What’s Wrong with the World

Of course it's remote material cooperation with evil. That doesn't mean it's necessarily wrong to vaccinate against sexually transmitted diseases. This is a straight-forward application of double effect, and it seems to me that the utility of wiping out a nasty disease is worth partially legitimizing illicit sex. Which is not to mention that HPV can be spread from non-sexual routes as well.

I've had a debate about this very issue. Brehany could have tried to be a little more sophisticated, but IMO the "more sophisticated" version of the argument would also fail. Here's how it goes: "The young person might indeed grow up and marry someone who has the virus. 11 and 12 year olds get more benefit from vaccinations than older people because kids' immune systems are really robust, so if you vaccinate the 11 or 12 year old, you'll get more protection from the virus than if you wait until adulthood to see whether the person is going to marry someone who has been unchaste and carries--or is likely to carry--the virus. So do it now as protection for possible later marriage."

I find this unconvincing. First, while it's probably true that in general children's immune response is especially robust, I'm not convinced that it's _that_ much more robust than the response of a 25-year-old as to make this such an important prudent move at 11 or 12. We're not talking about someone getting married in old age with a positively weakened immune system! Second, it's not known (as it _usually_ isn't known when a new vaccine is introduced) whether a booster will be necessary. Hence, contrary to the claim that a shot at 11 or 12 would protect a young person a decade later right before marriage, it might be wearing off just then and a booster needed anyway. Third, this reasoning seems disingenuous, as we do not apply it to other vaccinations for things people only _might_ be exposed to later in life under special circumstances. "Oh, here, Johnny. When you're in your twenties you might go on a relief group trip to some Third World country, and your immune response at the age of 11 is more robust than it will be then, so we're going to vaccinate you for typhoid now just to get your immune system started working on that matter." Of course not. When there are illnesses which people really are exposed to only on a case-by-case basis, depending on circumstances in adulthood, we wait to see whether they're going to need the vaccine. _Nobody_ would be recommending this vaccine as a widespread thing if the mere possibility of much later exposure were really the "need," and parents need not be vaccinating for that reason.

Without getting into details, the virus can be spread by a variety of sexual acts (here I am not talking about kissing and hand-holding). I saw one article in (I'm sorry to say) Focus on the Family's magazine that felt it was required to mention the fact that the virus could be spread by sexual acts which cannot get a person pregnant as an additional argument to parents. In other words, "See, your teenagers might not 'go all the way', but if they're doing _this_ they could catch it, so..." I thought this was insulting to Christian parents and young people.

Brett, as far as I've been able to discover, the virus strains against which this vaccination is directed are _not_ the strains for what one might call "the common wart" that people can easily catch on hands from casual contact or on feet from, say, shower rooms at a public pool. (So getting this vaccination won't protect your child from ordinary common hand or foot warts. It isn't even that useful.) They are different strains for which no documented case exists of spread of the disease by truly casual contact. Surface contamination transmission has been hypothesized as a bare possibility but not supported as a live possibility. That's why it's considered a sexually transmitted disease, and that's why mankind has never had (as with, say, chickenpox and measles) outbreaks among schoolchildren who are having no sexual contact with one another! Mother-to-child transmission during pregnancy is considered a possibility, but again, the mother has to catch it first, and vaccinating your 11-year-old, who has already been successfully born without picking it up and who isn't going to be exposed now unless he marries someone with it ten years from now, doesn't address that.

Lydia: OK, that's good to know. So it seems that in fact, every (current) HPV vaccination is an act of (at least) remote material cooperation with evil and that it is never or very rarely used completely innocently (e.g., the example of a woman engaged to a repentant rake). Again, though, remote material cooperation with evil can be licit, if 1) the evil effects (legitimization of illicit sex) are not intended and 2) the good effects chosen are proportional to the evil effects produced.

I'm trying to figure out exactly what position is being argued here. Is it that Christian parents should not vaccinate their children against HPV, or is it that children in general should not be vaccinated against HPV?

It's also worth noting the different degrees of legitimization for illicit sexual acts between three different acts of remote material cooperation with evil:
1) I am going to get vaccinated against this sexually transmitted disease because I am weak and may succumb to temptation in the future, and I would like to mitigate the evil effects thereof,
2) I am going to vaccinate my child against this sexually transmitted disease because she is weak and may succumb to temptation in the future, and I would like to mitigate the evil effects thereof,
3) We are going to vaccinate these children against this sexually transmitted disease because they are weak and many of them will likely succumb to temptation in the future, and we would like to mitigate the evil effects thereof.

I have several positions on this:

1) This vaccination, because it is for a sexually transmitted disease, should _not_ be routinely recommended, much less required, for people so young that they are not likely to be getting married at that age. To recommend or require it for people of that age is tacitly to treat sexual promiscuity for teens and even preteens (!) as a normal part of society, and to treat it as such is definitely going to be, in part, a self-fulfilling prophecy. It sends a societal message that we should not be sending.

2) This vaccination, because it is for a sexually transmitted disease, should not even be contemplated by parents heading up sexually traditional homes (these might be Christians, but one would like to think there are non-Christian families heading up such homes as well) for their children. To give it to their children is to insult their children and to introduce to their children, as a live and real option, the possibility that they might "just happen to" be engaging in sexual promiscuity during their teen or even pre-teen years. Part of heading a sexually traditional home is that you teach traditional sexual mores to be accepted and followed *as a matter of course*. You don't say to your children, "Now, this is what I've taught you, but I'm not all that sure you're going to stick to it." That's not the kind of relationship you're setting up among yourself, your children, and your sexual standards.

In essence, we shouldn't be considering vaccinating minors for this disease any more than we would vaccinate minors for syphilis or gonorrhea (if there were such vaccines). To do so is to treat as "just another day at the office" an utterly depraved society in which twelve and thirteen-year-olds are expected to be having premarital sex. That isn't just another day at the office, and we shouldn't be accepting the "they're going to do it anyway" mindset.

It's worth noting that there are at least two reasons why we generally prefer to vaccinate children rather than adults: children are less likely to be exposed to the disease we're vaccinating against, and it's much easier to vaccinate a large fraction of the school-age population. Vaccinating 12-year olds against HPV does not necessarily mean that we expect them to immediately engage in premarital sex. It's also because it's much easier to ensure the population of 25-year olds is vaccinated if we vaccinate them at 12 than if we vaccinate them at 25.

Brett, the point, I think, is that parents who are responsible for the choice with respect to their 11-year-old kid are expected to make a choice that is morally informed, and that means that they understand the proportionate good that justifies an act that is remote material cooperation with evil. If they don't clearly see a proportionate good, then they shouldn't choose the vaccination. If there isn't proportionate good, you shouldn't choose something that is (even remote material) cooperation with evil.

However, I am still a little puzzled about characterizing the act of getting a vaccination as cooperation with evil. As groundwork, let's recall the 3 criteria for a good human moral act: the nature of the act must be good (especially, its direct object), the intention must be good, and its conditions / circumstances must be appropriate. In HPV vaccination, clearly the mere reality of getting the vaccination itself is fine as an act in its own right: a married woman getting the vaccination because her husband has the germs is doing something moral.

Certainly, the choice to get the vaccination can be made specifically with an intention that accommodates desires for illicit sexual activity. If an 18-year old girl goes to her doctor and asks for the vaccination so she can start hooking up, getting the vaccination becomes for her an evil act because of her intention. The nature of the act is OK, but her intention makes the act immoral.

When a parent chooses the vaccination for a child, with a specific intention that the kid be "safe against the disease in the remote future when he / she becomes at risk", the intention itself is not evil. This intention is compatible both with a desire that the kid be safe from the disease during promiscuous sexual activity in teen years, and from the disease later after marriage, and that latter desire is perfectly legitimate. If the intention is generic about "future risk" I don't think that can be called an evil intention.

The problem, though, seems to be that choosing the vaccination NOW, for a problem that is at this time remote, is one of the conditions / circumstances of the parent's choice. And since the choice being made now needs a suitable reason now for it, the promise of a future good that may come to be needs some kind of thread or connection to the now when the act must be justified. It would seem at least problematic to explain the choice now, when the kid is 11, rather than later when he is 21 or when marriage is proximate, other than in terms of the possibility of sexual behavior during teen years when it is immoral.

Finally, then, the parental choice to act now when the kid is 11 cannot be made (morally) apart from a view to possible immoral sexual behavior, and the reality of the vaccination would tend sit as an encouragement for the kid to be open to such immoral behavior - or so the argument goes. Actually, to be more precise, getting the vaccination removes a motivational impediment for the immoral choice of illicit sex. But I see 2 questions springing out of calling this cooperation with evil. First, the motivational aspect of removing such an impediment only comes about when the kid is aware of the nature of the vaccine and what it does. There is no necessity for that: if the kid needs 3 shots for other things, you can easily add a 4th and just say generically: "these are vaccines against some diseases." The kid need never know specifically what he is being protected against.

Secondly, more philosophically, removing something that happens to be an impediment to an immoral act but is not an intrinsic part or effect of the immoral act is not automatically "cooperation with evil", at least that's the way it seems to me at first glance. I don't know if I can make my thought clear, but I will try with an example. Suppose the bank vault has shelves of $20 bills, with some of them seeded with ink packets that are meant to spray on a thief. If a bank clerk comes along and removes the ink packets, he does not perform an action that ought to be characterized as "cooperation with robbery" simply. If he does the act because he is an inside agent of a bank heist gang, then yes of course it is cooperation with evil. But simply removing the ink packets isn't cooperation with evil absent some such circumstance or intention, because the condition "not having ink packets" isn't naturally and intrinsically identical to "inviting thieves", it is a negative condition rather than a positive one. If the clerk does it because he has some motivation that is completely independent of the potential for robbery, he hasn't made a moral error by failing to balance the ratio of that independent good with the evil of permitting the money to be more accessible for thieves. He may have done something _stupid_ by failing to consider additional consequences, but stupidity isn't immorality. There is nothing about packets of money that makes the ink a natural moral component of impediment to evil that must be part of the moral choice.

There seems to be a serious difference between getting a kid the vaccine and, say, giving your teen a package of contraceptives "just in case". The contraceptive only "works" by reason of getting in the way of the normal, natural process of the sexual act, its own internal logic and reality. Thus an intention of "preventing" an undesired outcome, pregnancy, cannot be an intention that is independent of the act as a human act. But getting HPV isn't somehow a natural or normal part of the act of sex (illicit or not), and therefore preparing and executing an impediment to the HPV isn't per se morally connected to the choice of having sex as an intrinsic element thereof.

I could be wrong about this. Maybe I am not analyzing the elements of the moral act properly. But even if I am wrong, I think that Lydia is saying that a broadcast approach that would be applicable for all kids is a morally untenable idea, not that a specific choice for the vaccine in a concrete situation is necessarily a bad idea. For example, if a single mom in the projects is thinking about her 12 year old daughter, and reflects (based on her own experience, and that of her friends) on the probability of her kid getting to age 20 without having been "forced" into sex, (either as out-and-out rape, or as something slightly less violent but the result of a kind of coercion) as being quite a low probability, that would alter the proportionate reason part of the consideration, and giving the kid the vaccine could not automatically be ruled out of bounds as a bad parental decision.

Oh, and by the way, I fully support Lydia's point at 11:32: in a normal household with traditional family habits and customs, there should be no reason to get the vaccine.

Well, Brett, actually, no. We vaccinate for most of these diseases in childhood because there is a high probability that children will be exposed to these diseases if they are not widely vaccinated! That's because diseases like polio, etc., can be picked up by casual contact. Moreover, children are more physical than adults and hence spread disease more quickly and easily than adults.

Because of the issue of vaccinations wearing off, there is a real question about how effectively we insure that "the population of 25-year-olds is vaccinated" by vaccinating 12-year-olds. I addressed this in my earlier comment. This sort of thing is mostly discovered empirically. For example, the series of vaccinations for polio given in young childhood appears to be effective for preventing adults from getting polio. But the young child vaccination for chickenpox, which started to be widely recommended about ten years ago, turns out to require a booster.

See also my comments above about typhoid. Actually, there are _no_ non-sexual diseases that we vaccinate children for that we don't actually think they could plausibly be exposed to before attaining adulthood. I dare you to find a single example. There is no way in the world that public health authorities are vaccinating 12-year-olds for HPV while expecting the majority of them not to be exposed until they are 25. No way.

Oh, and by the way, I fully support Lydia's point at 11:32: in a normal household with traditional family habits and customs, there should be no reason to get the vaccine.

Really? I think you're vastly overrating the control that a family has over a child's behavior. I knew a family from church when I was in high school that was a generally upright, traditional family with high standards and good morals. Eight of their nine children turned out wonderfully: stable and happily married. The ninth is a small-time crook with five children of four different mothers.

I would agree that in a society with traditional family habits and customs, there should be no reason to get the vaccine, but we don't live in and will not in the immediate future live in such a society.

And then we have the externalities. A woman who gets ovarian cancer is likely going to have a six figure medical bill and will certainly have a high five figure one. One way or another we all pay for this.

Two proposals:

1. Parents should have three options regarding vaccination, two of which are: Vaccinate the kid or post a bond that will cover the costs should the child at any point in their life come down with the disease the vaccine was designed to prevent. No exceptions, if they can't afford the bond, the kid gets the shot (I would prefer no exceptions period but we all have to compromise).

2. This conscience thing is spinning out of control in the world's democracies. We have religious fundamentalists in the United States, Europe, and Israel making demands on the larger society that are corrosive to those societies as democracies.

We used to allow for conscientious objectors and Israel made allowances for a handful (I've seen the number 400) of ultra-orthodox Jews. Europe now has a significant Muslim population making demands.

The time has come to walk this back and this issue is a perfect example. It seems to me there are two ways to not send a message. Give parents a choice and allow them to define the meaning of getting or not getting the shot, or, since this is clearly a matter of public health, remove from parents the choice should they decide to remain in this country.

This gets to my proposed third option (A variation of which Israel will soon face if the majority fails to clamp down hard on the ultra-orthodox). Maybe some re-sorting is in order. Being humane, I would suggest generous emigration grants to those who find commonsense requirements intolerable (with Israel Gresham's Law will apply and the more liberal will go elsewhere).

Paul, should you read this, I would ask you to ponder all the elaborate twisting and turning in the comments above that, in effect, justifies the death penalty for behavior that is seen as immoral (making stupid decisions is part of growing up; it seems to me that part of being a good parent is intervening in potentially fatal decisions as minimally as possible). This is why I don't see the value in going off into abstract discussions that only obscure the actual underlying conditions.

The only way to see this is that some people find it acceptable that a certain number of women will die so long as they can get their way.

Brett, here's an interesting question: If that family you know had taken the "they're going to do it anyway" attitude, would they have had eight out of nine children end up in such a happy and healthy situation? In other words, how do you know it wouldn't have been _worse_ had they not treated sexual morality as the norm rather than sexual promiscuity as the norm? We send messages by these things. We really do.

Also, I think you make a mistake when you treat this as chiefly a matter of "control." In a healthy, traditional family the children actually share normal sexual values. Control isn't the issue. I would have been incredibly insulted had my parents suggested that I get vaccinated for an STD at the age of 12 "just in case" they couldn't "control" me. It wasn't like that at all. I'm not saying there were never any conflicts in my family. Far from it! But on these matters, we were on the same wavelength.

I wish we could all make an agreement to ignore Al, trolling as usual. The death penalty. Good grief.

Brett, the point, I think, is that parents who are responsible for the choice with respect to their 11-year-old kid are expected to make a choice that is morally informed, and that means that they understand the proportionate good that justifies an act that is remote material cooperation with evil. If they don't clearly see a proportionate good, then they shouldn't choose the vaccination. If there isn't proportionate good, you shouldn't choose something that is (even remote material) cooperation with evil.

Well, yes. Here the proportionate good is: preventing a deadly disease that is currently endemic in the population with an incidence rate of >80%.

Finally, then, the parental choice to act now when the kid is 11 cannot be made (morally) apart from a view to possible immoral sexual behavior, and the reality of the vaccination would tend sit as an encouragement for the kid to be open to such immoral behavior - or so the argument goes. Actually, to be more precise, getting the vaccination removes a motivational impediment for the immoral choice of illicit sex.

Right, and if the parent's intention is to facilitate immoral sexual behavior, then that is formal material cooperation with evil and illicit. If the intention is to minimize the physical harm from any immoral sexual behavior, then that is remote material cooperation with evil and may be licit if a proportionate reason exists --- which in my mind, prevention of a deadly disease clearly is.

[R]emoving ... an impediment to an immoral act ... is not ... "cooperation with evil".

Suppose the bank vault has shelves of $20 bills, with some of them seeded with ink packets that are meant to spray on a thief. If a bank clerk comes along and removes the ink packets, he does not perform an action that ought to be characterized as "cooperation with robbery" simply. If he does the act because he is an inside agent of a bank heist gang, then yes of course it is cooperation with evil. But simply removing the ink packets isn't cooperation with evil absent some such circumstance or intention, because the condition "not having ink packets" isn't naturally and intrinsically identical to "inviting thieves", it is a negative condition rather than a positive one. If the clerk does it because he has some motivation that is completely independent of the potential for robbery, he hasn't made a moral error by failing to balance the ratio of that independent good with the evil of permitting the money to be more accessible for thieves. He may have done something _stupid_ by failing to consider additional consequences, but stupidity isn't immorality. There is nothing about packets of money that makes the ink a natural moral component of impediment to evil that must be part of the moral choice.

A bank clerk who removes ink packets thereby facilitating a subsequent robbery is cooperating with evil. The type of cooperation depends on his intentions. If he does so intending to facilitate a robbery, then he is formally cooperating with evil, and his act is illicit. If he does so realizing that his actions facilitate robberies but with a different intention, then he is materially cooperating with evil, and his actions may be justified if his intention is to promote a good proportional to the evil of facilitating robbery. If he does so in ignorance of his effects on robberies, he is not culpable for cooperating with the robbery, though he may be culpable for ignorance.

There seems to be a serious difference between getting a kid the vaccine and, say, giving your teen a package of contraceptives "just in case". The contraceptive only "works" by reason of getting in the way of the normal, natural process of the sexual act, its own internal logic and reality. Thus an intention of "preventing" an undesired outcome, pregnancy, cannot be an intention that is independent of the act as a human act. But getting HPV isn't somehow a natural or normal part of the act of sex (illicit or not), and therefore preparing and executing an impediment to the HPV isn't per se morally connected to the choice of having sex as an intrinsic element thereof.

The original article's author answered this correctly: Contraception is an intrinsically evil action that can never be justified. Preventing a disease is not an intrinsically evil action.

I could be wrong about this. Maybe I am not analyzing the elements of the moral act properly. But even if I am wrong, I think that Lydia is saying that a broadcast approach that would be applicable for all kids is a morally untenable idea, not that a specific choice for the vaccine in a concrete situation is necessarily a bad idea. For example, if a single mom in the projects is thinking about her 12 year old daughter, and reflects (based on her own experience, and that of her friends) on the probability of her kid getting to age 20 without having been "forced" into sex, (either as out-and-out rape, or as something slightly less violent but the result of a kind of coercion) as being quite a low probability, that would alter the proportionate reason part of the consideration, and giving the kid the vaccine could not automatically be ruled out of bounds as a bad parental decision.

This is true, the actual likelihood of one's child being exposed to HPV is clearly controlling. If that probability is exactly zero, then clearly the vaccine is not justified. But even in happy Christian homes, in America today, that probability is not exactly zero. Lots of middle-class girls get pressured or coerced or seduced into sex. I was discussing this thread with my wife, and she mentioned that of her high school friends (at an upscale Catholic girls school in L.A in the mid 90s) about half of them were pressured into sex by their boyfriends. She told me one appalling story about a young man who systematically went about seducing one of her friends by posing as an upstanding Christian man who was deeply in love with her, and then after he had successfully seduced her, told her that he had been lying for months and that he was only ever interested in sex. My wife then got to spend several hours along with other friends talking this young woman out of killing herself.

Even good girls make mistakes or get coerced into sex. Mitigating the physical harm --- which, again, is death and mutilation --- that men like that can inflict on vulnerable young women is a good thing, yes, even if that reduces the incentives to avoid immoral sex.

"The death penalty"

Lydia, I understand your reluctance to analyze this is terms of what is actually going to happen but we know a certain number of teens are going to make decisions with which we disagree. We also know that as a result a certain number will suffer injuries of various kinds (I still have the scars).

You want to spin this in a direction that avoids the real question. We currently a a whooping cough epidemic because too many parents have opted out of childhood vaccinations. We have a communicable disease here that can be easily prevented. A certain number of women who get this virus will go on to develop ovarian cancer. If you, knowing this, you still value your "traditions" over doing your part to prevent these deaths, I don't see what other conclusion is possible.

Brett, here's an interesting question: If that family you know had taken the "they're going to do it anyway" attitude, would they have had eight out of nine children end up in such a happy and healthy situation? In other words, how do you know it wouldn't have been _worse_ had they not treated sexual morality as the norm rather than sexual promiscuity as the norm? We send messages by these things. We really do.

I agree with you. Honestly. I wish you would believe me. Vaccinating children for sexually transmitted diseases sends a message that it is possible for those children to catch those diseases, in all likelihood through immoral sexual conduct. Sending that message is a bad thing, because it encourages children to think of that behavior as something they might do. But vaccination also has the effect of protecting children from a deadly mutilating disease that (currently) 80% of the population eventually catches, and those good effects of preventing death and disease significantly outweigh the bad effects on children's morals.

After reading through some medical literature, I have been overstating my case: the 80% prevalence figure is for all types of HPV, including low-risk types that have little medical impact. The prevalence for the dangerous high-risk HPV strains appears to be ~15-30%.

Brett, I'm sorry, but the "80% of the population" statistic just isn't relevant if one is working with a significantly different reference class. I may have very good reason to believe that my children are not representative of the population at large.

I think that here, too, your anecdotal evidence about "nice families" does tend to conflate seduction and rape. Parents need to return to the idea of what is now called "courtship" (though I myself tend to disagree with some of the ideas associated with the "courtship movement," such as that young couples should never be alone *at all*, that one should never look for a mate but should simply "allow God to bring a mate to you," and a few other thing slike that). Now, this involves an overall training of a young woman to look for the right kind of young man and, above all, to take good counsel from older people. Also, yes, to have circumstantial situations set up that make seduction far more difficult if some rotter does slip through the filters. I'm sorry to have to put it this way, but lots of "upscale Catholic girls" just don't have this kind of home setup and background, though it would be better if they did. Plenty of Protestant girls don't either, though it would be better if they did. (This takes us back to Bill's #1 in the main post: 1. "We hope you will, but we don't trust you to refrain from sexual activity.")

I'm going to be honest here: I don't believe the majority of truly well-raised, sensible, sexually traditional girls with lots of parental guidance that they willingly accept are very vulnerable to seduction. But the whole "date rape" phenomenon has tended to obscure the distinction between rape and seduction, and we should be clearer than that.

Obviously, _real rape_ is a different matter, but if you truly live in such drastically violent and dangerous circumstances that it's _likely_ that your daughter is going to be _really raped_, you have more urgent problems than HPV and possible later cervical cancer! As in, your daughter will be lucky to live that long rather than being murdered. Most people simply don't live in such bad circumstances as that.

Now, there's another point here too, Brett: It seems to me that you're setting up "bad consequences" on the one side and "morality" on the other, acknowledging that routinely vaccinating 11 and 12-year-olds for an STD is going to increase the probability of promiscuity, but saying that that's just a matter of increasing immorality which is somehow justified if it lessens the "bad consequences" side.

But this is just the mistake many advocates of sex education also make. Consider: There are _many_ bad consequences of promiscuity, and the HPV vaccine protects against only _one_ of these. There are other diseases, against which there are not vaccines. There is pregnancy. There is emotional misery followed by emotional hardening, and later difficulty forming a stable marriage. Promiscuous young women are not generally happy and healthy young women, even from the most amoral perspective. There was a doctor who worked on a university campus who went around talking about this a few years ago. I don't remember her name. But she was very direct about the way that, as health professionals, they should be speaking to young women about this. She talked about the way that she saw misery and illness caused by sexual promiscuity and yet warning young women against hooking up *for those reasons* was nonetheless taboo.

Now, if you admit that this vaccination will increase the likelihood of sexual promiscuity, think of the other problems you will be increasing on the "consequence" side as well. Even from the utilitarian point of view you evidently want to apply here, it is not _remotely_ obvious that there is a net gain here--a lesson the pro-sex education crowd never seems to learn, as STDs and teen pregnancies spiral.

I was discussing this thread with my wife, and she mentioned that of her high school friends (at an upscale Catholic girls school in L.A in the mid 90s) about half of them were pressured into sex by their boyfriends.

Reason #12,566,987 to seriously consider homeschooling, if we needed still another.

I know Catholic schools. I went there. I know how deficient they have been over the last 50 years. I also know the difference between that and a social environment that consciously, capably, forthrightly knows the evils to be combated and still engages to establish a wholesome environment in which young people can (with high probability) behave with normal Christian integrity (including sexually), I have lived there, too. Passing on your Christian ideals to your children is what it means to be a Christian parent, and is not a nearly impossible thing to accomplish, it is merely difficult, and God's grace accomplishes the difficult in us regularly.

It is not impossible for there to be situations where the moral and physical goods to be expected from giving the vaccine exceed the moral and physical evils to be expected from giving it. But it is by no means a certainty, and parents have a duty to weigh them carefully, taking the relative weight of the goods and evils appropriately into account.

I may have very good reason to believe that my children are not representative of the population at large.

That's true, but the population at large is who we're talking about vaccinating. I thought it was your position that children in general shouldn't be vaccinated even if they are at high risk of HPV?

I think that here, too, your anecdotal evidence about "nice families" does tend to conflate seduction and rape.

It wasn't intended to. It was intended to be an account of a straightforwardly wicked seduction. I don't think forcible rape is very common. I think seduction and coercion are much more common than many think.

I'm going to be honest here: I don't believe the majority of truly well-raised, sensible, sexually traditional girls with lots of parental guidance that they willingly accept are very vulnerable to seduction.

I agree. But truly well-raised, sensible, sexually traditional girls with lots of parental guidance that they willingly accept are a small minority of the population of teenage girls.

Now, there's another point here too, Brett: It seems to me that you're setting up "bad consequences" on the one side and "morality" on the other, acknowledging that routinely vaccinating 11 and 12-year-olds for an STD is going to increase the probability of promiscuity, but saying that that's just a matter of increasing immorality which is somehow justified if it lessens the "bad consequences" side.

I'm not sure what you mean by this. I think I've been fairly clear: Vaccinating children against sexually transmitted diseases is not intrinsically evil, and has both good and evil effects. Therefore, it can only be justified if the evil effects are not intended and the good done is proportionate to the undesired evil effects. The evil effects include legitimization of immoral sexual behavior as well as cooperation with the formal evil done by parents in Bill's category #2 and scandal provided to those who think that you are therefore in category #2. The good effects are the prevention of tens of thousands of cases of deadly and mutilating diseases. In my opinion, that good desired is clearly proportionate to the evil effects produced.

The good effects are the prevention of tens of thousands of cases of deadly and mutilating diseases.

That's a little disappointing, Brett. The rest of my comment went on to address what you have just said. You aren't even considering that increasing sexual promiscuity is probably _increasing_ the incidence of mutilating diseases as well as other negative mental and physical health consequences.

This is relevant to the question of vaccinating the population of children (children!) at large. If you are increasing sexual promiscuity in teens in general by vaccinating teens in general and by the message that sends, you are almost certainly doing more harm than good, even from a consequentialist perspective.

And in any event, it is parents who should be weighing these things up. The whole idea of some committee deciding this for the entire population is a problem to begin with. If these decisions are made by parents, each parent will be dealing with a smaller and more tailored reference class.

If you are increasing sexual promiscuity in teens in general by vaccinating teens in general and by the message that sends, you are almost certainly doing more harm than good, even from a consequentialist perspective.

Alright, well, I think you're wrong. Straightforwardly so, and I think you're getting there by minimizing the actual effects that these diseases have. But I think it's become apparent at this point that there's no zone of agreement between us, so I'm not sure how profitable future discussion is.

And in any event, it is parents who should be weighing these things up. The whole idea of some committee deciding this for the entire population is a problem to begin with. If these decisions are made by parents, each parent will be dealing with a smaller and more tailored reference class.

Ideally, yes. Practically, the children who are most at risk for these diseases are children whose parents are uninvolved, absent, or actively destructive.

Really, Brett? So if you increase the incidence of genital herpes, gonorrhea, syphilis, and chlamydia (just to mention a few that come to mind off the top of my head), that's worth it as "doing more good than harm" if you've decreased the incidence of genital warts? Seriously? That's just listing some physical STDs and not getting into the emotional misery and societal breakdown caused by promiscuity. Death and disease? You betcha. That's what increasing promiscuity gives us.

Oh, and increasing teen pregnancy, abortion, and fatherless children.

To be perfectly straightforward with Brett: when I mentioned 'remote material cooperation' I was speaking in minimalist fashion, because I believe that in many instances the cooperation is in fact proximate or even formal. E.g., the policy activists who militate for the wholesale vaccination of, and dispensing of contraceptives to, the 12 year old population of boys and girls so as to facilitate their right to 'sexual expression' are certainly guilty of this. Some parents too, though I hope not most.

I appreciate his retracting the 80% figure, which struck me as wild, but whatever the real number, another friend points out that individual moral acts cannot be justified by an appeal to statistics, but must be evaluated in their own right.

I also think he misuses double-effect, one of the strictures of which requires that if the actor can "attain the good effect without the bad effect he should do so," and it seems to me that prevention of disease by inculcating virtuous behavior can be achieved. Another is that that "there be a proportionately grave reason for permitting the evil effect." It is not at all clear that prevention of future disease is a graver reason for permitting the act at the cost of increased sexual promiscuity, since contracting a disease is morally neutral while fornication is intrinsically immoral. That is, the former can kill the body while the latter kills the soul. Third, one may not intend the evil effect. This can get psychologically complex, but it seems to me that if you know your act will almost certainly result in promiscuity (as Brett seems to acknowledge), then saying you do not intend such a result might well be a feat of mental legerdemain worth re-examination.

Re Tony's remarks, one thing I left out of the post was this: "The distinction to keep in mind is that getting vaccinated is not in itself immoral, but obstructing the fertility of the sex act is. That is, the act of using a condom is evil, while the act of getting vaccinated is not. However, an act that is not intrinsically evil, but is in fact a good or neutral act all on its own, can be made evil by virtue of the circumstances or intentions under which it is carried out." So yes, an innocent scenario can be supposed, but I imagine these are rather rare.

if the kid needs 3 shots for other things, you can easily add a 4th and just say generically: "these are vaccines against some diseases." The kid need never know specifically what he is being protected against.

I think Lydia answered this in her 12:55 comment. I would personally have a problem with such deceit.

Lydia's analysis of the whole situation is so thorough I can't think of anything to add. Re her concern about the vaccine's effectiveness (which would have to be taken into any double-effect account), I gathered from the article that cervical cancer typically shows up 20-40 years down the road, and that there are serious questions as to its actual effectiveness in achieving what is claimed for it.

Since al is rarely interested in the moral content of individual acts, I'll take Lydia's advice.

And I thank you all for your good comments.

I've just had a brilliant idea to suggest to Brett: Since he considers contracting one of the high-risk HPV viruses to be such a grave public health matter, he should consider advocating strong, abstinence-only education in the public high schools. It might even be worth the alleged "evil" of allowing these to be religiously based, if they would delay the age of sexual initiation and reduce the number of partners. This would have the added benefit, from his point of view, that one wouldn't have to try to calculate the utilitarian "score" of a public health policy that would decrease the incidence of one STD by a means that would plausibly increase the incidence of others! (Surely that's a complex rather than a "straightforward" calculation even for the coldest-blooded of utilitarians.)

Maybe we could get creative and try to think of other ways to reduce sexual promiscuity, like, oh, I dunno, seriously criminalizing pornography and telling the lawless Supreme Court to take a hike. Maybe we could start some even minimal moral censoring of prime-time TV, banning the smut that glorifies promiscuity, including teen promiscuity.

Sexually virtuous behavior, besides avoiding, as Bill has so aptly and eloquently pointed out, one efficient route to the death of the soul, has a great many public health benefits. It doesn't seem to have occurred to our elites for about fifty years even to consider what policies they could engage in to _that_ end. To the contrary: Again and again our brilliant policy analysts have taken _exactly_ the tack Brett is taking: "Hey, so it will probably increase sexual promiscuity, but that's just a _moral_ thing, and it'll decrease bad consequences, so it's worth it." With, ironically, dreadful consequences.

If we're getting this upset and worried now about just the genital HPV viruses alone, to the point that we're willing to go to such great lengths to prevent their spread, maybe we could start thinking outside the box, huh?

I would note here that sales activities for tobacco products that are deemed to target children and young people are illegal. Not so with promoting sex to minors through advertising and television. Indeed, the latter aren't even _looked down on_ or disapproved of by opinion-makers, TV program reviewers, etc., in our society. This is a point that Wesley J. Smith has brought up quite insightfully.

Lydia: I'm baffled by where you're getting the attitudes and opinions you appear to be attributing to me. I'd appreciate it if you'd stop implying that they're mine. For the record: I support abstinence-only sex education, obscenity laws, censorship, and morals legislation. I think the Hayes code was a wonderful thing and that it should be reinstated. None of that is incompatible with also believing that vaccinating high-risk children against deadly and debilitating diseases is a good thing.

Okay, thanks for the clarification, Brett. But the thing is, if, as you acknowledge, this widespread vaccination as a routine matter makes promiscuity more likely by sending a message to young people, then it seems to me you really are committing the same errors in both moral and utilitarian reasoning that are committed by people who don't share your other admirable views.

"Since al is rarely interested in the moral content of individual acts, I'll take Lydia's advice."

Which is fine and, as Brett's side of things is more than adequate for discerning folks, I'll leave you all with two thoughts:

A rejection of a given mode of argumentation isn't trolling.

A non-trivial number of parents are going to have to face their daughters needlessly dying because of a decision they made. I would put not having to be one of them at the top of my list. That may not be high-faluting moral argumentation but I see that consideration as dispositive.

Talk is cheap and things often look way different should things go south,

"When World War I broke out in Europe, the former President led the cause for military preparedness, convinced that the nation should join the war effort. He was greatly disappointed in President Wilson's call for neutrality and denounced his country's inactivity. When the United States finally entered the war in 1917, he offered to organize a volunteer division but the War Department turned him down. However, all four of his sons volunteered to fight in the war. When his youngest son, Quentin, was shot down and killed while flying a mission in Germany, Roosevelt became despondent. Thereafter, although he continued to tour the nation making speeches in favor of war bonds and the war, his mood and voice were less enthusiastic. For the first time in his life, sadness overtook the once unconquerable warrior." Less than a year later TR died.

Now I can see how a young woman who has decided to marry a man carrying the virus because of some debauchery in his past (of which he has repented, swearing allegiance to monogamy henceforth) might have need of the vaccine. Outside of marriage, I don't see the need for it at all.

HPV cannot be tested for in men. The only way to know if you have it is if you show signs of genital warts, which is severely problematic because those strains are a minority of the forms of HPV (and of those strains which cause an increased risk of cancer). Furthermore, HPV can in some cases be transmitted to children by their mother during child birth. That is somewhat rare, but still a factor that needs considering.

A non-trivial number of parents are going to have to face their daughters needlessly dying because of a decision they made. I would put not having to be one of them at the top of my list. That may not be high-faluting moral argumentation but I see that consideration as dispositive.

Everybody dies, al. Daughters will die indeed because of the decision (or ignorance or apathy) of their parents AND also their own decision(s) to be promiscuous (and/or the decision(s) of their lover(s) to be promiscuous) AND also their failure to die from some other disease beforehand AND also just dumb luck AND also perhaps even because a butterfly failed to flap its wings in China.

Promiscuous young women are not generally happy and healthy young women, even from the most amoral perspective. There was a doctor who worked on a university campus who went around talking about this a few years ago. I don't remember her name. But she was very direct about the way that, as health professionals, they should be speaking to young women about this. She talked about the way that she saw misery and illness caused by sexual promiscuity and yet warning young women against hooking up *for those reasons* was nonetheless taboo.

Lydia, I think you are referring to Miriam Grossman, who wrote the book Unprotected about what you describe.

http://www.miriamgrossmanmd.com/

A non-trivial number of parents are going to have to face their daughters needlessly dying because of a decision they made. I would put not having to be one of them at the top of my list. That may not be high-faluting moral argumentation but I see that consideration as dispositive.

HPV only moderately increases the risk of cervical cancer and cervical cancer is one of the more easily treated forms of cancer. It's also one of the only forms of cancer that most women are likely to detect in its early stages. The truly poor aside, most women who die from it likely would end up dead because they didn't bother to get an annual check up with an OB/Gyn.

Yes, J.W., that was it.

"HPV only moderately increases the risk of cervical cancer..."

Which is one way to view things. Looking through the other end of the telescope we find that ~90% of cervical cancers are the result of a HPV infection. This means ~12,000 cancers with ~4,000 deaths annually.

"The truly poor aside.."

While vaccinating for infectious diseases provides for individual immunity, it can also lead to herd immunity should enough of the target population acquire individual immunity. That leads to a couple of obvious observations.

Any moral calculus needs to factor in an individual's responsibility in achieving that herd immunity. Folks with the knowledge and means are able to make a decision that not only protects themselves but also protects those who lack the means, knowledge, or sense of responsibility to protect themselves. In the case of something that can lead to cervical cancer this also means protecting the unborn as treatment that leaves a woman able bear children does seem to increase the likelihood of late term miscarriages. While concerns as to any "message" that might be sent by vaccination are speculative and risk involving projection, the herd immunity factor is real and based on actual science. Thjat would seem to give it considerable weight.

The other insight gained is that claims of conscience are an optional luxury granted because the costs of denying them far exceed any benefits derived from an universal mandate.

Another thought. Even if the vaccine is only effective for a number of years before a booster is needed, those years are the ones in which an individual is likely to engage in risky behavior. True promiscuity is an emotional dead end and most folks don't make it a lifestyle.

(A word to the wise: Things may have changed, but back when I was a kid, the parents were always the last to know and finding out almost always involved another angry parent, a call from the school, hospital, or local constabulary (except for that one time with the FBI) - "heartfelt" confessions were always an attempt at preemption and damage control.)

The promiscuity argument bites the dust. Via Sullivan and the NYT,

"Results

HPV vaccine initiation was higher among those aged 15–19 years than those aged 20–24 years (30.3% vs 15.9%, p

http://www.ajpmonline.org/article/S0749-3797%2811%2900733-1/abstract

The promiscuity argument bites the dust. Via Sullivan and the NYT,

"Results

HPV vaccine initiation was higher among those aged 15–19 years than those aged 20–24 years (30.3% vs 15.9%, p

http://www.ajpmonline.org/article/S0749-3797%2811%2900733-1/abstract