Practitioners' First Choice
Practitioners' First Choice

Should public health decisions, like vaccination requirements, be voted on by the public?

Dr. Uche:

At the risk of sounding like an autocrat, I’m going to say NO.

Even as a medical doctor I don’t feel like I’m qualified to vote on many public health decisions. Public health, epidemiology etc are very specialist areas and quite frankly the burden of knowledge needed to make educated decisions in these fields is extremely high. Furthermore, that wouldn’t change the polarity of outcomes…just look at Cov-19. The public and the pros have disagreed vehemently among their peers.

I think it’ll be preposterous to have the public vote on public health decisions a la the Brexit Referendum. You could, however, convince me that we could add an extra layer of voting in picking the officials that we entrust with the power to make these decisions. I think after the global pandemic it’ll be fair to say that people wouldn’t mind selecting key individuals to shepard our health outcomes. 


So as a former health policy analyst working in US and global health I can say with both confidence and irony that public health decisions should be voted on by the public.

Being on the inside, it is a bit eery how much influence a small group of highly educated, usually wealthy individuals have over global public health directives. A handful of unelected PhDs holding decision makers create “evidence-based” policy for entire populations of people who are legally forced to comply. This doesn’t sound very democratic to me.

Domestically, citizens should have more say over policies that affect their access to certain public resources like public schooling, transport and sanitation laws. Further, any funding that goes to global health initiatives abroad should be consented on by the public who often don’t know their tax payer dollars are going to fund the health systems of other nations abroad. Be that the laws or the officials themselves, elections over public/population health matters should be occurring regularly.

Tooch (Guest):

In a post-covid era, to some, having the public vote on health decisions may sound like a utopia, however, in reality it is a suboptimal solution. Here’s why.

During the onset of the pandemic, we needed a fast response – quick action. Whether you agree with the mandatory mask or quarantine rules, we can agree that the decision was made quickly. Had these decisions been sent to a public vote, how long would it take to reach a decision? Too long.

Public votes have the potential of increased chaos, as it essentially gets turned into an election – not to mention, at large, I’d say the public have a better understanding of economics than they do human biology. What this gives rise to are ‘big voices’ – individuals of the general public with specialised knowledge who can garner, then manipulate mass attention. Why is this bad though? Well, much like how it works now, whereby ‘big pharma’ influences legislation to protect and perpetuate their bucks, in a public vote landscape, big pharma will quickly identify the big voices and pay them to push their narratives. Manipulation ensues…

The ‘big voices’ of the general public have less responsibility than the gov, and no international reputation to protect, therefore, they are likely to compromise their ethics in the info they spread, if the price is right. What do they care?

So revisiting the covid vaccine and mask wearing, if it were down to a public vote, would the results be any different? Unlikely.

Our Guest contributor for this blog was Tooch! Check out his Tik Tok and Twitter @PolyTooch

*Disclaimer: All opinions expressed on this platform are those of the individuals and not representative of any particular institution. This is not to be taken as medical advice.


2 Responses

  1. Great read! Definitely not a clear cut yes/no. Really really interesting takes on such an important topic. Thanks all!!

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