I have been a fan from the moment I saw you play quarterback for the Cal Bears. I was at a daughter-father weekend at the University of Illinois in, I think, 2003, or 4. My daughter got tickets and we watched you pick the Illinois defense apart. Your skills were so striking that the Illinois fans, stunned after the loss, talked about you rather than their team.
I have remained a fan of your football gifts since, but also your demeanor as a team leader. When you speak after a game, you praise your team. You talk about the “line’s protection” or how open Randall was, and how the team made your job easier. You take responsibility when you don’t play your best, but never have I seen you disparage the players with whom you share success.
I decided to write this letter after seeing what has happened since your COVID-19 diagnosis. I think you made a mistake regarding vaccination, but I think you made an error due to a mistaken understanding that others are also making. There is a conceptual issue at stake and I assume, humbly, that you did not know about this issue. That conceptual issue has to do with under what circumstances can an individual make their singular decisions.
I am a physician trained in decision-analysis. Most who study decision-analysis spend their time on policy decisions. I, on the other hand, focus on the process of informing a person about a decision they must make, and then work with that person to help them make their own choices. I don’t give out decisions, I help people make their own.
The process, however, must be one in which the person can know the potential consequences of their choice before making it. To make a decision a person must compare options and learn the potential added benefit of one option over another, while, simultaneously, learning the potential added harm. The balancing of these potentials is a person’s right, and job. Only an individual can know if the value to gain with benefit is greater than the value that may be lost should they be harmed.
For informed decisions there are, then, requirements. First, the numeric amount of added benefit and added harm must be known. If these are not known, informed choice is impossible. Second, and crucially, the consequences of the choice must be born by the person, and no-one else.
Examples of informed choices abound, but a common example is the choice to have surgery or not for prostate cancer. Surgery adds benefit, the chance of dying of cancer is reduced about 2% over 10 years, but the complications associated with surgery, if they occur, reduce quality of life. One harm, for example, is impotence; there is at least a 40% increase with surgery. The balance, then, is whether the value to gain of 2% is worth the value to lose of 40%. Note, too, that only the person will reap or suffer the consequence of the choice for surgery. This is a tough decision, and only an individual can make this trade-off.
However, if neither the numeric added benefit or harm is known, or if the consequences of an individual person’s choice affects others, informed, individual decision-making can’t occur. The decision for vaccine is an example. I could not inform you of how much numeric benefit you may get from the vaccine, for sure, because the studies are not good enough to know. In the better studies, we know the likelihood of transmission of COVID goes down, but serious outcomes, like death, are hard to estimate with the types of data we are getting. Also, I could not inform you of the harm, as we are in the infancy of knowing about these vaccines. I can tell you, only, that there are far more people getting COVID and getting sick from the virus than are getting sick from the vaccine. But, that is not good enough information to fulfill the requirements of making informed, individual choices.
Also, the consequences of a single person’s choice for the vaccine do not fit an informed-person-decision-making-paradigm. As an individual, my decision to take a vaccine will affect the likelihood of the disease for others. I am not a single agent for this decision, so I have to think of the “team” during my choice. There is a social consequence that must be considered above and beyond my preferences. Making a decision for a vaccine, as the quarterback of the Green Bay Packers, is not an informed individual’s choice, it is a decision that must be considered in light of others on the team. By choosing to not be vaccinated, it is as if you decided to face the opposing team on your own, without your line, or Randall on the field. This is not a good football play.
To be clear, I forgive your choice. I am not here to disparage. In fact, I think you have done us a great service. Given your stature in the game of football, your choice, your open discussions, the consequences you personally faced, and the consequences to your team have exposed, in my view, the confused social construct we have followed for the COVID pandemic.
I hope this letter sheds a different light on the consequences of your choice, and the requirements for informed individual’s making choices versus “all of us making decisions for the rest of all of us”. I don’t think you were thinking about the decision in the light it deserved, and more importantly, warranted. I hope that someday soon I will see you back at the podium focused, again, on your shared participation with the team, and with those who love to see you play.
Sincerely,
Your Fan,
Bob
1 thought on “When can individuals make decisions only for themselves? A letter to Aaron Rodgers.”
Very nice!!!!