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MEMBERS’ ARTICLES Individual Autonomy versus the Public Good: A Case from St. Vincent & the Grenadines By: Dr. Shakel Henson Introduction The ethical principle of respect for persons encompasses individual autonomy, which emphasizes the rights of individuals to have a say in their own decision-making. In today’s liberal world, more persons are aware of their rights and it is expected that their autonomy will be respected.
BSc, MD, MPH, MSc, MSc,
Current times, like the coronavirus disease (COVID-19) pandemic, have reminded us that infectious diseases warrant actions that will best protect the public’s health. It is, however, challenging to balance respect for individual autonomy with the protection of the public’s health amidst these infectious diseases, like COVID-19, which require mandatory actions, such as quarantine, to minimize the spread of the disease for the public good.
MS Bioethics, FRSPH,
COVID-19 in St. Vincent and the Grenadines
Dr. Shakel Henson,
With COVID-19 being declared a pandemic in 2020, many countries worldwide continue to struggle to control it (WHO, 2021). Initially, St. Vincent and the Grenadines (SVG), an Englishspeaking Caribbean country, was fortunate as there were only a few reported COVID-19 cases. At the beginning of 2021, this situation drastically changed and COVID-19 became a burden to the country’s health system (MOHWE, 2021). The cases were many: one thousand, nine hundred and fifty-four (1954) as of the 19th May 2021 out of a total population of approximately one hundred and ten thousand (110,000) (MOHWE, 2021; The World Bank, 2021). Shortly after, however, the COVID-19 vaccine became available to the citizens of SVG (MOHWE, 2021). Ideally, this would have been the perfect solution to the COVID-19 situation but the response rate to vaccination thus far has not been sufficient to achieve herd immunity and be protective of the public’s health. Individuals have a right to choose whether or not to be vaccinated. This decision to not take the COVID-19 vaccine can be justified by the fact that the vaccine was developed in a short time period and there are uncertainties regarding the side effects (CDC, 2021). However, in light of the significant impact of COVID-19 on morbidity and mortality rates globally (WHO, 2021), it may be argued that the public good should take precedence over individual autonomy. Currently, though, taking the COVID-19 vaccine is not mandatory. In what situations should the public good supersede individual autonomy? St. Vincent’s La Soufriere Volcano On the 9th of April 2021, SVG experienced another disaster, an explosive volcanic eruption. As a result, over 20, 000 people were forcibly displaced (NEMO, 2021). Many occupied shelters in the south of St. Vincent while others moved in with family members. This meant that many individuals who had not been vaccinated for COVID-19 now had to live in close proximity to others, a defiance of the COVID-19 protocol for social distancing. With a large portion of the main land being inhabitable due to the active state of the volcano, living in close proximity was the better option to exposing citizens to the risk of death from the hazards of this volcano. Evacuation was mandatory as it was in the public’s interest. It was a means of saving lives and it took precedence over individual choices to remain in the danger zones of the island. Stringent measures were implemented for the public good. In one particular case, a citizen was detained by the police as he refused to comply with the mandate to stay out of the danger zone and away from the active volcano . Individual Autonomy versus the Public Good Like St. Vincent’s active volcano, COVID-19 threatened the health and lives of many Vincentians. However, the approach to each situation has been different. Contrary to the actions taken to protect the public’s health prior to the explosive eruption of the La Soufriere volcano, there were no mandates issued with respect to the taking of the COVID-19 vaccine.
