The CBC has some interesting reporting on the medical ethics of triage in relation to the voluntarily unvaccinated:

Udo Schuklenk, Ontario Research Chair in bioethics at Queens University and co-editor of the journal Bioethics, questions the argument that vaccine refusers are victims of misinformation.

“There’s many people in my field who go on about equity considerations, and [how] these people don’t know better and they have been misled,” he said. “And my view is, they have made their autonomous choice.”

“And if you’re telling me that they are unable to make a sensible choice, then we should take this choice away from them. But we should not, on the one hand, give them this choice, and then not hold them accountable for it.

“The vast majority of people in my field of bioethics would disagree with me on what I just said. They’d say there’s many people who don’t know better and have been misled. And my point is, that may well be true, but then this should have a consequence on the kind of choices that these people are permitted to make.”

I understand and can broadly applaud the ethics of doctors treating everyone equally based on the severity of the risks they face, without consideration of whether they brought on those risks voluntarily. At the same time, public health measures in the face of an epidemic are an ancient and appropriate authority of the state and it seems totally reasonable to restrict the activities of people who refuse to comply.

Surely one of the big injustices of the pandemic has been all the people who need non-COVID treatment suffering worse outcomes because the voluntarily unvaccinated are absorbing too many of the resources of the medical system.

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Everyone is aware of the placebo effect, in which a mock or inert intervention like a sugar pill in a clinical trial will nonetheless produce what seem like real effects to the people who receive it. The nocebo effect is the opposite: where people exposed to something harmless can experience apparent ill effects because they believe it is harmful.

A recent study found nocebo effects to be widespread with the COVID-19 vaccines: “the ‘nocebo effect’ accounted for about 76% of all common adverse reactions after the first dose and nearly 52% after the second dose.”

This is a reminder about the humility we need to maintain when interpreting our own medical experiences. Just because something came after something else doesn’t mean the first thing caused the second, and just because an effect seems psychologically or emotionally connected to a cause does not mean there is an empirical or causal connection.

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In 1994–5, the last year of Saddlemyer’s mastership, one innovation was so popular that it immediately became a college tradition. This was the Murder Game, played in February when the stress of term work and the gloom of winter had become oppressive. Robertson Davies’s assessment was characteristically astute: he saw the game as creating a false tension during a period of real tension, a false tension whose arbitrary removal eased the real tension. It was introduced to the college by Kelli Shinfield (JF, 1994–6), then doing an MA in English and later married to Darren Novak (JF, 1995–8). Initially, she conceived this elaborate game of hide-and-seek as being focused on one person who was “it” or the “murderer,” “who would kill off the college members one by one or get accused first (but if a player made a false accusation they would be eliminated). Instead, it became a circular game, where every member who elected to play had a target to ‘kill’ while simultaneously being a target for someone else.” Shinfield recalls being “caught completely by surprise that anyone would object on moral grounds” and feeling “heartened by Master Ann Saddlemyer’s staunch defense of the game, letting people opt out.” She thought the game was eminently suited to a college whose residents were “so preoccupied with each other and inhabiting a perfect building in which to hide and hunt.” She also thought it would be a different (albeit slightly paranoid) way for people to relate to each other, [and] that it might create unusual and interesting friendships and alliances between people who would not otherwise get to know each other.” [Opening quotation mark absent —MPI] In her experience,

some of the quieter Junior Fellows turned out to be remarkably sneaky, aggressive and competitive, and those of us who were more outgoing tended to get knocked off early. Some students were passive, some were furious when eliminated. We speculated on who was holed up in their room stocked up on canned goods. Some people opted out and watched the rest cavorting with a sense of “what fools these mortals be” and some with great care and humor stalked their victims’ every move. It was a fabulous distraction from the dreary grey of February watching the remaining few tigers circle each other, each knowing the other’s identity, enlisting friends and acquaintances to help get their targets alone.

Marc Ozon, a resident junior fellow in 1994–6 and an early participant in the game, adds a few details:

It’s not to everyone’s taste, frankly. Some people took it very personally. One could opt out, but at the same time, it’s a small enough community that there’s an implicit peer pressure in comments like, “Come on, it’s only a bit of fun.” It is relatively innocuous, but there is a certain tension. You’re walking around; you could be “killed” at any point. As I recall, at the beginning of the game, each person drew the name of a victim. If a person was alone anywhere in the college, they could be “killed.” The idea was to continue “killing” without actually being a victim yourself. You inherited your victim’s victim. So A kills B, who was supposed to get C, so A then goes after C. You never quite knew who had whom. The game was very good at identifying those who had the time, energy, and competitive spirit to really throw themselves into it. There were accounts of people hiding out in hallways, around one of the corners, or in the shower. You can see why some people got a little up tight. So this is like sports, a way to blow off a bit of steam. It’s a bit of organized fun with people you know. Inevitably there’s someone who gets a little upset. It takes as long as it takes for the last person to be standing. My recollection is that it took about a week with the last day or two being just the last couple of people. There was also a rule whereby you had to kill someone once every twenty-four hours. If you’re just sitting and not doing anything about your prospective victim, a designated person can come and get you, and take you out of the game.

Grant, Judith Skelton. A Meeting of Minds: The Massey College Story. University of Toronto Press, 2015. p. 415–6

I don’t know about earlier, but by the time I played after 2012 there would always be two people alive at the end since they would close the circle and end up as one another’s targets. If there was a single winner, it was because they had the most points from kills and from any other bonuses awarded by the game administrators.

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I don’t know exactly why, but the insomnia which has been my normal state of life for as long as I can remember has given over to what’s more like never-ending tiredness: going to bed tired, waking up tired, spending all day tired.

It may be from the loss of academic and social non-dissertation activities that give structure and variety to life, or just from the exhaustion of watching wave after pandemic wave crest and break while we collectively flounder. No doubt it comes partly from the rage of seeing the way in which we’re destroying our world, and yet our politics simply side-steps the issue as voters and lobbyists wedded to the status quo keep us cycling between political parties and leaders that match up their inadequate ambition with unserious implementation.

Maybe more than anything my own exhaustion reflects how everyone else seems to have been eroded and abraded: turning inward, turning silent. Maintaining any kind of social connection has jumped in difficulty, even though I suspect that most people could work to reduce their feelings of isolation and hopelessness by cultivating community in the ways which are possible without close physical presence.

I feel like I need something to lay down a boundary in time — or make one day or week seem different from another — to get back to a tempo of thesis work that will let me get the thing done before the university cuts me off irretrievably at the end of the year. And yet nothing of the sort is possible. I can’t reset the location, content, or cast of characters in my days, and so life feels like April 2020 made eternal.

I know it’s one of our worst human habits to develop the pattern of entitlement and resentment: growing to feel entitled to whatever good things we have happened to get, internalizing the notion that we have them as the result of merit or a just universe, and then cursing the injustice of losing it. The habit of mind we need to cultivate is that “nothing here is promised, not one day.” If we’ve ever had the good luck to experience something positive, we should see it as an unwarranted boon from a universe that is indifferent to all our notions of deserving or fairness, and if we should lose it we should hang on to the gratitude for having ever had it.

We’re all going to lose more than we can guess — maybe everything — as the full consequences of our fossil fuel civilization work their way through the planetary system. If our collective response to loss continues to be anger, resentment, and turning against each other, it’s hard to see how we will achieve the cooperation that has the sole prospect of saving us.

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