Non-judgmental Ethics Sunday: Your Sister Won’t Vaccinate Her Son. Can You Help Him?

January 1, 2017 by Joshua
in Ethicist, Nonjudgment

Continuing my series of responses to the New York Times’, The Ethicist, without imposing values, here is my take on today’s post, “Your Sister Won’t Vaccinate Her Son. Can You Help Him?

My sister and her ex are against vaccinating their kids, and I completely disagree with them. Vaccines have helped usher in the modern age; our life spans have been lengthened by the eradication or suppression of smallpox, polio, measles, flu, and so on. Recently, my 12-year-old nephew told me out of the blue that he wasn’t vaccinated and wanted to be. He got swine flu a year or two ago. He was very sick and has no desire to repeat anything like that again.

We talked about reasons that people don’t give their kids vaccines, where vaccines come from and how they work. He is wholeheartedly on board with the idea of getting vaccinated for a host of childhood diseases. Is there any way I can help him get vaccinated? Does he really have to wait until he is 18 and free from his parents’ decisions? A.F., Portland, Ore.

My response: This is a matter of negotiation with your sister, her ex, and your nephew. The stronger your negotiation skills, the more likely you’ll reach the outcome you want. Simple as that.

You can improve your skills at leading and negotiating. Anyone can. They apply to most relationships, meaning that developing them will lead you to make your relationships more meaningful and valuable.

I would look at them like cooking skills or ability to fix things around the house. You don’t have to learn them, but they make many parts of life easier, so why not? You won’t feel so helpless in situations like this. Instead of impotently writing newspaper columnists, you’ll act with some expectation of success or you’ll at least feel comfortable that no one else could do more.

The New York Times response:

Parents have the primary responsibility for medical decisions like these: They have the right to make them while the children are under their care. Unless you want to get your sister’s parental rights terminated, it’s not your place to have him vaccinated without their consent.

I assume you’ve discussed the general issue of vaccination with your sister in the past and tried out the arguments you make here in support of vaccines on her. Have you also talked about what happened when your nephew had swine flu? Or mentioned that her son is worried about not having been vaccinated? These circumstances ought to move your sister and her ex.

But the anti-vaccination movement is not, alas, a bastion of rationality. So, assuming his parents don’t have a change of heart, I fear your nephew may have to wait. The good news is that he doesn’t have to wait to turn 18; in Oregon, you’re free to seek medical procedures without parental consent as soon as you are 15. Until then, you can continue to be the voice of sage counsel.

Like so many recent Ph.D. graduates in the arts, I am having a terrible time finding adequate work. I am currently employed as an adjunct instructor, but making roughly what Starbucks and the Gap pay teenagers on summer break is not why I went to school for 10 years.

To make matters worse, two years ago I began to suffer from a rather serious chronic illness: Lyme disease. While I have aggressively pursued treatment and continue to, I have yet to find a protocol that helps my symptoms at all.

This is an invisible illness, so I can easily hide it if need be — I doubt that any of my students, for example, have any idea that I am not the perfectly healthy person that I appear to be. I have informed the administration where I currently work of my illness. And, following the strong advice of my current doctor, have cut my course load back significantly so I can focus on getting healthy.

Here is my quandary. Just as with every year at this time, I am once again on the job market, applying to positions in my field across the country (I have applied for close to 100 jobs in the last four years, with barely a whiff of interest). While I am not very confident that I will earn a job offer, I’m not sure what I will do if I am fortunate enough to get one. Here, I feel, are my choices:

1) Disclose my illness to my new employers before I sign the contract, telling them that I am currently not healthy enough to work full time but hope to be soon. Here, I run the risk that they withdraw the contract. Poof! — I could lose something that I’ve worked for 10 years to achieve and may not come along again for several more years.

2) Go ahead and sign the contract, then disclose my illness. This means that they probably can’t take away the contract, but I would be beginning the relationship with my new employers on less-than-honest footing.

3) Just sign the contract and go to work. While I probably could do the work, I would not be performing close to 100 percent. My work would no doubt suffer, as would my health.

What do you think? G. B.

My response: The question is what do I think, not what is effective strategy, right, wrong, good, bad, or so on. I think you sound entitled, which, in my experience, repels people. Just because you worked at something for ten years doesn’t mean anyone else should value it. More precise than entitled, you sound like you want to impose your values on others. I don’t think that perspective will help you get a job offer.

If you want to make more money and others value your ability to serve coffee over your ability to teach your subject, you may want to consider serving coffee. If you see more value in teaching, then I suggest viewing your contribution with more humility might help you appreciate your situation more.

Speaking from experience, I got a PhD in a field that didn’t let me do what I wanted. I left the field, as much as I love it, and I consider my life better for it. That’s why I teach my entrepreneurship course—to enable people to create the lives for themselves that they want.

(To clarify, since many people associate entrepreneurship with Shark Tank: my course doesn’t just teach the popular view of entrepreneurship of creating a project a venture capitalize might invest in, but to find problems that you can solve, will enjoy solving, and that others will pay you for, creating a supportive community and lifelong skills along the way. It teaches initiative, resourcefulness, responsibility, team-building, listening, and other fundamental skills. People who do its exercises look at people like the letter-writer like they’re looking for a handout instead of taking responsibility and creating the life they want.)

You don’t have to keep doing something that doesn’t support the life you want to live just because you sunk a lot of costs into it. Otherwise you’re using your education to limit your life options instead of expanding them. I suggest you’re using them backward, in that case.

Alternatively, if you recognize the sacrifices or investments required to keep doing something others don’t value as much as you do, you may be able to feel more satisfied with the challenges it brings.

The New York Times response:

Un-fun fact: an effective vaccine against Lyme disease was taken off the market a decade and a half ago — in part because of the anti-vaccination movement and the flurry of lawsuits that it helped fuel.

Your situation has, as you probably know, a name. Not your medical situation, but your vocational one. You are a member of the academic precariat: a class of college teachers with irregular employment, working on short-term contracts with few, if any, benefits. The proportion of faculty off the tenure track — academics doing jobs at universities and colleges that don’t have a path to permanent secure employment — has been rising for some years. More than 70 percent of the teaching in higher ed is done by people without tenure. (In 1975, for comparison, it was 54 percent.) Of nontenured or nontenure-track university teachers, only 17 percent are full time. Because the terms of employment vary significantly in their details, it’s a hotly debated topic whether this is fair to the teachers or good for the students. But my own view is that rolling back the proportion of teaching done this way would be beneficial to both parties. For one thing, the current situation discourages many talented people from entering the profession.

Among the reasons for increasing inequality in the world today is that we haven’t put enough thought into organizing society so that everyone gets meaningful employment at reasonable wages. Higher education isn’t the only domain in which jobs are increasingly divided between a precariat and a small, well-paid elite. Getting away from that situation is a pre-eminent policy challenge of our time, one with ethical as well as social-scientific dimensions.

Your situation is compounded, of course, by your health problems. (Let’s set aside the medical controversies over chronic Lyme and whether aggressive treatment — typically involving antibiotics — is appropriate.) Prospective employers might be tempted not to hire someone who has a condition like yours. Not so much because of insurance issues; the departments that do the hiring seldom worry about those. But they will naturally be worried about hiring someone who can’t do the teaching they need.

So should you disclose your medical situation? The Americans With Disabilities Act (A.D.A.) limits the questions an employer can ask about your health. Legally, then, you may be free to keep quiet about your health issues as a job candidate. As an ethical matter, your health is your business, and you have no obligation to volunteer information — if you are capable of doing the job.

Are you? Your doctor evidently thinks you need steady part-time employment, which, I gather, you think you could do more than adequately. But this means that your second choice isn’t really an option. Here, you’re proposing to apply for a full-time job that you know you can’t really do, then introduce your medical condition and ratchet back your responsibilities. That’s dishonest and unfair to your employer, because there are others out there who can do the whole job.

Ethically speaking, you can try to continue your current employment or apply for part-time work elsewhere: That’s something you can manage, and makes your medical situation irrelevant. It probably leaves you ineligible for medical coverage, too. And such work is mostly so badly paid that you can’t make a living without assembling a bunch of part-time gigs, which, in your case, has been judged medically inadvisable. In some European countries your situation might entitle you to public financial support. Not here, I’m afraid.

So you’re stuck. In these circumstances, it would be understandable — wrong, but understandable — if you kept your potential employers in the dark in order to get the job you want. Indeed, that’s part of the problem with our poorly developed state and federal system for covering circumstances like yours: It encourages dishonesty.

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