance, but you can find more information regarding these studies here and here. It suffices to say that the foundation of stable government must be on unchangeable truths, not on variable perspectives.

One example of this is our drunk driving laws. No one will refute the idea that driving intoxicated increases the risk of injury to ourselves and others. As a society, we have publicly determined that this risk is unacceptable. So far, so good. Where we cross over to the irrational, is when we try to legislate this risk as if it is reality and has already happened, and is not just a possibility. The case to legislate against drunk driving was not founded on a new protection of unalienable rights, but on risk assessment.

If you read up on the principles of bargaining and stakeholding inequality, you can see how it played out in the case of drunk driving statutes. The public determined the medial risk of driving on a road shared with drunks was unacceptable, and instead of making efforts to mitigate that medial risk lawfully through personal decisions, they decided to convince lawmakers to institute statutes which transfer that risk laterally onto drunks. Now the drunks not only bare all of the medial risk of driving drunk — including being responsible for restitution in the event of an accident — but they also carry what was originally the medial risk of every other person the road, a burden which is not naturally theirs to bare. Our medial risks are our responsibility and cannot be transferred laterally. A lawful approach is to increase laws regarding consequences when the rights of another are actually violated. In this way we avoid the transferring of risk, and instead increase the natural medial risk of the drunk beyond an acceptable level, which will in turn affect their decision-making process.

When we keep our laws in the realm of actual events, we avoid the pitfalls of risk assessment, in particular acceptable risk and its inherent flaws, risk transferring, stake-holder inequality, and bureaucratic bargaining.

In summation, laws cannot be made regarding risks because risks are possibilities, not realities, and law deals only with realities — actual events. The degree of control we have over medial risk is great, the degree of control we have over natural risk is less, and the degree of control we have over lateral risk is least of all due to the protection of individual rights and law. Risk cannot be transferred laterally through the use of statute because law cannot infringe on the right of liberty of any person who has not committed a crime. Law must deal only in actual events and not possibilities.

A Case Study – Personal Risk Measurement, Analysis, and Conclusion on Behalf of my Children in the Case of the MMR Vaccine

As an example of the use of risk assessment in personal decision making, I wanted to take a topic which I have been thinking a lot about. Vaccines are a touchy subject these days, and while I have read a number of articles promoting vaccines and warning against vaccines, most are filled with fallacy and bias. Even the science is often biased, or at best contradictory, enough to introduce considerable uncertainty.

Personal Background and Methodology

In an effort to remain unbiased in my conclusion, I will first explain the background with which I approach this research to identify potential bias and prevent them from unknowingly swaying my analysis. I have a degree in Biology. I place a high value on scientific study and analysis regarding medicine and its applications. I accept that it is not only impossible to arrive at completely scientific conclusions, it is also unwise, as there is evidence-based value in certain “folk” and “alternative” medicines. I believe we are better off maintaining as natural an environment, externally and internally, as possible until specific cases warrant otherwise. In the cases of vaccines, this means my previously held belief is that we are better off not injecting something into our bodies until evidence warrants the injection. However, I also recognize that the injection itself is not the only risk at play in this decision, and it is with this background which I attempt to measure, analyze, and come to a conclusion, both personal and societal, regarding whether or not I will vaccinate my children. I am very open to a change of opinion. For the purposes of simplicity, and with regard to current events, I will restrict this study to the MMR (measles, mumps, rubella) vaccine.

There are three diseases to look at in this case. I will use numbers from last year, or the last two years when 2014 data cannot be found, as we know that the number of cases is on the rise. Numbers from 60 years ago when incidence levels were really high, or 10 years ago when they were really low, will skew current risk assessment. I will use a greater range of years when the 2014 numbers are more than 50% higher or lower than previous years to reduce the risk of basing analysis on outliers.

Measurement

There were 644 cases of measles in the United States in 2014, an average of 1 in 7 were hospitalized, and there were no fatalities. 2013’s number of cases was 187, and the numbers have been more in that range for the last 20 years. Because of this, it is impossible to tell if this year is an outlier, so I will take an average of the last two years, which is 416. This translates to 59 hospitalizations.

The number of cases of mumps has varied in recent years, going up and down, though most recently going up. 2013’s number was 438, and 2014’s was 1,151. I am going to use an average of 795. There is no official data on hospitalizations, but the average from cumulative reports by the CDC is 2%, making the number of hospitalizations 16. There have been no recent fatalities.

There were 9 cases of rubella in the United States in 2013. I did not find data for 2014, but the numbers have been below 10 for 5 years, so I’m going to stick with the 9 number. There is no data on hospitalization, and there were no fatalities.

The effective rate of the MMR vaccine is 95% against measles, 85% against mumps, and 99% against rubella.

The risks of the MMR vaccine are as follows:

  • rash: 1 in 20 doses
  • fever: 1 in 6
  • swelling of the glands: 1 in 75
  • seizure: 1 in 2,000 (based on a reported number of 1 in 1,000 and another of 1 in 3,000)
  • pain and stiffness in joints: 1 in 4
  • low platelet count: 1 in 30,000
  • idiopathic thrombocytopenic purpura (ITP): 1 in 24,000
  • serious allergic reaction: 1 in 1,000,000
  • serious neurological disease: 1 in 365,000
  • there are a number of other life-threatening adverse reactions, including permanent disability and death, which occur in numbers fewer than 1 in 1,000,000

There is always the risk of something we haven’t identified yet or which has not shown proven causation. The assessment of risk regarding those issues are completely subjective and will not be given a heavy weight in my conclusion, though as information becomes available it is not unreasonable to accept the weight of these issues in general risk assessment. We will discuss death rates in the analysis.

Analysis

I’m going to analyze these numbers by keeping them in their fraction form, but normalizing them to 1 in 10,000 for comparison. Minor symptoms are considered ones which are similar to what would be experienced by someone who has contracted the disease, but which do not require hospitalization.

 

Event Risk (per 10,000)
Contracting measles 1.3
Contracting mumps 2.5
Contracting rubella .03
Hospitalization for measles .19
Hospitalization for mumps .05
Minor symptoms from vaccine 5 – 2500
Hospitalized conditions from vaccine .01 – .42

There were 2 reported deaths associated to the MMR vaccine last year. There were 2 deaths in 2013. This number is from the vaccine surveillance reporting system. They say that not all reports have proven causation, but they also estimate that only 10% of symptoms, including death, are associated to vaccines when they should be because the right questions were not asked of the patient by the supervising doctor.

Conclusion

I have two conclusions based on the data I have seen. The first is for me and my family, and the second takes into consideration society and population biology.

Given the numbers, I have determined that the vaccine is riskier than the diseases being vaccinated against. While the differences in occurrence, hospitalization, and death are insignificant statistically given the huge sample size, they are significant to me personally. Both sets of numbers, for the diseases, and for the vaccine, seem to be an acceptable level of risk, considering how small they are. However, I like the odds better with the diseases.

Other factors are also at play. I am confident of my ability to nurse my children and find more than adequate care providers and facilities if needed (by calling ahead, do not just show up to a clinic or hospital with measles symptoms), which reduces my risk. I live in a generally healthy area which is not overcrowded, my children are exceptionally healthy, and do not have compromised immune systems due to age, diet, or any other factor. All of these things lower my risk even more. I do not include our homeschooling as a factor in lowering our risk because we do come in contact with the public just as much as publicly schooled families.

Now, it must be said that this assessment is only valid so long as it is current. I am only analyzing my risk as it currently stands. My analysis would certainly be different if the numbers were different, but my decision for right now is based on right now. I will continue to monitor the numbers, and when the risk presented by the diseases outweighs the risk of the vaccine, I will most likely change my conclusion. Included in my risk assessment is the understanding that should there be an outbreak, there might not be enough vaccine for everyone who wants it, including myself and my children. I have to weigh that into my decided point of action as well.

As for population biology, it is true that herd immunity affects the statistics of disease prevalence. If everyone made the same conclusion as I, the outbreaks of measles and mumps would most certainly rise. To what degree is unknown, however, because we have nothing to compare this scenario to. We cannot look at pre-vaccine numbers because more has changed in our medicine since then than just the introduction of vaccination — most notably our concepts of a healthy lifestyle. Not to mention that the number of deaths due to measles had already drastically dropped off, though the number of cases had only slightly declined, prior to the introduction of the measles vaccine.

When we look at previous outbreaks, such as the one in 1989-1991, we find that it is mostly children who have had only 1 dose, or are too young to have any doses, which propagate the disease (71%). Less than 6% of those who contracted measles were unvaccinated when vaccination was not medically contraindicated. During that time, there were nearly 56,000 reported cases of measles resulting in at least 11,251 known hospitalizations and 166 measles-suspected deaths. 91% of those deaths were unvaccinated people, 55% children and 5% people who were unvaccinated when not contraindicated. The data on this outbreak has been collected and disseminated by the CDC. It is clear that the children have the most medial risk, but they also present the most lateral risk to others. This cannot be avoided, it is just one of the natural risks of life, the possibility of disease.

In the most recent outbreak at Disneyland (December 2014-January 2015), 55% of those who contracted the disease were unvaccinated, and 9% were too young to be vaccinated. While the disease does travel through individuals who are not immune (vaccinated or otherwise), the CDC believes this outbreak to have been imported. Furthermore, some of the cases reported as seeing symptoms of the measles were in children who had recently received the vaccination, symptoms of the measles being a common side effect. It is too early at this point to determine the weight of vaccines in this outbreak, though it appears that the unvaccinated are carrying most of the medial risk and presenting little lateral risk to children or otherwise non-immune individuals.

It also cannot be ignored that the MMR vaccine is a live, attenuated vaccine. This means that while the pathogen is genetically modified to not cause disease, the possibility still exists that an attenuated microbe in the vaccine could revert to a virulent form and cause disease (National Institute of Allergy and Infectious Disease). Let me repeat, however, that this risk is very, very small. That said, one of the known side effects of the MMR vaccine is contracting measles even without mutation, which is why it is contraindicated in patients who have weakened immune systems. There is always the risk that the vaccine itself could stem an outbreak.

My conclusion considering societal factors is that it is not unreasonable to wonder if we might very likely see a drastic reduction in vaccines without a drastic increase in outbreaks because of these other factors affecting patient outcomes beyond vaccination alone. Until numbers show me otherwise, I cannot base my decision on herd immunity because the full scope of the causes of our herd immunity are unknown.

While analyzing risk, I need to consider as many factors as possible. For example, if I choose to remain unvaccinated, it would be riskier for me to travel outside of the United States, in particular to certain countries where the incidence of measles is higher. It would also be riskier for me to take my children to Disneyland any time soon (January 2015). I will probably avoid these two things, and definitely re-look at my risk analysis should my travel plans change.

Furthermore, should there be an outbreak in my local area I would look at the numbers again and reanalyze. Should the number of serious hospitalizations nation-wide for the three diseases combined reach significantly over 150 annually, which is the break-even point, I would most likely vaccinate, so long as that number was not representative of only a few localized outbreaks. Right now that number is only 75. This would also apply if we did a lot of travelling on airplanes, which are hotbeds of disease. Again, there are many factors which play into risk assessment, which is why it is unique to each individual and cannot be done en masse.

Risk, Vaccines, and the Law

There are a number of arguments presented for and against vaccination. If we only looked at safety of the vaccines, it would be easy to conclude that since there is no statistical significance in patient outcomes (except for certain minor symptoms) between those who do not receive the vaccination and those who do, each individual should be left to decide for themselves, to determine their own personal risk level.

There is, however, one argument that has far reaching implications. The concept of herd immunity has led some to suggest that each individual has a duty to receive a vaccination in order to protect the rest of the population. Herd immunity is a real biological concept, and cannot be refuted. It is the suggestion that there must be a law to mandate vaccination to protect herd immunity which I will discuss in detail here.

Government enforced vaccination by individual mandate has a number of flaws. One is the idea that vaccination reduces the risks. While we can reasonably assume that mass vaccination can maintain a lower level of disease acquisition, this does not translate to a reduction in the risks of life-threatening illness or death because the vaccination comes with its own set of risks. It is not adequately proven that the vaccine is safer than the disease, so we cannot say that widespread vaccination would necessarily increase public safety. We cannot base current risks solely on the risks of 60 years ago. Should vaccination rates decline and disease incidence and morbidity increase, then perhaps this argument might hold some water. However, under that condition there is still insurmountable limitation to a vaccine-mandate law.

We have discussed before the problems with legislating risk. Such mandated legislation is against natural law, violates natural rights, and is inherently imprecise because there is considerable uncertainty and such a statute could only be based on perceived and acceptable risk as put through the machine of bureaucratic bargaining, which is fraught with stakeholder inequality. What makes mandating vaccines even worse is that not only does it implicitly legislate against a risk, but it also explicitly mandates a risk.

Getting a vaccination has risks. Currently, the numbers show it is more risky that not being vaccinated (at least as analyzed for MMR). However, even without comparison to disease, the consensus is that there are risks to vaccines. Unlike drunk driving laws, which legislates a transfer of risk but does not force anyone to increase their natural medial risk, a vaccine-mandate law actually forces the individual to take on more natural medial risk. Whether this risk is less or more than remaining unvaccinated is irrelevant. We simply cannot pass laws that infringe upon a person’s right to life and self-determination of medial risk. A law to mandate vaccination will kill people.

Now, let’s branch into hypotheticals a little and say that vaccines are perfectly safe. We still cannot legislate for mandated vaccines because it is an infringement upon the rights of individual liberty, and law must remain in the realm of actual events and cannot rightfully, morally, or lawfully legislate risk. It is true that our individual liberty ends where another’s begins, and all individuals have a right to their life. If the choice an individual makes infringes on another’s rights of life, liberty, or property, then that individual has no liberty rights claim and is subject to appropriate consequences.

In this scenario, we are dealing with a real event, something someone actually did. We have already established that we cannot legislate risk, so until someone actually and actively infringes on another’s rights he is safe from civil or criminal prosecution under the law. If an individual contracts the measles and goes out into public and another gets infected and is permanently disabled, then the victim can pursue restitution through the courts. However, just like in any legal proceeding, the burden of proof is on the plaintiff. To prove negligence the plaintiff must prove breach of duty and causation.

Breach of duty would mean that the defendant had a duty to take certain actions to make sure he did not harm anyone else. The specifics of each case would need to be weighed to determine this breach, as there will be many variables such as awareness of the infection, knowledge of the contagiousness, and intent. There is no way to determine these variables before an event has occurred, so there is no way to say that every such case implies a breach of duty.

Proving causation is even more difficult. In most cases where disease is concerned, there are too many variables in our everyday life to determine with specificity the cause of our illness. This is not true in all cases, but certainly in most. For measles, it is difficult to show beyond reasonable doubt that the illness developed from one cause or another. Again, there is no way to determine causation before an event has occurred, so there is no way to say that every case implies causation.

Therefore, we see that even if we overcome the lack of evidence that vaccines are perfectly safe, we still must deal with the natural law. Risk cannot be legislated because law pertains to real events, and risk is a possibility — an abstract. One cannot infringe on the rights of another based on risk assessment. Any decision to create a statute regarding mandatory vaccination is susceptible to considerable scientific uncertainty and thus based on bureaucratic bargaining subject to stakeholder inequality. Laws cannot be framed which create risk for the sake of preventing risk. Law is only rightfully used to secure the rights of an individual and administer justice when an infringement has occurred. Once the infringement exists, it is then determined whether a breach of duty has happened and there is direct causation. We cannot judge these instances before an event, as the particulars of each case are needed to rule in these matters.

Risk, Vaccines, and Current Legal Prognosis

Vaccines are similar to car insurance, though the stakes seem to be higher. It does not protect an individual completely, there will always be those rare cases where something is not covered by your insurance. Nevertheless, in general it can protect you and your family from financial catastrophe.

Unfortunately, the way we look at car insurance in our American culture is indicative of the course which we will most likely see with vaccines. When insurance was first issued on automobiles, it was intended for people who had more expensive cars and wanted to make sure they were protected from financial loss should an accident occur. Policies were incredibly expensive, and only the wealthy could afford them. As more cars hit the roads, insurance companies realized they could use more discretion in issuing policies and used detailed risk assessment to give people the financial protection they desired at a cost which maintained profitability for the company.

Not long after this, in the 1920s, states began passing regulations requiring drivers to show financial responsibility should they cause harm to another. In the beginning, the requirements to demonstrate financial responsibility were only applicable if an accident actually occurred. However, the people began to realize they could save money if they transferred the risk from themselves to another party. Originally, they did this by letting the insurance company carry the risk.

It did not take long before the insurance companies began to realize that they would make more money if the people carried the risk. They had to pick one of two choices, either raise the rates of the drivers even more, or transfer some of the risk to other drivers by forcing them all to carry insurance. This is when the concept of insurance changed from protecting ourselves, to using risk to calculate how much damage we might do to another. We have every right to take actions to protect ourselves as this is part of medial risk assessment, but once the states crossed over to enforcing lateral risk assessments the name of the game was changed.

Lawmakers who once considered insurance a measure of free will, were now being lobbied to mandate it for all drivers. As we have discussed, under conditions of considerable uncertainty which occur when the science is not solid, the process dissolves to bureaucratic bargaining. In 1957, states began passing mandatory auto insurance laws. Today, only New Hampshire allows drivers the choice to accept their own risks and drive uninsured, respecting the limits of natural law on assessing lateral risk. In New Hampshire, the consequence for causing an accident and not having the resources to repair the damages is not being allowed to drive anymore.

It was lawful, and still is, to carry insurance to protect yourself financially should you do damage to another’s person or property. It is not lawful, however, to force someone else to carry insurance because they might do damage to you. Again, medial risk assessment and action falls under our natural rights, but lateral risk mitigation infringes upon the natural rights of others. When I get in my car, I take on personal risk. I cannot decrease my personal risk by transferring some of that risk laterally and then creating statutes to prevent the transfer of risk back to myself because in order to do so I must violate the natural rights of another.

We have a number of statutes on the books which violate this principle. Mandatory automobile insurance is one of them. Mandatory health insurance, drunk driving laws, and enforcement of road rules pre-event, such as speeding tickets, are examples of others. Mandatory vaccination is another. It will not be long before we are asked to participate in bureaucratic bargaining with our legislators and other stakeholders to determine what we value more: (1) our natural rights, or (2) a reduction of personal risk through mandated risk transferring. Unfortunately, history has shown that the people of this great country have all too often sided with their fear of risk and have taken a stand against the natural rights of all men. I can hope, but have little faith, that the people will choose differently in this case, even though the importance of maintaining our freedom ought to be paramount.

Risk, Vaccines, and Ethics

While we cannot lawfully legislate against the risk of the disease and mandate vaccination, there is still the topic of ethics to address. I cannot say what one should or should not do, because conventional ethics is completely subjective. What is clear is that I cannot force you to vaccinate or not vaccinate. However, while I may have a right to do what I want so long as I do not infringe upon the rights of another, I have a responsibility as a human being to not do anything which increases the risks of another beyond an acceptable threshold.

Here we see this acceptable risk threshold idea again. Just like before, we cannot scientifically determine acceptable risk as there are a host of varying factors. There is no saying what is the acceptable risk for disease, and, therefore, what is the appropriate action to take regarding the risks we impose on others. This is something we need to work out for ourselves. We must use our best judgement and attempt to make decisions which affect the public health out of love and consideration for others.

Should the numbers for the general population change to increase public risk, even though my personal levels of risk haven’t changed, I have a responsibility to consider the facts in light of the risk I might cause for others. There is no saying what this would look like. As of right now, this scenario is hypothetical. Knowing myself, I would probably take on a little more personal risk if I could clearly see that it would dramatically reduce the risk to others.

Everyone has their own threshold for this. Some people are quick to risk their lives for another, and others are far more cautious and reserved. I do not believe there is a definitive right and wrong regarding this subject, except than to remain willfully ignorant of the risks and refuse to consider others in our decision-making processes constitute a level of selfishness which is unbecoming a good and decent human being according to my ethics. Even so, my ethics cannot trump your natural rights, your assessment of risk, and your decisions regarding vaccination.