Should vaccinations be compulsory?

Health Secretary Rt Hon Matt Hancock MP recently articulated his support for compulsory vaccinations. He commented that there is a 'very strong argument' for making vaccinations compulsory, and I am wholly with him on this.

Anti-vaxxers

There is a small but significant group of people - anti-vaxxers - who don't believe in vaccinations. This scepticism might take a number of forms. Anti-vaxxers might believe that: 

1. vaccinations don't really work; 
2. other methods are better at protecting from illness; 
3. it's dangerous to inject diseases into people; 
4. vaccinations carry a significant risk of disease or other condition (such as autism); 
5. we shouldn't interfere with nature; 
6. vaccinating a particular child isn't necessary, because the disease in question is uncommon - perhaps because so many other people are already vaccinated.

Some of these standpoints are based in sheer ignorance, while others are based more on hope/faith. Below I examine these claims and argue that vaccination should be compulsory for all who can be vaccinated.

Vaccines don't work

There is a massive body of evidence which shows that vaccines work, and protect against illnesses far better than other methods. Nonetheless, just as abstinence will protect one against sexually transmitted infections better than a condom can, avoiding all human contact is likely to be very effective in the fight against communicable diseases. But in most cases, it's wholly unrealistic, and not a method used by anti-vaxxers anyway.

People might suggest that other methods - such as prayer, homeopathy, voodoo magic and so on - will protect against illnesses as well as or better than vaccines can. I would love to see a clinical peer-reviewed study into this. Group A is vaccinated against measles; Group B prays; Group C uses homeopathy or something similar. Then all participants in each group are exposed to measles in the same way - say, a person with measles coughs in their face. Then, we monitor the results, and see which of the people contract measles. 

Obviously, this sort of study would never pass ethical review - and why not? Because it'd be considered too dangerous for groups B and C! This is of course because we know that the non-vaccinated people would be in critical danger of developing measles, a disease which can kill.

Vaccines cause sepsis, autism etc

Although it's possible to cherry-pick anecdotal stories which show a person who was vaccinated later getting the disease, or to give credence to discredited 'scientific' studies such as the one which linked the MMR vaccine to autism, the overwhelming body of evidence shows that vaccines work, and are not dangerous.

There are some tragic cases where children die suddenly, and it is totally understandable that parents and other relatives or friends would try to find meaning in the death, and to know why it happened. Take sepsis as an example: it arrives with commonplace symptoms such as rapid shallow breathing, low temperature, and nausea, and by the time symptoms seem serious enough to seek medical help, the patient might be beyond the stage where they can be saved. It's only natural to think back to what could have caused it, and what has happened in the few days prior to the illness or death.

If a child has a vaccination, and then a few days later develops sepsis or some other horrible illness, it is understandable that a parent would make a causal link between the two, even if that link is unjustified. But any good statistician knows that correlation doesn't prove causation. Just because a child begins exhibiting symptom Y a few days after event X does not prove that X caused Y. Science doesn't work like that; superstitions do. If a child get sepsis a few days after walking under a ladder this is not compelling evidence of a link either.

So although it's understandable why people would make the link, it's unjustified.

We shouldn't interfere with nature

I have a great sympathy for this sort of attitude, and when it comes to something really invasive like a blood transfusion or an organ transplant, I am even more sympathetic to the standpoint. I can totally understand why some people might prefer to live a more simplistic and natural life, free from medical intervention and 21st century attempts to play god with medical science. It's not a belief I share, but I can understand the motivation to pursue such a life.

Often, but not always, such a standpoint might be grounded in religious beliefs such that one decides that if it is God's will that he dies from measles or heart failure, then so be it, God has decided. To try to circumvent God's plan by using medical interventions is contrary to God's plan and it therefore wrong. I respect that thinking, and when it involves things that only affect oneself, I would never argue that we should force people to have medical procedures they don't want.

HOWEVER

Whilst lifestyle and religious beliefs should be tolerated and respected, when S's religiosity starts to have a potentially fatal effect on everyone else's lives, tolerance and respect needs to come to an end.

If it were someone's religious or personal belief that one should carry razor-sharp weapons in each hand, and swing his hands vigorously as he walked, this is fine on a deserted island, but totally unacceptable in a public place - particularly around children who would be in greater danger from such activities. It would be legitimate to say he cannot enter a public place whilst swinging his knives around.

Analogously, if someone chooses to remain unvaccinated for religious or personal beliefs in the sanctity of nature, this is fine if they are alone or around others who share that belief. But when they bring their potentially disease-ridden bodies into a public place, they are playing Russian roulette with other people's lives - particularly children who are in greater danger from many communicable illnesses. It then becomes legitimate to say he cannot enter a public place whilst he is unvaccinated.

As John Stuart Mill wrote: "The only purpose for which power can be rightfully exercised over any member of a civilised community, against his will, is to prevent harm to others." (On Liberty 1859/1974:68). I may have mentioned elsewhere that Mill is a legal genius, well ahead of his time, and although there are some problems with his theories which future scholars have had to iron out, the principle stands as a really useful one to live by. Do as you please, but when it starts to endanger others, your right to individuality ends. Mill would have supported compulsory vaccination.

Herd immunity

When a high enough proportion of people (typically 95-100% is quoted) are immune to an illness, the remaining 0-5% are safe too - after all, the disease is really uncommon and unlikely to be spread around. If I'm unvaccinated, but all the people I come into contact with are immune to an illness, then I'll never get the illness, because they'll never get the illness.

That's the theory, at least. For some illnesses, this is absolutely true, but I think there might be some illnesses which an immune person can still carry and pass on to others (I'm not totally sure about this though - maybe I'm just remembering that scene in 28 Days Later where the immune children passed on the zombie sickness to their mother?!)

Anyway, even if no one can carry an illness they're immune to, the herd immunity argument only works when the number of people immune to the illness is very high. If only 1% of people are susceptible to measles because everyone else is vaccinated, then there's only a very slim chance of coming into contact with another unvaccinated person - and a slimmer chance still that the unvaccinated person just so happens to be contagious at that moment.

But as the number of unvaccinated people rises, the chance of catching the illness increases. Vaccination against measles among UK children now stands at around 90% - one of the worst uptake rates of any developed country. Herd immunity to measles has been lost.

Some people can't be vaccinated, because they have an autoimmune disease or something similar. And babies aren't vaccinated against every illness the moment they leave the birth canal, but rather, they receive vaccinations in their first few months of life. This means that young babies and some older children and adults are susceptible to preventable illnesses. Why should their health be risked because S decides not to vaccinate their child and instead rely on herd immunity? The herd immunity approach should be reserved for those and only those who cannot be vaccinated for health reasons. Everyone who is able to be vaccinated should be vaccinated.

Smallpox and Measles

Child with smallpox

Does anyone remember smallpox? I don't. No one I know - indeed no one in the entire world - has had smallpox during my lifetime.

In the 20th century, smallpox was responsible for 300-500 million deaths worldwide; in 1950, there were an estimated 50 million cases of smallpox each year. I'm not a mathematician, but that seems like quite a lot. Yet in the last 40 years, there have been 0 cases of smallpox in the world, and it's all thanks to a worldwide vaccination programme. Without the vaccination programme, it would be highly likely that some members of my family and yours would have died from smallpox.

Measles hasn't been eradicated, and is still out there in the world doing its thing. It isn't just getting a bit spotty and feeling under the weather for a few days: it's horrendous, and can be fatal. In 2016, an estimated 90,000 people died of measles worldwide, and plenty of others suffered terribly with the disease, and were left deaf, blind, and with profound physical disabilities or even brain damage.

Wouldn't it be nice if measles went the way of smallpox, and we could eradicate it forever? It could be done through vaccination, if enough people were on board. It certainly seems as though a small but significant group of anti-vaxxers are trying to save measles from extinction, in much the same way that we might save whales and tigers from the brink. They are going out of their way to allow the disease to spread and remain alive, and they take to the streets to campaign, to get others to join their crew.

I would never wish illness or death on anyone, and I hope that anti-vaxxers never have to suffer the heartbreaking situation where their children die from a preventable disease simply because they refused to vaccinate them.... but some of them will die. Moreover, some newborn babies and people with autoimmune disorders who cannot be vaccinated will also die, simply because the anti-vaxxers wouldn't believe the science. It's a tragedy. A preventable tragedy.

Is it OK to ask whether a woman has kids?

People have made a claim in recent years that no one should ask a woman whether she has children, whether she's planning on having (more) children, and why (not). The claim is that having children is a personal issue which can be very upsetting for some women to talk about, whether they are being asked by strangers or close family members. Below I consider whether these claims are justified: is it really so bad to ask these questions?

Do you have kids?

For many years I couldn't imagine myself as a mother – nor indeed was I sure I wanted to become one. In my 20s, particularly after I'd been in a relationship for a few years, people would ask about whether I was planning on getting married, and whether I planned on having children. Although I found the questions a little tiresome, I gave my answer (‘no’ or ‘I don’t know’) and it was usually met with acceptance. Luckily for me I was surrounded by people who didn't pressure me or try to guilt me into following the conventional path of marriage and children. If I had been subjected to frequent questioning and pressure from my family, friends or even strangers, this could have been unbearable. So I can wholly understand why it is so annoying for people who are frequently on the receiving end of pressure to produce offspring.

During my childless years, strangers also occasionally asked me whether I had kids, and I didn't really mind this, it's a reasonable question to ask of a woman in her 20s or beyond. I wasn’t berated for being unmarried and childless, but I used to have to field the questions about why I didn’t have children, and those were more frustrating, as though I had to explain and justify why I hadn’t procreated yet. After all, parenting is (in many societies, at least) a lifestyle choice and not a moral requirement. So asking someone whether they are a mother seems permissible, but continuing to question them about why they are or aren’t a mother becomes something else. (Analogously, asking someone if they’re a vegetarian is reasonable, but asking “why are you vegetarian?” is infuriating. No one should have to justify their food intake any more than their procreation status, but that’s another post for another day). What we can avoid, and indeed should avoid, are the ‘why’ questions about someone is childless. When someone says they don't have any children, the whys and wherefores of their situation are no one’s business but their own. Asking whether they have children is engaging in small talk; asking why they don't have children is prying and pressuring.

Making connections 

People make connections with others by talking. It's how friendships build up, and conversations often make the day more pleasant and less boring. Generally, small talk focuses on elements of people's lives or the news – look at the weather, what's your job, where do you live, and suchlike. Asking someone whether they have children is in this category, it seems. As a mother, I know that talking about children to someone else who has children is a great way to find common ground and build a rapport. How else could I find out that we have this in common if I weren’t to ask them if they have kids? If someone asks another person whether they have kids and the answer is yes, this will probably be followed up with questions such as how many, boys or girls, how old are they, and so on. This is how people converse and make friends, and this should not be prevented.

There are of course some questions that are out of bounds for strangers to ask one another, for example about their sex lives, or their toileting habits. These are highly personal questions which would rightly be met with shock and condemnation if they were to be asked in most situations, but whether or not a person has children is not in this league. “Do you have any kids?” is much more similar to “What’s your job?” or “Do you have any pets?” than it is to “How often do you have sex?”

But childlessness can be a touchy subject. And there are many reasons why a woman might not have children. (The same is true of a man, but I don't think childless men are questioned and judged in quite the same way as a childless woman is: after all, a woman's sole function on earth is to raise children, right? (*sarcasm)) 

So, why doesn't S have children? Perhaps she doesn't have enough money to support a child; perhaps she is single and has no partner with whom to conceive a baby; perhaps she has chosen to focus on her career rather than motherhood; perhaps she is not attracted to men; perhaps she's planning on having children, but just not right now; or perhaps she simply does not like children and doesn't want to have any! These (and many others) are perfectly legitimate reasons for someone not to have a child. And it may well be the case that if these are the reasons someone doesn't have children they may feel comfortable saying these to family members or strangers. 

But there may also be people who would really like to have a child but for some reason they don't. For example, perhaps she or her partner may have a health condition which makes it difficult or impossible to conceive; perhaps she has been pregnant but suffered miscarriage or stillbirth; perhaps she had one or more children who have now died; perhaps she has gone through a divorce and not been given custody of her children; or perhaps her children have been taken into care because she was an inadequate parent. These are not likely to be topics of conversation which someone is happy to explain to strangers, and it is understandable why someone in one of these situations would hate being asked whether they have kids, and I have every sympathy for these people.

"I just get so upset when I think about the rain"

However, anything can be a touchy subject: any question which someone asks to another person in the process of small talk could potentially be upsetting. For example, suppose I strike up a conversation with a woman about the weather, complaining that it's raining again - this may seem to be an innocuous conversation starter, but she may find the conversation upsetting for some reason. For example, perhaps her partner is a meteorologist and she is just discovered he's been cheating; perhaps her daughter slipped when it was raining and fell under a bus and was killed; perhaps she is on the way to her sister's wedding and the rain is going to ruin the day; perhaps when it rains she is reminded of the time she was raped in the pouring rain; or perhaps she was talking about the rain when her mother had a stroke and has been institutionalised ever since. Any of these could be the case, and this could mean that my chatting about the rain upsets the person I'm talking to. However, the mere possibility that someone may be upset by talking about the rain should not preclude us from talking about the rain to anyone.

If mere chit chat about the rain could upset people, then it is easy to see how asking someone about their job, or whereabouts they live, or whether they have any pets, could be even more distressing topics of conversation, after all, they may have lost their job, or maybe they're about to have their home repossessed, or maybe their dog just mauled a child to death - who knows? The same can be said for asking them whether they have children. It might upset them, but given that most people are not upset or offended by being asked whether they have kids, it is reasonable to ask the question. I cannot allow the fact that someone might be upset by talking about children prevent me from asking them whether or not they have children. (As suggested above, interrogating them about why they don't have children is something quite different indeed. The why questions are just prying, and imply judgement too.)

The verdict

This hasn't been my most eloquent or philosophically flawless argument, but I think it is intuitively correct: we need to make a judgement about the chance that someone would be offended, versus the opportunity of building a rapport. "How often do you have anal sex?" is quite likely to offend, and minimally likely to build a rapport, whereas asking about the weather is very unlikely to offend, but doesn't build much of a rapport either. "Do you have kids?" is a reasonable way to build a rapport with someone, and although it carries the possibility of upsetting a minority of people, this should not preclude us from asking it - so long as we don't interrogate others about why they do or do not have kids.

Is it wrong to pierce a baby's ears?

In many cultures, it is common for parents to pierce the ears of newborn baby girls. This practice is very ethnocentric, meaning that it is commonplace in some cultures, and unheard of nd frowned upon in others. Some people  claim it is harmless, beautiful, and kinder than piercing the ears of an older child- and others claim it is cruel, sexist, and a violation of consent.

If you'd like to read a range of anecdotes and  viewpoints, see this Quora discussion. Below I examine a range of viewpoints and ultinately conclude that although it is a bodily violation and not medically necessary, it may be culturally necessary in some cultures to avoid bullying.

Wrongness

Many things are wrong. It's wrong to accept d a gift without saying thank you without taking a gift, and it's wrong to put millions of people to death because you don't like their skin colour. Both of these are wrong, but they are not equally wrong. Wrongness is a spectrum, and the above two acts are at opposite ends of the spectrum. If baby ear piercing turns out to be wrong, I'll need to say where on the spectrum it lies - just how wrong it is.

Wrongness comes in (at least) two forms: intrinsic wrongness and instrumental wrongness. If something is instrumentally wrong, it is wrong because of its negative consequences. If something is intrinsically wrong, it is wrong in itself, because of the type of act which it is - even if no negative consequences ensue. For example, we might think that dropping litter is instrumentally wrong because it harms the environment and disgusts people. On the other hand, we might think that lying in court is wrong in principle, regardless of the consequences. Of course, some acts may be both intrinsically and instrumentally wrong. Murder is probably wrong in both ways: it is instrumentally qrong because it upsets people, and intrinsically wrong because it's simply wrong to take a life. I'll show below that altbough baby ear piercing is intrinsically wrong (by a very small degree) it may be instrumentally right in some cultures.

Arguments in favour

First, I'll consider arguments in favour of piercing babies' ears. These are:

1. Babies feel less pain
2. Babies don't mess with their earrings
3. It looks cute
4. Most girls love their earrings
5. The holes stay open for life
6. It helps tell girls apart from boys

Babies feel less pain

The first argument in favour of piercing babies' ears is that babies feel less pain, or that they quickly forget about the pain. As for the first claim, here's a little experiment you can do: lay down a newborn baby next to a child, and an adult. Now, get an object such as a pencil case or water bottle, drop it onto each of them, and see who cries. My guess is that the baby would cry, while the others would not. Indeed, if one were to try a more unpleasant (and possibly illegal) experiment of hitting the people, I think the baby would certainly cry, the child may cry, and the adult would not. So the claim that babies don't feel the pain is totally unfounded.

As for the claim that babies don't remember the pain, this is more plausible. If we had hit the newborn, the child, and the adult, it is likely that 5 minutes after the hitting, the child and the adult would both remember that they'd been hit. Would a newborn baby remember it? There's no way to know. She might not behave like she recalls the pain, but that doesn't mean that the pain has indeed been forgotten. 

If it is true that babies forget the pain whereas children and adults do not, then it would seem to be more permissible to hit a baby for fun, than to hit a child or adult for fun. This seems intuitively distasteful. But this doesn't mean it is wrong, of course. There is not a clear way to ascertain whether babies remember the pain.

Babies don't mess with their earrings

It is important to keep newly-pierced ears clean; that much is certain. Adults with newly-pierced ears are good at keeping them clean, but children (aged 2-10) are likely to mess with their earrings with germy hands, possibly causing infections. Very young babies are not able to control their limbs properly, and couldn't fiddle with their earrings even if they wanted to, so their new piercings are likely to stay cleaner than those done on an older child.

But that alone isn't reason enough to pierce their ears. Amputation of the legs is likely to heal better (and be coped with more easily) when performed on a newborn rather than an older child or adult -- but that alone is not reason enough to amputate a baby's legs! We'd need to have some other (positive) reason to pierce a baby's ears or amputate their legs in addition to babies' advanced healing abilities.

It looks cute

I can understand why people think it looks cute, but I myself do not find it cute. It's not commonplace in the UK to pierce babies' ears, and yet we still have babies and children which are very cute. 

Besides, many things might be cute - surgically grafting cat ears onto a baby's head, or tattooing little hearts onto their bodies, but this does not give us adequate reason to do it. Later on, when I discuss consent, we will see that cuteness is insignificant when weighed against body modification.

Most girls love their earrings

This is probably true. Most girls like to look girly, and the chance to wear sparkly earrings like a princess is undoubtedly attractive to many girls.

But not all girls. Some girls don't want to wear earrings, but by the time they are old enough to object to their earrings, they have already had their ears pierced.

But for girls who don't want to wear earrings, they can just take them out, and the scarring is minimal. So ear piercing on a baby isn't like tattooing a baby, where it is significantly more difficult to reverse the procedure if they don't like it.

The holes stay open for life

Oddly, this is often given as a reason in favour of baby ear piercing. People say things such as "I haven't worn earrings in 10 years, but the holes are still there so I can put earrings in if I want to". This contradicts the above argument - that one can just take out the earrings if one doesn't want them. But the fact that the holes stay there for life is surely a reason to say that baby ear piercing is a lifelong infliction - a reason against it. And yet, proponents of babies with earrings use "the holes never heal up" as an argument in favour of ear piercing in newborns. Counterintuitive, huh?

It helps tell girls apart from boys

Among cultures where baby ear piercing is commonplace (such as Spain and other Latino cultures), this argument is frequently put forward, but it is utterly flawed.

First of all, why is it essential for people to know the sex of a baby? They should act the same way towards the baby regardless of its genital configuration or whether it has small pieces of metal in its ears. Perhaps they just want to know which pronouns to use, so they can say "She's gorgeous" or "He's gorgeous" rather than "It's gorgeous". Fair enough, but there are many cultures where baby girls' ears are not routinely pierced - how do they cope with telling baby boys apart from baby girls?

The answer is this: they dress their babies in gendered clothes such as pink flowery dresses or blue dungarees. Or, if one encounters a baby dressed in unisex clothing, one asks "is it a boy or a girl?", and no one takes offence. 

So this argument - the aid to telling boys from girls - is absurd. One doesn't need to tell a baby boy from a baby girl, but even if they do, they can look at the clothes or just ask - piercings are unnecessary for this purpose.

It's tradition 

This is probably one of the weakest arguments in favour of baby ear piercing. There are many abhorrent traditions involving the ritual alteration or mutilation of people's bodies. Some examples include Chinese foot binding, head binding, female genital mutilation, circumcision, tribal tattoos, and the stretching of the neck.

A tradition is only a tradition as long as people keep practicing it. If a tradition is cruel, outdated, unwarranted, or just plain stupid, then there is no need to keep following it. There is a saying: Who is the greater fool: the fool, or the fool who follows him? It suggests that copying stupid actions is even more stupid than the person who did it in the first place. The practice of foot binding (for girls) in China had been a tradition for a long time, but thankfully, people stopped practicing it, and it is now seen as the vile and unnecessary practice it truly is.

So piercing babies' ears solely because it is a tradition is absurd. We would need a better reason than mere tradition for piercing babies' ears.

Arguments against 

Now let's consider some of the arguments against baby ear piercing. These are:

1. It's dangerous
2. It's sexist
3. It's body mutilation
4. It requires consent

It's dangerous

Earrings can be grabbed and yanked out by the baby themselves, or by other children. They can get caught when removing clothing, or when playing, hugging etc. and when this happens, it hurts. But in the UK, quite a few kids (again, mainly girls) have their ears pierced, and almost all women do. How many people have had an earring ripped out such that their earlobe was actually torn? I would say the number is minuscule. Ear piercing is not dangerous.

It's sexist

Recall the argument above in favour of piercing girls' ears because "it's cute". Why is it only cute for girls and not for boys? The answer, of course, is because we have gendered ideas about what is attractive for boys and girls.

When people pierce a baby's ears, it is always baby girls whose ears are pierced. Very occasionally, one might pierce a single ear of a baby boy, but this is much less common than piercing both ears of a baby girl.

And the reason why it's girls rather than boys who have their ears pierced is undoubtedly because women wear earrings to look beautiful, like princesses and so on. So piercing the ears of a baby girl is a symbolic act which says "I want my daughter to look beautiful". This is highly distasteful, the reinforcement of the idea that girls should look beautiful, with sparkly jewellery, whereas boys should not.

This ethos is unpleasant enough when it circulates among adults, but it becomes more and more grotesque when inflicted on young children and babies. Does a 5 year old need to look beautiful? Of course not, so a new born baby girl certainly does not.

On the other hand, gendered clothes exist for children of all ages, including newborns. If we object to ear piercing among baby girls solely on sexist grounds, we should also object to gendered clothing. It should either be abolished, or it should be acceptable to dress a baby boy in a flowery dress. But many people against ear piercing still think that gendered clothing is acceptable, so sexism alone can't explain the wrongness of ear piercing.

It's body mutilation

Forcing pieces of metal through a child's skin is a form of body mutilation, as is tattooing, circumcision, female genital mutilation, foot binding, and several other (once) common practices. If we object to ear piercing, but not another form of body mutilation, we would have to show that ear piercing is more harmful or less necessary than the one which we accept.

Let's take circumcision, since it is shockingly common. Figures show that over 80% of US males are circumcised, and over 90% of males in Muslim-majority countries. I find this abhorrent and shocking; in the UK, only 4% of males are circumcised, and I can't fathom why anyone would do it to a baby. Given that there is no good medical reason for routine circumcision on babies, I find it sickening and intrinsically wrong that someone would remove part of the genitals of a newborn baby. Of course, people often claim that it's more hygienic (which it isn't), but mostly that it's a tradition - often underpinned by religion. As shown above, tradition alone is no good reason to alter the bodies of babies.

Anyway, since the removal of part of the genitals is far more intimate, invasive, and irreversible than the piercing of the earlobes, it is impossible for anyone to seriously claim that routine circumcision is acceptable but ear piercing is wrong.

Of course, someone might claim that both are wrong, because both are mutilation. This seems true, as they both irreversibly alter the baby's body. However, it is possible to remove earrings, and the remaining ear is very similar to an unpierced ear (there may be a small pinprick still visible). Compare this to circumcision, which irreversibly alters a boy's penis - if a circumcised boy decides he doesn't want to be circumcised, tough, he cannot reverse it, whereas removing earrings will give the person an almost identical ear to an unpierced one. Moreover, when one considers that a man will use his penis for urinating, making love, and masturbating, but a girl will use her earlobes for absolutely nothing, this further shows why ear piercing is far, far less harmful and less invasive than circumcision is.

It requires consent

This is related to the above argument. The suggestion is that body modification is something which morally requires consent, and a child - much less a newborn baby - is unable to consent. Some people even suggest that any touching of the body requires consent. 

This latter claim is reasonable for adults and older children, but is absurd with regards to nonverbal babies and perhaps even all children under 10. Babies and young children need to bathed, dressed, and to have their toileting needs met, but I cannot obtain consent to change my new born baby's nappy - I just change it. The fact that she cannot talk does not seem to be an issue - few if any people claim that I am violating the bodily integrity of my new born by changing her nappy without first obtaining her consent.

Sometimes young children who can speak say they don't want to have a bath or to have their nappy changed, but their wishes should not universally be respected, or they'd be living in filth, which is not in their best interests. Sometimes children's lack of consent should be ignored for their greater good.

This argument works for nappy-changing, but not quite so much for ear piercing, unless we could show that a child's wellbeing would be severely limited as a result of failing to pierce her ears. In somewhere such as the UK, it seems evident that young girls with pierced ears have a childhood indistinct from young girls with unpierced ears. But elsewhere, things may be different.

Recall above that ear piercing is, in Spanish and Latino cultures, used as a shorthand for telling the sexes apart: girls have pierced ears, boys do not. This means that a girl with unpierced ears may be met with confusion or unkind comments, in the same way that a boy who wears dresses may be treated in the UK. This could mean that a girl with unpierced ears could be an easy target for bullies, and this would limit her wellbeing. This alone might be incentive enough to pierce a baby girl's ears.

I said above that traditions are only traditions as long as they keep being practiced, and that is true, but the first few people who break with a tradition may have to be remarkably thick-skinned. Children can be remarkably cruel, and the sphere of gender roles is somewhere that children can bully one another mercilessly. A child who doesn't conform to gender expectations can be an easy target.

A parent might think that baby ear piercing is a silly tradition and that it's unnecessary, but go through with it nonetheless to spare their daughter the burden of being different. If one lives in a Spanish or Latino culture, then failing to pierce a baby girl's ears may be setting her up for a difficult childhood.

Conclusion 

Piercing the ears of a baby girl is invasive and unnecessary. It will be painful to the baby, but she will probably forget about the pain soon after, and the piercings will heal cleanly if the ears are pierced when she is young. It is reasonably non-permanent, and girls who later decide not to wear earrings can remove them and almost no scar is left.

Generally, people should have autonomy over their own bodies, and consent should be obtained prior to invasive procedures or body modification. Ear piercing is a slightly intrusive and momentarily painful procedure, so requires consent (circumcision definitely requires consent). However, we often think it acceptable to give a baby a painful inoculation in spite of the pain or her lack of consent, because we believe it is medically necessary. 

Pierced ears are obviously not medically necessary, and since it is painful and a form of body modification, we can say that it is wrong. It is intrinsically wrong to unnecessarily modify someone's body without their consent, even if no harm ensues. But how wrong is it on the spectrum if wrongness? I believe it is at the end of the spectrum, right next to going to a birthday party without a present. Although I maintain that it is intrinsically wrong to pierce a baby girl's ears, it is only a tiny crumb of wrongness.

It is intrinsically wrong, but, I maintain, it may be instrumentally right, because although it isn't medically necessary, it may be culturally necessary. In the UK it is seen as trashy and oversexualised for a little girl to have pierced ears, so it is certainly not a cultural requirement here. But some places have girls' earrings so ingrained in their culture that having a little girl with unpierced ears is like putting a boy in a pink dress with a bow in his hair. It could be seen as cruel to treat a child in such a way, because it invites confusion and unkind comments from others. So in cultures where it is commonplace for all young girls have pierced ears, it might be best to safeguard girls from bullies by piercing their ears - and probably the best time to pierce them is in the first few months of life, when they heal cleanly.

"They mustn't have had many good submissions" - impostor syndrome and negative assumptions

A couple of months go, I sent off an abstract to a CFP for a conference and this week I got an email saying I'd been accepted/invited to present my work there. "Hooray!" I thought - which was almost immediately followed by the thought "Maybe they didn't have many good submissions." I astonished even myself with my instantaneous self-doubt! "Maybe they're desperate for speakers?" I wondered, and "Maybe their reviewing procedures are biased?" I asked myself as I recalled the double-blind review procedure.

I can, through an act of will - and in defiance of my inner critic - insist to myself "No, my work was selected because it was good, not because they are desperate or careless with their selections", but it does sometimes feel forced and disingenuous to say that to myself. 

Of course, I recognise that my self-doubts are impostor syndrome, plain and simple (but if I recognise I have it, then I realise I'm good, and if I know I'm good then I don't have impostor syndrome!) 

Anecdotally, impostor syndrome seems commonplace among high achieving people. As kids, they see coming second as failure; getting 98% in a test just shows you weren't perfect; and no matter how well they do, still the feeling remains inside them that it's simply not good enough. Does this come from the school system? (I've seen the 'Two stars and a wish' strategy all over the place - ie each piece of work receives two positive comments and one suggestion for how it could be improved further.) I think self-doubt is perhaps reinforced by a school system which of course wants to push children to make progress. If my teachers hadn't reminded me that I needed to put capital letters after a full stop, I probably wouldn't do it now. But it can't be just the school who are to blame, as there are many kids who (outwardly, at least) aren't self-critical. But so often these aren't the kids who are getting 95% and just have a positive self-image; they are the kids who are getting 45% but just don't care that they're doing badly. There really does seem to be a correlation between high achievers and the feeling that one isn't (yet) good enough. 

Some self-doubt and feelings of inadequacy is probably what causes the high achieving - or at least helps it along. I work hard, achieve well, feel like it's still not good enough, and so work harder and achieve more. It's a good recipe for high achievement!

John Stuart Mill (I ❤️ Mill!) wrote that it's better to be Socrates dissatisfied than a fool satisfied. In many ways, it seems to be true - the esteemed but sometimes dissatisfying life of high achievers does seem to be of a higher quality than the satisfaction a 'fool' gets from, say, reality TV and beer. I'd hope that achievement and happiness are not mutually exclusive, but if they are, then for my son I'd choose happiness over achievement every time. 

But what of my own impostor syndrome? Well, I suppose I really ought to heed the advice I've given to various kids about taking pride in your achievements and accepting praise and compliments with good grace. So I'll say this (even though it feels boastful and forced): if I've been chosen to speak at a conference, it's because I'm good enough to do so. I'm awesome!!

Stop the books about child abuse

Wander around a bookshop and it won't be difficult to find masses and masses of books about child abuse. Amazon even has a specific section dedicated to books about child abuse! I think "A child called it" was an early pioneer of this genre, with its black and white photo of a sad-looking child and its provocative title, it became a bestseller. Since then, hundreds of child abuse books have followed. Many follow the example of pale backgrounds, washed-out photos of sad-looking children, and provocative or disturbing titles like "A special place" "Stop, Daddy, stop" and "Our little secret". These books are obviously flying off the shelves, because each year, yet more books about child abuse pop up, ready to be consumed by people who enjoy reading about child abuse.

Am I the only one who finds this disturbing?

Child pornography is illegal. You wouldn't find it on the shelves at eye level in Asda, nor would there be a whole section dedicated to it in Waterstones - and rightly so. People who abuse children are the scum of the earth, and people who want to look at images or videos of child abuse are a pretty close second. So why is it seemingly perfectly acceptable to read about child abuse in graphic detail? People wouldn't buy their grandad a subscription to a child porn website for Christmas, so why do they buy their granny yet another book which describes child sex abuse?

Below I consider and reject several possible reasons for thinking that looking at child pornography and reading about child abuse are morally distinct. Perhaps we should stop short of making these books illegal, but I do think we should stop these books from adorning the shelves in bookshops, and carefully monitor people who buy or read such books.

It's not all sexual

OK so not all books about child abuse are about sexual abuse; most are "merely" about emotional and physical abuse, and neglect. But some books are about sexual abuse, and those are my main targets in this post.

And as an aside, although there might not be a specific law against watching people beat, torture, kill, emotionally abuse or neglect their children, we might (rightly) think that people who enjoy watching these things are doing something morally troubling, if not wholly wrong. Yet we seem to think it's fine for people to read about all these types of abuse: Why? Some possible reasons are discussed below.

Visual / literary medium

Firstly, child porn is visual, whereas child abuse books are literary. Perhaps we differentiate between them because we think it's wrong to look at abuse, but OK to read about abuse? This is probably a distinction that most people do make, but without good reason.

Suppose there was a website where paedophiles share stories about the sexual things they've done to children (sadly, such websites probably do exist). If a person were to spend an evening reading the stories on such a website - but without looking at any pictures - I think we would view this person as morally bereft, and almost as bad (if not just as bad) as someone who looks at child porn. So this makes me think that it's not just about the distinction between the visual / literary medium.

The author

So if it's not the visual/literary distinction, then maybe it's because most child porn is created by the perpetrator, and shown from the position of the perpetrator, whereas child abuse books are told from the point of view of the victim.

Or at least, that's what we're supposed to think. How many readers really check whether the author of a book is the victim? Perhaps some authors of child abuse books are actually perpetrators, retelling the abuse they've committed from the point of view of their victim. Or perhaps the stories are fictional, the author detailing their appalling sexual fantasies in literary form. I imagine that at least some of the child abuse books on sale are as a matter of fact written by paedophiles. Still think it's OK to read these books?

What if it turns out that some child porn photos / videos are shared online by the child themselves? This wouldn't be enormously surprising, given that 'sexting' is a thing among tweens and teens: they share pictures of themselves naked or performing sex acts on snapchat, whatsapp, and other platforms. But surely we wouldn't think that it's OK for someone to view these images of child porn simply because the child (even if they've now grown up) was complicit in the sharing of the images? Someone who shares images of themselves being on the receiving end of child sexual abuse is (as far as the law is concerned) just as guilty as anyone else who shares images of abuse.

So if some books are written by paedophiles, and some child porn is shared by the victims, then the "who is the author" argument doesn't help us to distinguish between the morally acceptable and the morally unacceptable, if we're wanting to show that books are permissible but images are not.

Why people read / watch

So maybe the reason we distinguish between child porn and child abuse books is because of the reasons why people read or look at them. I think the assumption is that people (usually men) who look at child porn photos and videos are doing it for sexual excitement and gratification: they find the images arousing. Whereas the assumption with child abuse books is that the people (usually women) who read them are reading it with sympathy and horror; they come away from the book thinking how terrible the abuse was.

But suppose that someone who reads a lot of child abuse books with sadness and horror decides to start looking at child porn with sadness and horror too. Suppose they go online and seek out horrible videos of child abuse and rape, and they sit there watching them feeling sad and disgusted with what they're seeing. I think we'd see such behaviour as decidedly odd, if not wrong and  criminal. We'd say "you shouldn't look at child porn, even if you're looking at it in sympathy".

And suppose a paedophile enjoys reading the child abuse books for sexual gratification. Suppose he sees the books as a way of indulging his sexual fantasies in a legal way. Suppose the rape and abuse scenes in the child abuse books are so arousing for him that he masturbates while reading them. I bet some people do do this. I think we would see this as morally troubling that someone would find these books arousing. I don't think we'd just shrug and say well it's fine because it's only a piece of literature, and buy him another child abuse book for Christmas.

This is probably the most convincing of the arguments, but given that we don't know the real reasons why someone looks at or reads about child abuse, it will be tricky for us to distinguish between those who are looking at or reading about child abuse with sympathy, and those who find it exciting. So we revert back to saying pictures-and-videos - bad, books - good.

No legal restriction on books

Perhaps the only reason why we feel that looking at photos of child abuse is wrong (but books about child abuse are fine) is simply because the former is illegal and the latter is not.  Those who look at child abuse pictures do so in secret, in their own homes, through untraceable proxies. They keep it secret from family and friends, and if they are caught with all that child porn, they'll be prosecuted. It's not socially acceptable to sit on a train watching videos of child porn. Whereas reading child abuse books is legal; people who read them don't need to do so in secret, and if the police discover that someone owns a lot of child abuse books, nothing happens. It's (seemingly) socially acceptable to sit on a train reading a book about child abuse.

But laws are fairly arbitrary, and change over time and borders. In some countries, (Japan, perhaps?) there are no laws against child abuse (in countries where child marriage is practiced, it is acceptable for a man to have sex with a little girl so long as he is married to her). And there are probably some countries where child abuse books are illegal. If UK laws had been the other way around, and it was illegal to read child abuse books, but legal to view child porn, then would public opinion switch too? I think it probably would. If people secretly went online to read child abuse stories, but child porn magazines adorned the shelves of Sainsbury's, would our opinions switch too? I think they would, and if I'm right, then we are fickle and uncommitted to our beliefs, proving that there is not much of a distinction between child porn and child abuse books; it's just legal precedent and social convention.

All together now

A final possibility is that some or all of the above reasons group together to distinguish child porn from child abuse books. Child porn is visual, illegal, usually created by abusers, and the viewers are (mostly) men who are watching it for sexual gratification. Child abuse books are literary, legal, usually created by victims, and the readers are (mostly) women who are reading it with sympathy.

When put like that, the argument seems more convincing... but if as I've shown above, each of the constituent parts of the argument are unconvincing, then merely adding several unconvincing arguments together doesn't really make it convincing. Five wrongs don't make a right.

Conclusion

It doesn't look like the law or public opinion on this pseudo-distinction between child porn and child abuse books is going to change any time soon. It looks as though, for the foreseeable future, looking at child porn will (rightly) be seen as abhorrent and immoral, but reading about child abuse will (wrongly) be seen as a perfectly legitimate pastime.

Am I the only one who finds this distinction weird? I don't know. But whenever I meet someone who enjoys reading books describing child abuse, I can't help but feel disturbed, and I wonder why they are reading these books. If you ask me, books which describe child abuse in graphic detail should not be adorning the shelves of supermarkets and bookshops, available for anyone of any age to buy, read, and enjoy. I suggest that the readers of child abuse books should be viewed with suspicion, and perhaps even scrutinised by the police.

Kids, peas, and the sorites problem

My son is a picky eater, and not a fan of vegetables, so in order to encourage him to eat a wider variety of food, he has a "super eating" food list. If he eats a food he's not keen on, he gets it written on his list. When he has 20 instances on the list, he gets a (non-food) treat of some sort.

Generally, the list technique is the only thing that has helped him eat a wider variety of foods, but being a child, he does like to push me on it. And today he unknowingly presented me with the Sorites problem with his peas.

Me: "Here's your tea. I've given you some peas; I know you're not all that keen on them, so if you eat all of them they'll count for your list."
Him: "Peas? Ugh! Do I really have to eat all of them?"
Me: "Yes please. Eat all of them."
Him: "But if I left a tiny one then would you still write it on my list? One little pea won't make a difference will it?"
Me: "Hmm, well I suppose if it really is only one pea that you're leaving then yes I guess I'd still count it for your list."
Him: "Because a pea is only small."
Me: "I suppose so..."
Him: "So if I leave two peas then that would be OK too wouldn't it?"
Me: "Well why would you be leaving two peas? Eat them."
Him: "But you said one pea doesn't make a difference, so two peas doesn't make a difference either."
Me: "Eat your peas please. I'll let you leave one, but not two."
Him: "Hmph. Well that doesn't seem fair."

He ate all but one of the peas, and I counted it for his list, but I was laughing a little to myself about being presented with the Sorites problem by my little philosopher in the making.

But next time, I should probably just stick to "Eat all your peas, and don't leave any"!