COVID-19 vaccine hesitancy, chemical retraumatization, and madness

Abstract

Protecting the Section 7 autonomy rights of Canadian consumers/survivors/ex-patients and the mad (c/s/x/m), as enshrined in the Canadian Charter of Rights and Freedoms, with past experiences of enduring intrusive procedures forced upon them, to decline immunization against COVID-19 is a mad liberation issue, to which Mad Studies must not shut its eyes. To some c/s/x/m, vaccine mandates mirror traumatic moments from their psychiatric past, when they had their autonomy stripped, and their right to legal consent infringed upon by physicians of the mind claiming diminished capacity. In this article, I propose expanding categories of medical exemptions to consider mental health contexts, and accommodations be provided to those with diverging minds who are vaccine skeptic. I conclude with a clarion call to madvocates to stand against the violence of coercing vaccinations.

Keywords:

• COVID-19
• vaccine hesitancy
• Mad Studies
• madness
• chemical trauma

Several members of the Canadian consumer, survivor, ex-patient and mad (c/s/x/m) community I hear from and peer support have genuine concerns with mandatory SARS-CoV-2 (COVID-19) vaccinations. However, there are no published studies on the attitudes of persons labelled as ‘mentally ill’ regarding immunizations against COVID-19 (Mazereel et al. 2021). COVID-19 is a communicable virus that directly and indirectly affects the immune and respiratory systems of the afflicted.

Historically, members of the c/s/x/m community have had their rights to informed consent trampled upon regarding medical treatment (Ontario Human Rights Commission 2014). In Canada, one reserves the right to refuse or consent to medical treatment in the interests of exercising bodily autonomy (see Section 7 of the Canadian Charter of Rights and Freedoms). As it applies to the vaccine hesitant, this charter right is currently under assault. Many higher education institutions and workplaces (including the Government of Canada) are now mandating that students and workers provide proof of full vaccination status or exemption status. If they do not, they risk removal. The Government of Canada has been stringent on what counts as a medical exemption: an allergic reaction to a chemical component in any one of the four approved vaccines, or myocarditis or pericarditis, a rare heart inflammation disorder, from having taken an mRNA COVID-19 vaccine. In either event, the person is exempted from taking a specific vaccine or receiving a second/third dose. Physical medical exemptions alone are being considered, excluding mental and cognitive reasons for exemption. Sanism is reinforced here by privileging those in physical ill-health over those with psychotic or delusional disorders. Disability support services in universities do not support mad students’ exemption claims on mental health grounds, nor offer accommodations to them opting not to comply with mandates. The biomedical model has made a resurgence, insofar as disability services enable the segregation of mad student populations from its university’s neurotypical student body. Those who have delusional or paranoid disorders, or suffered abuses due to medical mandates, ought to be offered exemption from vaccination mandates on mental health grounds and accommodated where possible.

COVID-19 vaccine hesitancy amongst the c/s/x/m community may be fuelled by past psychiatrization and experiences as in-patients, such as: being force-fed neuroleptics, being injected with psychotropics as conditions of court-imposed community treatment orders, or being strong-armed into ingesting a cocktail of pills. Like COVID-19 ‘mandates’, these mandates were imposed on them in the interests of ‘community health.’ Consequentially, they distrust medical mandates, with good reason. To call them anti-vaxxers is disingenuous. They want their Section 7 autonomy rights preserved to choose what enters their bodies free from coercion. For some, the sense of autonomy was never recovered but forever sacrificed at the altar of psychiatry. Some have spent years or lifetimes unchaining their captive freedoms from the medical monolith. Incarcerated psychiatric patients had had their releases threatened or postponed when they refused to undergo life-changing electroconvulsive therapy. These survivors are confronted with a fresh medical mandate that connects the resumption of freedoms to medical compliance. For example, the non-compliant faces the ruinous prospect of losing their hard-fought-for livelihood, e.g. equal educational access is denied, thus disabling their right to earn an income, or wellness and recovery routines such as fitness and physical therapy centers become yellow-taped off and inaccessible to them if they do not provide proof of fully-vaccinated status. I am writing this paper from the subject positionality of someone nested in the mental health consumer community, who is dubious of medical mandates, not vaccines themselves. I sought a medical exemption from my academic institution on mental health grounds. The request was roundly denied, nor was I extended disability accommodations, e.g. that they exempt me from showing proof of my vaccination status. This decision resulted in the institution cutting my Ph.D. funding (by removing my ability to work as a teaching assistant) and threatening to unregister me from the program.

Hesitancy or rational grievances?

The vaccine was granted emergency use and was formulated far more speedily than other vaccines. The accelerated pace of in which the vaccine was developed does not capture the confidence of those with diverging minds who are skeptic of vaccine mandates. Concerns regarding safety are twofold: firstly, the c/s/x/m communities fear being doubly disabled by one of the many impairing side-effects coming to light: such as heart inflammation or paralysis (Public Health Ontario 2022). Secondly, more research is direly needed on the possible interaction between psych-meds and COVID vaccines so that the ‘mentally ill’ can make an educated and voluntary choice (informed consent) (Mazereel et al. 2021). Consumers/survivors and mad people may rely on psychiatric prescriptions for staying well, and taking a pill is routinized into their recovery plan. It is essential to feel confident that immunization will not throw any wellness plans into chaos. Without this critical information, the community cannot objectively weigh the health risks and benefits of taking a vaccine (Mazereel et al. 2021). A legal argument could be made to refuse the vaccine on the basis of not being able to give informed consent under section 11(2)(2) of the Health Care Consent Act (HCCA)) (1996), specifically section (3) because the material risks of vaccinations are unknown to them. The burden to show proof of double vaccination status, for example, to keep active registration in university, would force c/s/x/m to forego their informed consent rights and get jabbed. Those holding out until more studies are available to them have a protected moral and legal right, absence of coercion, “to weigh the safety and efficacy of the vaccine so that they can make their decision,” based on informed consent (Harjee et al., v. Her Majesty the Queen 2021, para. 25).

Some suffer debilitating psychosis when weighing the vaccine’s safety, considerations of compliance, and the subsequent social death of not taking the vaccine. Pre-jab vaccine anxieties stoke a return of psychosis, delusions, and paranoid symptoms and exacerbate existing mental disorders. These symptoms stem from the palpable fear of being injected with a substance yet to be studied in full in our population, and how it will interact with our psychiatric medications. Moreover, these symptoms, and worse, can result after inoculation.

Challenges to legal capacity and involuntary hospitalization

Vaccine hesitancy is conflated with madness. Those who are hesitant are either cast off as crazed conspiracy theorists, or have their concerns mistaken (and misdiagnosed) as a sign of psychosis. Physicians deny the possibility that the resister is well and rational. Sane society makes blanket assumptions about Canadians with psychiatric diagnoses, who happen to be tentative of medical mandates, as in need of treatment, cure, receiving lack of treatment, or are incurable. Presently, psychiatrists are contemplating ‘capacity assessments’ to gauge the decision-making capacity of mental health consumers to determine whether overriding the rights, for instance, of those labelled as ‘schizophrenic’ and forcibly injecting them with COVID-19 vaccines, is justified (Varshney et al. 2021). They may be decried as having a reduced capacity for insight because they may not necessarily agree that the pandemic is a problem (Alkenbrack 2021). Psychiatrists may exploit this as a pretext to intervene and deny ‘schizophrenics’ their legal right to consent. However, the Charter clarifies that “capable adults have the right to consent or refuse to consent to treatment” (Ontario Human Rights Commission 2014, 56). Capacity assessments are being considered to determine if psychopathy informs their hesitancy (Goldberg 2021). Mandating a mad citizen to undergo a capacity assessment further pathologizes the refuser as paranoiac. It again places them in the position of surrendering their autonomy and re-experiencing chemical trauma at the hands of psychiatry. Could the act of resisting mandatory vaccination lead to capacity challenges that result in forced vaccination and one’s choice about bodily autonomy being overridden and body being invaded? For instance, psychiatrists in Ontario may attempt to leverage The Mental Health Act’s (1990) legislative objective of facilitating treatment where incapable individuals are in serious jeopardy of deterioration (see section 15(1.1)). Under section 19(2)(a) of the Health Care Consent Act (1996), physicians can legally make this call if their patient’s condition deteriorates or is likely to, and said treatment would minimize or reduce its rate. While there is no concrete evidence of c/s/x/m being forcibly jabbed against COVID in Ontario, a 13-year-old girl with diabetes was ordered by a Saskatchewan court to be vaccinated against coronavirus despite her not consenting (Olijnyk 2021). She was forcibly injected with the vaccine on the grounds of her disability. Inserting any chemical into someone without their consent is violence (Fabris 2011), no matter how the sanestream media spins it.

The worst-case scenario would be if physicians perverted sections 20(1) to 20(5) set out in the Mental Health Act, R.S.O (1990) to forcibly confine capable, non-consenting c/s/x/m community members to administer a COVID-19 vaccination. Refusing potentially life-saving treatment vis-à-vis the vaccine may trigger apprehensions under section 20 of the Act, where those with known histories of mental illness, who are deemed ‘risky’ and out of their senses, are perceived as posing a threat to self and society, and their involuntary hospitalization is the surest safeguard of protecting society. The danger of being declared incapacitated by an intractable illness, having their autonomy stripped (again), livelihoods threatened, and being chemically straightjacketed parallels their past chemical trauma and psychiatric abuse.

To counter skepticism, Goldberg (2021) proposed prioritizing and rolling out vaccination programs in mental health clinics yet ignored evidence of oppressive experiences in these climes. The authoritative aura of the clinic and medical professionals can coerce the mad into accepting the ‘shot,’ a decision they may regret upon exiting the environs. What are the ethics and human rights violations if care is conditioned on compliance, or if proof of vaccination status is required to render mental health care? The argument for prioritizing c/s/x/m communities to get vaccinated because they are viewed as more ‘vulnerable’ is a strawman claim and contains a eugenical flavor. Giving priority to this community is about assuaging sane society’s fears of the mental Other as infectious and ‘super-spreaders’ that upholds the age-old contaminated-contaminator dyad.

Conclusion

We engaged in the Mad Studies project must avoid slipping into hypocrisy. Although very vocal in cautioning the psychiatrized to distrust psy-systems and medical regimes because of the well-documented harms and forced treatment, the silence from psychiatric survivors and anti-psychiatry on this matter concerns me. In my opinion, present-day medical mandates may retraumatize the c/s/x/m in ways far worse than the initial source of psy-trauma due to the systemic nature of COVID-19 mandates and the public’s wholesale acceptance of them. This human rights struggle ought not to be ignored, as sane society turns a concern for community health into a mad liberation issue. Further concerning is the increase in incidences of depression, suicide, and drug (mis)use and abuse due to lockdowns, and shelter-in-place orders, which have received scant attention in Mad Studies. The moral suasion involved in the government’s coercive tactics to elicit a higher level of compliance to become double vaccinated, or be punished unjustly for non-compliance, is stoking psychological trauma. The mad are presented with an invidious dilemma: comply or else. They either cave into the medical complex’s demands, surrender autonomy and take the jab, which may result in symptom relapse, paranoia of physical chemical modification, negative interaction with their medications, or myocarditis or paralysis. Or, they resist, suffer social death, and face increased isolation. Taking the second option, they risk being deemed incapable and re-experiencing violent psychiatric harm. Toward the laudable goal of containing COVID-19, coercion is creating a mental health crisis among the already psychiatrically-disabled.

Disclosure statement

No potential conflict of interest was reported by the authors.