{"id":4125,"date":"2021-03-18T16:27:20","date_gmt":"2021-03-18T15:27:20","guid":{"rendered":"https:\/\/blogs.bmj.com\/medical-ethics\/?p=4125"},"modified":"2021-03-18T16:32:41","modified_gmt":"2021-03-18T15:32:41","slug":"the-vicious-circle-of-precaution","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/medical-ethics\/2021\/03\/18\/the-vicious-circle-of-precaution\/","title":{"rendered":"The vicious circle of precaution"},"content":{"rendered":"

By Ezio Di Nucci.<\/p>\n

The precautionary principle has been implicitly<\/em> utilized and explicitly<\/em> invoked in March of 2020 when many governments introduced restrictions and lockdowns to contain COVID-19. \u2018Implicitly utilized\u2019 because the preliminary evidence and modelling those restrictions were based on was a good example of the kinds of problems the precautionary principle is meant for – think of climate change. And it was also \u2018explicitly invoked\u2019, for example by Denmark\u2019s Prime Minister in implementing a lockdown against the advice of her own health authorities<\/a>.<\/p>\n

A year later, the precautionary principle is now again explicitly invoked by many European governments in deciding to pause the AstraZeneca vaccine because of blood clots reports<\/a>. This time the explicit invocation is harder to trace back to implicit utilization, given that there is no evidence \u2013 not even preliminary evidence \u2013 that there is any increased prevalence of blood clots among those vaccinated with AstraZeneca (or indeed any other COVID-19 vaccine) than in the population at large.<\/p>\n

We shouldn\u2019t be too quick to conclude, though, that there isn\u2019t anything behind the explicit invocation of precaution this time around, as maybe the risk that those precautionary decisions are based on isn\u2019t the prevalence of blood clots but a different kind of side-effect, namely vaccine hesitancy and reduced uptake of a particular vaccine – or indeed COVID-19 vaccines more in general \u2013 as a result of such reports, even without increased prevalence or causality.<\/p>\n

The irony of this particular way of \u2018rescuing\u2019 the precautionary principle for the case of the decision to suspend the AstraZeneca vaccine is obviously that, if vaccine hesitancy was the worry in the first place, individual countries sporadically deciding to pause the vaccine after anecdotal reports (and again against the advice of the relevant health authorities, EMA in this case<\/a>) without a coherent or coordinated joint response, will hardly reassure folk.<\/p>\n

There is, then, both coherence and incoherence in the decision-making described above, and it is helpful to keep the coherence separate from the incoherence, because in fact it will turn out that the former is possibly even more problematic than the latter \u2013 an analytic philosopher\u2019s worst nightmare!<\/p>\n

Incoherence because last time (lockdowns in March 2020), the explicit invoking of the precautionary principle matched its implicit utilization; while this time (vaccine policy in March 2021), the explicit invoking of the precautionary principle doesn\u2019t actually match its implicit utilization. And then it\u2019s just a theoretical issue whether in this new case we should talk about the precautionary principle being just improperly invoked or actually improperly deployed (I would personally tend towards the former hypothesis).<\/p>\n

It is the coherence, though, that is maybe more interesting here, especially when we consider that last year\u2019s appeals to caution were always accompanied by \u2018we follow the science\u2019 statements while this year\u2019s cautionary appeals are explicitly not following the science; and it is in fact those countries like the UK that are not pausing the AstraZeneca vaccine which are \u2018following the science\u2019.<\/p>\n

This is important for two reasons: risk-tolerance and democracy. Firstly, a society with a substantially lowered risk-tolerance might turn out to be more rather than less dangerous, as we will see in a moment.<\/p>\n

Secondly, some people were worried that last year\u2019s \u2018follow-the-science\u2019 precautionary restrictions might have set a dangerous precedent for emergency executive action which bypasses standard democratic procedure.<\/p>\n

As with lowered risk-tolerance, people were worried about this in terms of our post-covid future, but they might have again been overly optimistic: the vicious circle of precaution means that while last year\u2019s caution was working against COVID-19, already this year it is working in its favour by slowing down (and possibly also depressing) vaccination rates. And \u2018ignore-the-science\u2019 by decree is even scarier than \u2018follow-the-science\u2019 by decree.<\/p>\n

 <\/p>\n

Author<\/strong>: Ezio Di Nucci<\/p>\n

Affiliation<\/strong>: University of Copenhagen<\/p>\n

Competing interests<\/strong>: None<\/p>\n","protected":false},"excerpt":{"rendered":"

By Ezio Di Nucci. The precautionary principle has been implicitly utilized and explicitly invoked in March of 2020 when many governments introduced restrictions and lockdowns to contain COVID-19. \u2018Implicitly utilized\u2019 because the preliminary evidence and modelling those restrictions were based on was a good example of the kinds of problems the precautionary principle is meant […]<\/p>\n

Read More…<\/a><\/p>\n","protected":false},"author":354,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[8070,8084],"tags":[],"class_list":["post-4125","post","type-post","status-publish","format-standard","hentry","category-pandemic","category-vaccines"],"yoast_head":"\nThe vicious circle of precaution - Journal of Medical Ethics blog<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/blogs.bmj.com\/medical-ethics\/2021\/03\/18\/the-vicious-circle-of-precaution\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"The vicious circle of precaution - Journal of Medical Ethics blog\" \/>\n<meta property=\"og:description\" content=\"By Ezio Di Nucci. The precautionary principle has been implicitly utilized and explicitly invoked in March of 2020 when many governments introduced restrictions and lockdowns to contain COVID-19. \u2018Implicitly utilized\u2019 because the preliminary evidence and modelling those restrictions were based on was a good example of the kinds of problems the precautionary principle is meant [...]Read More...\" \/>\n<meta property=\"og:url\" content=\"https:\/\/blogs.bmj.com\/medical-ethics\/2021\/03\/18\/the-vicious-circle-of-precaution\/\" \/>\n<meta property=\"og:site_name\" content=\"Journal of Medical Ethics blog\" \/>\n<meta property=\"article:published_time\" content=\"2021-03-18T15:27:20+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2021-03-18T15:32:41+00:00\" \/>\n<meta name=\"author\" content=\"Hazem Zohny\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"Hazem Zohny\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"3 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/medical-ethics\\\/2021\\\/03\\\/18\\\/the-vicious-circle-of-precaution\\\/#article\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/medical-ethics\\\/2021\\\/03\\\/18\\\/the-vicious-circle-of-precaution\\\/\"},\"author\":{\"name\":\"Hazem Zohny\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/medical-ethics\\\/#\\\/schema\\\/person\\\/e73152f6aa4e164c7d625d77cf4fed35\"},\"headline\":\"The vicious circle of precaution\",\"datePublished\":\"2021-03-18T15:27:20+00:00\",\"dateModified\":\"2021-03-18T15:32:41+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/medical-ethics\\\/2021\\\/03\\\/18\\\/the-vicious-circle-of-precaution\\\/\"},\"wordCount\":643,\"commentCount\":0,\"publisher\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/medical-ethics\\\/#organization\"},\"articleSection\":[\"Pandemic\",\"Vaccines\"],\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"CommentAction\",\"name\":\"Comment\",\"target\":[\"https:\\\/\\\/blogs.bmj.com\\\/medical-ethics\\\/2021\\\/03\\\/18\\\/the-vicious-circle-of-precaution\\\/#respond\"]}]},{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/medical-ethics\\\/2021\\\/03\\\/18\\\/the-vicious-circle-of-precaution\\\/\",\"url\":\"https:\\\/\\\/blogs.bmj.com\\\/medical-ethics\\\/2021\\\/03\\\/18\\\/the-vicious-circle-of-precaution\\\/\",\"name\":\"The vicious circle of precaution - 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