By Dr Anthony Lewis
Anthony is Chair of Windsor Humanists and Chair of the South Central England Humanists Network. In this article, he argues that the right to control our own bodies is a solid, modern liberal principle. However, the modern tilt towards deference to experts that we witnessed during the COVID-19 pandemic illustrates that we need to reassert the primacy of consent. We should never lose sight of the fact that bodily autonomy is the bedrock of a civilised society.
Note on the title of this article: “Brave New World” (1932) is a dystopian novel written by Aldous Huxley, depicting a futuristic society characterised by technological advancements, social control, and the suppression of individuality and freedom in the pursuit of stability and happiness.
It is a fundamental principle of a civilised society that everyone has the right to control their own body. The sanctity and dignity of every human being is central to the Universal Declaration of Human Rights (UDHR). The right to control our own bodies and the ability to make decisions about our own health are solid, modern liberal principles. The concept of consent lies at the heart of modern medicine and public health practice. However, as the recent pandemic has demonstrated, these individual rights to bodily autonomy are not absolute but are conditional because we are also a social species and we exist in relation to others.
Our individual actions often lead directly to consequences for the safety and security of other people, the environment, and ourselves. Additionally, the natural world often presents serious threats to all of us, such as the recent COVID-19 virus. As a result, society also has an interest in protecting us collectively against such threats, for example by mandating the recent COVID-19 vaccines. Our individual rights are therefore hedged by our collective social rights whilst, at the same time, our social rights must respect the fundamental principle of the sanctity of the person.
Striking a balance between autonomy and public protection
Striking a balance between these competing individual and social rights is not easy, and cuts to the core of many current moral controversies. These include balancing the right to free speech against another’s right not to be slandered, the rights of a woman to bodily autonomy and access to abortion versus the rights of an unborn child, and the rights and wrongs of capital punishment and assisted dying. Where to draw the line varies for each of these ethical issues, and where this balance lies is also continuously evolving as new technology and medical treatments challenge previous sentiments.
Our beliefs and life experiences inform our personal stance on moral issues. Often, for the most difficult moral issues, there are valid arguments on all sides of the debate. This is illustrated in the table above which summarises the arguments for and against capital punishment. The UK population is consistently split on the issue but a YouGov opinion poll found that people are against the death penalty for murder but supportive in the case of the deliberate killing of a child. Despite this finding, the UK government has a longstanding policy of opposition to the death penalty “in all circumstances as a matter of principle”, as laid out in Policy Statement HRC40. I believe that it is important to maintain alignment between changing public mores and public policy, and to secure the consent of a majority of the public. Debate can be fractious, as demonstrated by the ongoing discussion about assisted dying in the UK and the debate on abortion in the USA, but it's necessary in our democratic societies.
Society can override our rights to personal bodily autonomy in many circumstances, including:
Incarceration and even lifelong imprisonment for committing serious crimes;
Compulsory drafting of the able-bodied during wartime;
The death penalty for treason or murder;
The forced commitment of individuals into mental health institutions due to diminished responsibility where they present a danger to themselves or others; and
During a public health emergency the state has the power to close society down and even to confine us to our homes for long periods.
A “Brave New World” ruled by experts and quacks
There appears to be a general trend in modern society towards increasing aversion to risk, which is driven by well-intentioned concerns for public safety, protecting the vulnerable, and improving public health outcomes. An increasing number of experts in the rapidly growing “wellness industry” often campaign to protect people from themselves and the consequences of their lifestyle choices. These experts may be people with genuine “deep” knowledge, experience, and skills in their subject area, such as researchers in universities or practitioners in business or medicine. But often, their expertise can be “thin” and based on ideas which are untethered from evidence, with little robust calibration against real-world data. At worst, it may be just “made-up nonsense”. The spread of homeopathy and similar “pseudoscientific treatments” demonstrates how such unproven ideas can take hold and be very hard to counter once they are established.
Is bodily autonomy being eroding bit-by-bit?
It appears, then, that we are increasingly willing to defer to experts of all types, even self-appointed “thin” experts, as well as those with genuine expertise and knowledge. But could we be ceding too much control to unelected autonomous organisations which often have a narrow focus on specific aspects of a complex area? As a result, are we, over time, eroding bit-by-bit the fundamental principles related to individual bodily autonomy and our rights to control our own body? Is this tendency to defer to experts a good thing, given how many times they have got things seriously wrong in the past? For example, lobotomy surgery to treat severe depression, the forced sterilisation of the mentally-ill, the widespread use of medical “bloodletting” as a treatment in the past for many ailments, or the Thalidomide tragedy. The list of irrational and sometimes catastrophic treatments is a long one. Could we be witnessing the emergence of a “tyranny of experts” which could lead to an authoritarian and dystopian society, like the one described in Aldous Huxley’s famous science-fiction novel Brave New World?
Suspending consent during public emergencies
Given the influence that experts and their computer simulation models now have on public policy, it is imperative that their recommendations and advice are subject to much more scrutiny and informed review and challenge. Especially given the increasing impact their advice is having on our rights to autonomy and to live our lives our own way. I cannot be the only humanist and scientist who was astounded during the pandemic at how a whole slew of significant public health policies were implemented with little evidence about their efficacy or effectiveness in the real world, driven by an emotional media that, in my opinion, verged on hysteria at times. I remain sceptical of the models used to justify the lockdowns, given my experience of using similar simulation models during my career in the energy industry.
“Does wearing the same cloth mask multiple times a day or even weeks at a time provide much benefit to anyone?”
A model is only useful if it predicts real-world outcomes accurately. Models need to be continually recalibrated to actual data with complete transparency about embedded algorithms and underlying assumptions. I suspect that when COVID-19 pandemic data has been fully analysed, the variation in “excess deaths” around the world will turn out to have been driven more by age demographics, population density and inequality, rather than by the length and severity of successive lockdowns, as argued by Sweden’s state epidemiologist Anders Tegnell in the UK's and Sweden's COVID inquiries. I also remain sceptical about the efficacy of wearing cheap masks for a highly contagious respiratory infection such as COVID, given that the evidence of their effectiveness in uncontrolled social settings is equivocal (see the recent review by Linda Geddes, November 2023, below). In clinical settings, they are clearly effective, as medical staff have to adhere to strict protocols on their use. But I am doubtful that wearing the same cloth mask multiple times for days or even weeks at a time provided much benefit to anyone. However, despite my scepticism about some of the policies, I did adhere to all the public health restrictions and I remain fully vaccinated against COVID, as the effectiveness of vaccines is proven.
Authoritarian tendencies
The pandemic has demonstrated how the principles of consent and bodily autonomy can get sidelined during a public health emergency. The various measures were nearly all mandated globally, with inadequate efforts made to communicate the rationale for many of them. Many professionals and experts who challenged the measures found themselves ridiculed or sidelined. The Great Barrington Declaration pointed out that there were alternative approaches, but many of the signatories found themselves ostracised. The UK’s response to the AIDS epidemic in the 1980s, with its focus on engagement with the most affected communities and public education about the risks, was perhaps an example of a better, more collaborative approach, given that it prioritized consent and communication rather than enforcement.
“There needs to be a presumption in favour of the primacy of our rights to bodily autonomy and to control our own bodies”
This modern tendency towards authoritarian control, prohibition, and enforcement is increasingly evident in many aspects of our lives. There are numerous pursuits that give pleasure to many people but are considered unhealthy or dangerous by some. Not all of us want to go base jumping, rock climbing, or even skiing, but society does not prohibit these activities despite their evident dangers. Many adult lifestyle choices are appropriately circumscribed by “age of consent” restrictions, to protect the young until they are deemed mature enough to provide informed consent, such as having tattoos, piercings, or engaging in sexual relationships. And how far should society go in proscribing the behaviour of consenting adults? For example, where should the line be drawn when adults deliberately hurt each other during consensual “S&M” sex acts? Has prohibition and enforcement worked at controlling the use of recreational drugs as part of the global “War on Drugs”? Or has the more educational approach used to reduce the harms caused by smoking tobacco achieved more during the same time period? Ultimately, should we all have the right to decide for ourselves when our suffering has become unbearable to the point where we can take our own lives with dignity and compassion, and of course, with appropriate safeguards in place to protect the vulnerable?
Bodily autonomy is the bedrock of a civilised society
Every society has ongoing debates about contentious moral issues, and not all of them will come to the same conclusions. But I believe that, central to all of these discussions, there should be a clear presumption in favour of the principles of bodily autonomy and consent. I acknowledge that there is a balance to be struck between the need to protect individual autonomy and the need to protect society. However, the modern tilt towards deference to experts and authoritarian control underscores the need for constant scrutiny of all proposals that seek to restrict control over our own bodies. As we emerge from a global public health emergency, we need to reassert the primacy of the principle of consent and not lose sight of the fact that bodily autonomy is the bedrock of a civilised society.
Useful links
UK Government Policy Statement HRC40 - https://www.gov.uk/government/news/hrc40-uk-statement-on-the-use-of-the-death-penalty#:~:text=
YouGov tracker Surveys on Public attitudes to the Death Penalty in the UK 2023 - https://yougov.co.uk/topics/politics/explore/topic/Death_Penalty
Article by Anders Tegnell on Swedens Covid Inquiry in Unherd 2023 - Anders Tegnell’s lesson for the Covid Inquiry https://unherd.com/2023/12/anders-tegnells-lesson-for-the-covid-inquiry/?tl_inbound=1&tl_groups%5B0%5D=18743&tl_period_type=3
Gavi - the Vaccine Alliance - Facemasks catch viruses – so why is the evidence on their effectiveness so confusing? Linda Geddes Nov 2023 - https://www.gavi.org/vaccineswork/facemasks-catch-viruses-so-why-evidence-their-effectiveness-so-confusing
Arthur Dobrin, DSW, is Professor Emeritus of University Studies, Hofstra University and Leader Emeritus, Ethical Humanist Society of Long Island - https://www.psychologytoday.com/us/blog/am-i-right/202201/the-right-your-body
Deferring to authority or experts or ideology - https://forum.effectivealtruism.org/posts/LKdhv9a478o9ngbcY/deferring