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Medical Associations Trusted Belief Over Science on Youth Gender Care

By Jesse Singal

Mr. Singal is writing a book about the debate over youth gender medicine in the United States and writes the newsletter Singal-Minded.

American advocates for youth gender medicine have insisted for years that overwhelming evidence favors providing gender dysphoric youth with puberty blockers, hormones and, in the case of biological females, surgery to remove their breasts.

It didn’t matter that the number of kids showing up at gender clinics had soared and that they were more likely to have complex mental health conditions than those who had come to clinics in years earlier, complicating diagnosis. Advocates and health care organizations just dug in. As a billboard truck used by the L.G.B.T.Q. advocacy group GLAAD proclaimed in 2023, “The science is settled.” The Human Rights Campaign says on its website that “the safety and efficacy of gender-affirming care for transgender and nonbinary youth and adults is clear.” Elsewhere, these and other groups, like the American Civil Liberties Union, referred to these treatments as medically necessary, lifesaving and evidence-based.

The reason these advocates were able to make such strong statements is that for years, the most important professional medical and mental health organizations in the country had been singing a similar tune: “The science” was supposedly codified in documents published by these organizations. As GLAAD puts it on its website, “Every major medical association supports health care for transgender people and youth as safe and lifesaving.”

But something confounding has happened in the last few weeks: Cracks have appeared in the supposed wall of consensus.

After expressing concerns about the evidence base in 2024, on Feb. 3, the American Society of Plastic Surgeons became the first major American medical group to publicly question youth gender medicine since its widespread adoption. The organization published a nine-page “position statement” advising its members against any gender-related surgeries before age 19 and noting that “there are currently no validated methods” for determining whether youth gender dysphoria will resolve without medical treatment. (The document also acknowledged a similar level of uncertainty surrounding blockers and hormones, though that’s less directly relevant to the practice of plastic surgeons.)

The next day, the American Medical Association — which has long approved of such procedures — announced that “in the absence of clear evidence, the A.M.A. agrees with A.S.P.S. that surgical interventions in minors should be generally deferred to adulthood.”

These statements were released days after a woman named Fox Varian became the first person to win a malpractice case after undergoing gender transition care and later regretting it. Ms. Varian and her lawyer argued that her psychologist and plastic surgeon in suburban New York, despite her serious mental health problems and apparent ambivalence over her transgender identity, failed to safeguard her by going forward with a double mastectomy when she was 16. (Many gender medicine practitioners and advocates believe that to carefully scrutinize or even explore claims of a transgender identity is to engage in de facto conversion therapy.) The jury’s $2 million award will most likely give pause to hospitals and clinics that continue to provide these treatments without substantial guardrails.

The science doesn’t seem so settled after all, and it’s important to understand what happened here. The approach of left-of-center Americans and our institutions — to assume that when a scientific organization releases a policy statement on a hot-button issue, that the policy statement must be accurate — is a deeply naïve understanding of science, human nature and politics, and how they intersect.

At a time when more and more Americans are turning away from expert authority in favor of YouTube quacks and their ilk — and when our own government is pushing scientifically baseless policies on childhood vaccination and climate change — it’s vital that the organizations that represent mainstream science be open, honest and transparent about politically charged issues. If they aren’t, there’s simply no good reason to trust them.

The most striking finding of the Cass review, a 2024 British inquiry that found “remarkably weak” evidence to back up the practice of youth gender medicine, was the shoddy quality of the professional guidelines for this treatment.

Researchers at the University of York, who provided underlying work for the Cass review, found that rather than being linked to careful, independent evaluations of the evidence, these guidelines relied heavily on other organizations’ guidelines. The authors wrote that this “may explain why there has until recently been an apparent consensus on key areas of practice for which evidence remains lacking.”

A 2018 policy statement by the American Academy of Pediatrics provides a useful example of how these documents can go wrong. At one point, it argues that children who say they are trans “know their gender as clearly and as consistently as their developmentally equivalent peers,” an extreme exaggeration of what we know about this population. (A single study is cited.) The document also criticizes the “outdated approach in which a child’s gender-diverse assertions are held as ‘possibly true’ until an arbitrary age” — the A.A.P. was instructing clinicians to take 4- and 5-year-olds’ claims about their gender identities as certainly true. It’s understandable why the Cass reviewers scored this policy statement so abysmally, giving it 12 out of 100 possible points on “rigor of development” and six out of 100 on “applicability.”

Policy statements like this one can reflect the complex and opaque internal politics of an organization, rather than dispassionate scientific analysis. The journalist Aaron Sibarium’s reporting strongly suggests that a small group of A.A.P. members, many of whom were themselves youth gender medicine providers, played a disproportionate role in developing these guidelines.

Dr. Julia Mason, a 30-year member of the organization, wrote in The Wall Street Journalwith the Manhattan Institute’s Leor Sapir, that the A.A.P. deferred to activist-clinicians and stonewalled the critics’ demands for a more rigorous approach. Dr. Sarah Palmer, an Indiana-based pediatrician, told me she recently left the A.A.P. after nearly 30 years because of this issue. “I’ve tried to engage and be a member and pay that huge fee every year,” she said. “They just stopped answering any questions.” This is unfortunate given that, as critics have noted, in many cases the A.A.P. document’s footnotes don’t even support the claims being made in the text.

The shakiness of the guidelines didn’t matter, though — they were cited numerous times in news accounts and court documents as evidence that the most important pediatric association in the country supported youth medical transition.

In 2020, Republican-led states began pushing in earnest to tightly restrict or ban youth gender medicine. In response, the professional organizations — including the A.M.A., the A.A.P. and the American Psychological Association — wrote a flurry of letters to legislators, amicus briefs and sciencey-sounding documents opposing the bans. These documents routinely exaggerated the evidence base for the treatments in question. There was more talk of consensus: “Every major medical association in the United States recognizes the medical necessity of transition-related care for improving the physical and mental health of transgender people,” explained the A.M.A. in a letter from 2021.

During this same period, a sea change occurred in Europe. FinlandSweden and Britain conducted systematic evidence reviews of youth gender medicine — a much more transparent and regimented process designed to attenuate the influence of human bias. Every such review revealed deep uncertainty about the evidence base, and as a result, the countries that conducted the reviews began more tightly regulating youth gender medicine. (Denmark has since followed suit, and there are some signs France and Norway may as well.) Which science, then, should be trusted? The confident American professional organizations or the skeptical European health care systems? What about when even the professional organizations start to schism?

I’ve been covering this controversy for about a decade from a left-of-center perspective, and I’ve found that anyone who questions these treatments, even mildly, is invariably accused of bigotry. It would be shocking if the professional organizations chiming in on these issues — which, like all such organizations, exist in part to increase the esteem of their members and to enhance their own influence — were immune from such influences. And now that the political winds have shifted radically, with the Trump administration launching an all-out assault on both the practice of and research into youth gender medicine, it seems some of them are realizing they would benefit from appearing a bit more moderate.

Perhaps I’m being unfair. But it’s impossible to know, because these organizations are quite opaque about the processes that give rise to their public statements. They’ve tried to have it both ways: They’ve presented themselves as representing “the science” while sometimes violating science’s traditional norms of transparency and open debate. (Neither the A.A.P. nor the A.M.A. would grant me an interview. The American Psychological Association responded to some of the questions I sent the organization via email.)

The A.P.A. presents a particularly striking case of why transparency is important. In 2024 it published what it hailed as a “groundbreaking policy supporting transgender, gender diverse, nonbinary individuals” that was specifically geared at fighting “misinformation” on that subject. But when I reached out to the group this month, it pointed me to a different document, a letter written by the group’s chief advocacy officer, Katherine McGuire, in September in response to a Federal Trade Commission request for comment on youth gender medicine.

The documents, separated by about a year and a half (and, perhaps as significantly, one presidential election), straightforwardly contradict each other. The A.P.A. in 2024 argued that there is a “comprehensive body of psychological and medical research supporting the positive impact of gender-affirming treatments” for individuals “across the life span.” But in 2025, the group argued that “psychologists do not make broad claims about treatment effectiveness.”

In 2024 the A.P.A. criticized those “mischaracterizing gender dysphoria as a manifestation of traumatic stress or neurodivergence.” In 2025 it cautioned that gender dysphoria diagnoses could be the result of “trauma-related presentations” rather than a trans identity and that “co-occurring mental health or neurodevelopmental conditions (e.g., depression, anxiety, autism spectrum disorder) … may complicate or be mistaken for gender dysphoria.” It seems undeniable that the 2025 A.P.A. published what the 2024 A.P. A. considered to be “misinformation.” (“The 2024 policy statement and the 2025 F.T.C. letter are consistent,” said Ms. McGuire in an email, and “both documents reflect A.P.A.’s consistent commitment to evidence-based psychological care.”)

Along those lines, how did the American Medical Association go from arguing that “forgoing gender-affirming care can have tragic consequences” for “pediatric patients” in its 2021 letter to its present stance that one such treatment, surgery, should be delayed — potentially for many years — as a general matter of course?

If, as I suspect, political forces are the culprit, that would lead to an inescapable conclusion: You cannot automatically trust what these organizations say at a given moment. Not unless they provide a lot more information about their decision-making processes.

Should we trust the science? Sure, in theory — but only when the science in question has earned our trust through transparency and rigor.

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The simple math problem that is not so simple

Recently Jackie O, an Australian radio host made news by failing to answer a simple math question.

What was the question? A bat and a ball together cost $1.10. The bat costs $1 more than the ball. How much does the ball cost?

She answered that the ball costs 10 cents. But this is clearly incorrect; since, in that case, the bat must cost $1.10 since the bat costs $1 more than the ball. But, if that were true, then the two together cost $1.20, $1.10 for the bat and $0.10 for the ball, rather than $1.10.

The correct answer is that the ball costs $0.05 and the bat costs $1.05.

But here is the rub. Faced with this question a vast majority of people provide the same response that Jackie O did; that the ball costs 10 cents. This is because the correct answer that the ball costs 5 cents is far from intuitive.

Before I get to this here are a couple more problems. You will enjoy this column more if you try them first before reading on.

Problem 1: In a lake, there is a patch of lily pads. Every day, the patch doubles in size. If it takes 48 days to cover the entire lake, how long does it take for the patch to cover half of the lake?

Problem 2: Suppose you are running a race. You have just passed the person running second. What place are you in?

For the first problem, the answer is not 24 days as most people respond. The correct answer is 47 days. Since the lily pads double every day, if the pond is half-full after 47 days, then it doubles and gets filled the very next day, the 48th.

For the second one, a common intuitive response is say that you are in first place. But this is not right; if you overtook the person running second then you are now in second place.

These problems, designed by an Yale behavioural scientist, are neither math problems nor are they particularly simple.

They are designed to demonstrate the limits of relying on our intuition.

Every day we are faced with a multitude of decisions; some trivial, some more complex. They range from what to have for breakfast and which suit to wear to an important meeting to which car or house to buy, what type of home loan to take out, whether to sign up for life insurance or to take out the extra super-cover warranty on the new big flat-screen television.

In many such instances, we tend to rely on our intuitions; go with our gut.

The questions above show why this may not be ideal. Very often the answer that is intuitively appealing ends up being incorrect.

In these simple riddles the price of being incorrect is minimal; a minor loss of face.

But when it comes to the bigger things in life like buying a car or a house getting things wrong can be costly.

One can think of our decision making as the result of two processes: System 1 and System 2.

System 1, which is essentially intuitive thinking, operates automatically and quickly, with little or no effort and little voluntary control. System 2, on the other hand, is deliberative and effortful. System 1 quickly gets into action as soon as we are faced with a decision. System 2 on the other hand requires time to engage.

One good analogy is to think of System 1 as an elephant that lurches into action quickly, while System 2 is the rider trying to guide the elephant; this can be done but is not easy and requires practice.

So, when it comes to decision-making should you go with your intuition or should you engage in careful thinking and maybe some research?

The answer is simple. If it is a problem that you have lots of experience with, say, grocery shopping or driving on the motorway, it is fine to rely on your intuition and operate on auto-pilot.

But if it is a problem where you have little or no experience or decisions that we face infrequently, such as buying a house (at least for most of us), then relying on intuition may drive you astray. In this case, it is better to rely on System 2 and careful deliberation.

Jackie O need not feel embarrassed. She has plenty of company. Most people struggle with these questions. It is the way our brains are designed; to come in with an immediate answer that feels feels right in our guts.

These problems are not simple, setting up as they do, a conflict between System 1 and System 2 thinking.

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The good but misplaced intentions of modern slavery laws

Recently we have seen the introduction of a bill that aims to establish a comprehensive legal framework to address modern slavery. The bill is backed by both National and Labour. Businesses with revenue exceeding NZD 100 million are required to “report on how they identify, address, mitigate and remediate incidents of modern slavery …within their operations and supply chains.” The bill “creates offenses for failing to meet the reporting requirements”.

Many commentators have focused on the additional compliance costs created by this law. Modern supply chains are complex and transnational. Identifying the presence of forced labour in some part of that supply chain is virtually impossible.

But more importantly laws banning particular practices are often not effective in achieving those goals and in some cases, as I argue below, may be counterproductive. . As the former World Bank Chief Economist Kaushik Basu points out, this is an area where “…prescription has outstripped analysis by a wide margin.” 

Problems in defining modern slavery

There are multiple different definitions of modern slavery from bodies such as the UN’s International Labour Organization. These definitions are expansive and many existing work situations in developing countries will satisfy them.  Some practices are clearly illegal, and most countries have existing laws to deal with these, with varying degrees of compliance.  

But other practices are less clear-cut. Consider the work conditions of Indian migrants who (often) take up menial jobs in the Middle East. They have long been subject to the “kafala system” where they are sponsored by and tied to an employer. Changing jobs or even leaving the job (or the country) can only be achieved with the employer’s consent. This certainly qualifies as “forced” labour. (Recently, some countries like Saudi Arabia have moved to eliminate this system. But these initiatives seem motivated more by the fact that the kafala system makes it difficult to attract high quality workers.)

While we may deplore the existence of such systems, the key question remains: why do people willingly sign up for these jobs? It is certainly not the case that people are unaware of the pitfalls. News about worker exploitation under the kafala system is widespread in Indian newspapers. The reason people sign up for these terrible jobs is that, although hard to imagine in the West, the alternatives are often far worse.

Child labour as modern slavery

A key category in the definitions of modern slavery is the existence of child labour. While avaricious businesses may well want to exploit the labour of children, parents do not. The only reason some parents send their kids to work rather than to school is that this is the only way they can guarantee a subsistence level of income. Note that those who are relatively well-off even in poor countries do not send their kids to work. Clearly children are forced to work when parents do not make enough.

Economist Kaushik Basu notes that, according to the 1851 census, in England and Wales about 37% boys aged ten to fourteen and 20% percent of girls in the same age-group were working.  These high rates of child labour existed despite the main Factories Acts (of 1833 and 1844), which placed curbs on child labour.

What led to the disappearance of child labour was not the Factories Act but the general increase in the standards of living and higher adult wages.

An extensive body of research finds that laws aimed at curbing child labour have often  resulted in higher child labour.

The intuition is not hard to understand. Fines for non-compliance with child labour laws adds to business costs, which often results in lowering adult wages. If those wages drop low enough this creates scope for child labour. For instance, if and when international trade agreements prevent children from working in Bangladeshi garment factories, the children of the needy do not stop working; they go on to more precarious work.

The World Bank recently disseminated a study by a group of American researchers looks at the impact of regional trade agreements (RTAs) on child labour. They find that RTAs that do not include any child labour protections leads to a decline of child labour, especially for 14 to 17-year-olds with corresponding increases in school enrolment rates. This is because RTAs, by opening up trade, lead to improvements in standards of living. However, trade agreements that include provisions banning child labour, actually increase child employment for both young children (under 14 years of age) and, especially, 14 to 17- year-olds. And there is a corresponding decrease in school enrolment for those age groups.

Proponents of such laws mean well. But, in my view, many policy makers in rich nations have little understanding of working conditions in poor countries or how humans respond to incentives. The road to hell is paved with good intentions.

There are certainly ways of reducing child labour in the affected countries such as mandating and enforcing minimum wage laws or subsiding schooling but trading partners passing laws banning this is hardly effective.

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Making the Waipapa Taumata Rau courses optional, rather than compulsory

Ananish Chaudhuri and Brian Boyd

Ananish Chaudhuri is Professor of Economics and Brian Boyd is Emeritus Professor of English, both at the University of Auckland.

Recently, the University of Auckland Senate voted by a three-to-one majority to no longer compel students to study one of a set of Waipapa Taumata Rau courses. Instead these courses will, in most cases, become optional.

Some commentators have lamented this decision to stop making the courses compulsory. A  colleague  wrote:

“So, the idea that first-year students – local and international – might learn a little more about the special nature of this country as part of their tertiary, including professional, learning is, from one perspective at least, part of the growing up of this country into a mature and tolerant society with a rich and varied history.”

Should all students be forced to learn about New Zealand history?

The first year of university education is no longer free. Domestic students paid around $1000 while foreign students paid nearly $6000 for this compulsory course.

Certainly universities force students to take some compulsory courses. But typically these are courses directly related to the students’ program of study. Should all students regardless of their discipline be forced to learn about New Zealand history? Especially given that having to take a new compulsory course means not being able to take another course more directly relevant to one’s area of study? Besides reducing choice, this also has negative implications for a student’s ability to complete their degrees within a reasonable time frame.

A large number of our students are international students who will move onto other countries following graduation. These students are coming here to get a high-quality education that will help advance their career goals. Should they all be forced to learn New Zealand history? This seems debatable. Most universities in liberal democracies don’t compel students to learn that country’s history.

Misperceptions about the resistance to these courses

The feedback from the students has been overwhelmingly negative; yet this feedback was not about an unwillingness to learn about NZ history. The objections related to factors such as lack of coherence and relevance to one’s disciplinary pursuit. Many students pointed out that this is material they have covered in school and is also covered in other courses they were taking.

For a while a petition, signed by thousands of students, circulated asking the university to make these courses optional. Currently, another student petition is circulating, signed by more than a thousand students, asking that the students who have been forced to take this course compulsorily be refunded.

Philosophical objections to the compulsory courses

A key philosophical question relates to the “history” being taught.

Here is a short description of one of those courses. “WTR 100 – draws on place-based knowledge to demonstrate how diverse knowledge systems and Te Tiriti o Waitangi shape perspectives and apply in your discipline.”

The term “knowledge systems” reflects a post-modern view that questions the universality, objectivity and truth of knowledge claims. Instead, knowledge is, to quote the description above, “place-based,” as if there were, say, Australasian truth, North Island truth, Auckland truth, Waipapa Tamati Rau truth, and so on. It proposes that academic (“Western”) knowledge needs to be balanced by incorporating Indigenous perspectives (Māori knowledge, Ngāti Whātua-o-Ōrākei knowledge?).

Each of these courses has a centrally mandated component common across all faculties, as if the place all students share, the campus, determines the relevant knowledge. Why not let the academics and the faculty decide the content of these courses and how they best relate to their discipline?

A related problem: in indigenous thinking, the dividing line between replicable science and testable knowledge on one hand and beliefs and myths on the other is blurry. While there is a concerted push for the inclusion of Indigenous knowledge systems in education in many countries, those within each tradition insist that it belongs only to that tradition and that it must not be contested by outsiders. Why then should mātauranga Mãori be introduced, in our case, across our education system, and as uncontestable knowledge, to people outside as well as inside Māori traditions?

Mātauranga Māori deserves appreciation as a collective creative achievement that uses the narrative imagination and the ecological resourcefulness all peoples have. But why should it be accorded a role alongside science any more than Hindu beliefs and practices (now placed alongside, or ousting, science in Modi’s oppressively ethnonationalist India) or Japanese Buddhism and Shinto (maintained but kept quite apart from science in modern and scientifically prominent Japan) or, say, the “knowledge systems” of the prescientific Britain of 1400 or 1600?

This remains a highly disputed topic, where there is little consensus as of now. Why would you take this highly controversial material and insist on making it compulsory for everyone? The university has done the right thing. Make it optional; those who wish to study this material and agree with or question its philosophical underpinning should be free to do so. The others can study what they are more interested in.

Making the Waipapa Taumata Rau courses optional, rather than compulsory Read More »

Trump may be wielding tariffs but he’s not winning the trade war

A recent New York Times article argues that Donald Trump is winning the trade war. “As major economies fall in line to sign agreements that include the highest tariffs in modern history, the president’s vision for global trade is rapidly being realized.”

Ostensibly this is because EU, Japan and other countries have made peace with 15 to 20 percent tariffs. While these tariffs are certainly lower than what was proposed earlier, they are still much higher than the approx. 3 per cent that prevailed prior to this. These tariffs are also at their highest level since the early part of the 20th century.

In an earlier article I pointed out that those protectionist policies in the years between the two World Wars quite likely resulted in the Great Depression. This time around the results will be less catastrophic because the intervening years have seen the rise the Asian Tigers, India, China and other middle-income countries. Consumer demand from these countries will prevent worldwide stagnation. But the effects will be felt, and in fact are being felt, globally in terms of slower output and higher prices.

Trade deficits are not always bad

Typically, tariffs are promoted as a way dealing with trade deficits. We are importing more than exporting. Foreigners are buying less from us than we are buying from them. This must be bad. This type of “mercantilist” thinking was prevalent between the 15th and 18th centuries but faded away after that as people and countries began to realize that if you can buy something more cheaply from another country than make on your own, it makes sense to do so.  

Often, the cause of trade deficits lies elsewhere. For instance, if lots of foreigners wish to invest in the US market then they will need to buy US dollars. This demand for US dollars pushes up the value of the dollar against other currencies. As the dollar gains value US exports (things Americans sell) become more expensive while imports (things Americans buy) become cheaper. The net result is a fall in exports and a rise in imports, voila, a trade deficit. But notice that this has nothing to do directly with exports and imports. The whole process is driven by foreign investors investing in the US, something that typically increases US productivity and standards of living.

Trade deficits also come about when a country does not save enough to satisfy the demand for investible funds. When household savings fall short of what businesses want to borrow, then the gap is met by funds coming from overseas. The exact same process outlined above plays out, resulting in trade deficits.

Countries like the US that do not save enough to meet the demand for funds from businesses will have a trade deficit. Countries like China that save a lot will send much of that money overseas and will have a trade surplus.

Tariffs have little to do with this and do not address the structural issues behind trade deficits.

The US is not winning

It is also not clear to what extent Trump’s vision, if there is a vision at all, for world trade is being realized.

The climb down from the very high tariff rates proposed back in April were caused by a massive sell-off of US Treasury bonds leading to a fall in bond prices and a corresponding rise in the interest that must be paid on those bonds.

This is putting upward pressure on US interest rates and explains the fight between Trump and Jerome Powell, the Chairman of the Fed. Trump wants interest rates lowered, while Powell is opposed and has held interest rates steady,  in face of rising interest rates on the US Treasury bonds.

In the meantime the Euro has been gaining while the US dollar slides. And while the Euro is probably not going to replace the US Dollar as the world’s reserve currency, that prospect has certainly improved in recent times. Investors are certainly looking more favourably at Europe given the uncertain investment atmosphere in the US. This is not good news for long term US productivity or prosperity.

At the same time, other countries are gradually putting together their own regional groups. There are now ten members of BRICS (which started with Brazil, Russia, India, China and South Africa). Indonesia became a full member in early 2025. There are eight other countries who are on track to become full members.  This group now represents roughly half of the global population and 41% of world’s gross output in purchasing power terms. It is an economic powerhouse, with top producers of key commodities like oil, gas, grains, meat, and minerals.

American is no longer the future.

As I pointed out elsewhere, increasingly America is no longer the future.

The events since Trump’s April 2 Liberation Day have not been favourable to long-term US interests. But I take little pleasure in these developments.

It is highly likely that as the US loses economic influence, China will emerge as the economic hegemon. Since the second World War, by and large the expansion of US economic hegemony was coupled with democratic advances globally. But with China we have a decoupling of economics and democratic values; the idea that economic development does not need democratic institutions, that there is no democratic dividend.  The result will be greater democratic backsliding.

Trump may be wielding tariffs but he’s not winning the trade war Read More »

There is a free speech crisis at our universities

A recent article in The Post by two University of Auckland academics makes three primary assertions. First, there is no free speech crisis at our universities. Second, universities are autonomous and should be “allowed to make this judgment call”. Third, universities should not be forced to “bend the knee to an external agency of the state.”

The authors are wrong on all three counts.

There is a free speech crisis at our universities

I provide three examples that I am familiar with. There are others but this should suffice.  

Readers may be familiar with the Listener Seven controversy. A group of academics from the University of Auckland published a letter in The Listener arguing that while Mātauranga Māori has value, it should not be accorded the same status as science. This is a valid view, certainly not illegal and one that is a matter of academic debate. Despite this, the university’s Vice Chancellor put out a statement that this position contravened the university’s view. The authors were subject to relentless harassment and various ignominies, both big and small.  

The academics who formed Covid Plan B and argued against extended lockdowns were making an academic argument based on the idea that the cost of the lockdowns far exceeded their benefits. Yet many of them were also hounded. One of them, Simon Thornley, has recently taken the University of Auckland to the Employment Relations Authority. According to the New Zealand Herald, “…court documents suggest his complaint relates to academic freedom…”. (Disclosure: I was closely associated with this group but I am not privy to details of the lawsuit.) .

As the journalist Graham Adams has highlighted, recently a Professor of Education was instructed by the University’s Equity Office to change her course outline to indicate that sex is not binary but rather a continuum. Now, whether sex is dichotomous, or a continuum, may well be the subject of debate, but the University’s Equity Office does not have the requisite expertise to arbitrate this. Its attempt to impose its view on an academic matter violates the academic freedom of the instructor.

A group of senior academics including leading biologists pointed out the fallacy in the Equity Office’s position, resulting in an apology to the concerned academic. But this does not detract from the fact that the incident should not have happened in the first place. Many others, especially junior academics concerned with academic progression, choose to accede instead of fighting back.  

Should universities, as autonomous, self-governing institutions be allowed to make this judgment call?

The 1967 University of Chicago Kalven Report argued: a university “…cannot take collective action on the issues of the day without endangering the conditions for its existence and effectiveness. There is no mechanism by which it can reach a collective position without inhibiting that full freedom of dissent on which it thrives. … if it takes collective action, therefore, it does so at the price of censuring any minority who do not agree with the view adopted.”

The university’s Vice Chancellor or Senior Management may have a view and it is fine for them to express that view. Putting the imprimatur of “the university’s view” on the view of the university’s management can and does significantly chill dissenting views. After all, who wants to go against the “university’s view”?

Universities in New Zealand are funded with tax revenue and have to bend the knee routinely

Given their public funding, university autonomy is circumscribed by a multitude of government demands. These include: the extent to which we can raise tuition fees from one year to the next; the size of the government subsidy for domestic enrolments; the size and composition of University Councils; the need to maintain a particular operating surplus; the need to make people redundant if we fail to maintain this surplus; whether and how our international students are treated by government agencies and so on.

The status quo cannot persist

A key problem is that our universities have become excessively focussed on a particular set of social justice goals and these objectives are detrimental to our research and teaching mission.  

Recently, a broad curriculum transformation project at the University of Auckland was overwhelmingly voted down by the University’ Senate, which represents academic staff in what the New Zealand Herald called an “unprecedented revolt.” The protesters disagreed on many issues but were united in the view that academics, not the University’s Executive, get to decide what to teach and how to teach it.

As I point out elsewhere, these events are causing reputational damage and may be a cause for high achieving students leaving for overseas institutions. This has implications for the quality of education we offer and perceptions of New Zealand universities. This is important because universities are key drivers of productivity and are a major source of export earnings.

So, if and when our universities prioritize a particular set of views that are at odds with fundamental principles of academic freedom, when University Executives and Councils routinely ignore protests against managerial overreach, what other option is there than to ask that universities adopt institutional neutrality?

There is a free speech crisis at our universities Read More »

Why are high achieving teens headed overseas and why this is not necessarily a good idea

Part 1: Why are high achieving teens headed overseas and why this is not necessarily a good idea

Part 2: Why going to study overseas, particularly Australia, is not necessarily a good idea

Why are high achieving teens headed overseas and why this is not necessarily a good idea

Ananish Chaudhuri

Ananish Chaudhuri is Professor of Economics at the University of Auckland and the author of “Economics: A Global Introduction.”

  • High achieving teens are heading overseas, particularly Australia, because New Zealand universities are increasingly less attractive
  • Part of this lack of attraction can be attributed to low levels of government funding that severely limit the quality of education our universities can offer
  • This lack of funding is regrettable since universities are the major source of innovations as well as export earnings
  • But part of the lack of attraction comes from excessive managerialism and politicization of our university.

NZ Universities are sidelining academic expertise and failing in their duty of care to students

As I have argued elsewhere, a key part of the crisis facing New Zealand universities is government apathy and underfunding.  We don’t take tertiary education seriously even though it is one of our biggest export earners and typically a key driver of productivity.

But at the same time universities are compounding this problem via greater corporatisation and a lack of trust between administrators on the one hand and academic staff and students on the other.

Faced with funding pressures universities have engaged in cutting front-line academic and professional staff while the number of managers of various types has steadily increased so that at most institutions non-academic staff vastly outnumber academic staff.

University Councils, which are supposed to exercise oversight, have limited academic representation. University of Auckland’s twelve-member Council has a single representative of academic staff on board. Most members are political appointees with little understanding of a university’s core mission.

Dissonance between academic freedom and managerialism

Two recent cases at the University of Auckland highlight this dissonance between university managers and academics.

As the journalist Graham Adams has highlighted, recently a Professor of Education was instructed by the University’s Equity Office to update her course outline to indicate that sex is not binary but rather a continuum. Now, whether sex is dichotomous, or a continuum, may well be the subject of debate, but it is doubtful that the University’s Equity Office has the requisite expertise to arbitrate this or to instruct a senior academic on this.

A group of senior academics including leading biologists wrote a letter to the University pointing out the fallacy in the Equity Office’s position resulting in an apology to the concerned academic.

A second issue, again highlighted by Graham Adams, deals with the introduction of a set of compulsory courses for all first-year students at the University of Auckland, courses that have faced significant pushback from students taking them. A petition asking the University to cancel these courses has been circulating for a while and has been signed by more than one thousand five hundred current students.

According to information available on the University website one such course WTR 100 “…draws on place-based knowledge to demonstrate how diverse knowledge systems and Te Tiriti o Waitangi shape perspectives and apply in your discipline.”

Questions about recent changes to the curriculum

It has never been clear why it should be mandatory for all students regardless of their discipline to learn about the Treaty. Is this knowledge useful for those working in New Zealand? Possibly. But the vast majority of our students will be looking for jobs overseas.

It is unclear how integrated these courses are or can be with other core subjects students are studying; whether they will complement other courses or merely serve as vehicles for delivering a particular worldview.

It is not surprising that these courses have attracted derision as sources of political indoctrination.

Recent initiatives at Auckland University opposed by a majority of academics

Less recognized is the fact that these courses are part of a broader curriculum transformation that was overwhelmingly voted down by the University’ Senate, which represents academic staff in what the New Zealand Herald referred to as a “unprecedented revolt.” To be sure not everyone was objecting to these specific courses, but there was strong opposition to various aspects of the transformation including the hasty nature of their introduction and the potential disruption from these changes to students’ planned program of studies. The introduction of these compulsory courses requires either elimination or at least postponement of other required courses.

The fundamental problem here is that these initiatives are violating academic freedom. They are being implemented with little or no input from the academics who have the most skin in the game. This has resulted in low morale among staff and a loss in our sense of purpose. This has obvious negative implications for the quality of education we are offering and why we are less attractive to students.   

However, having said this, in the second part of this article, I argue that at this point of time at least it still makes sense to study in New Zealand, at least as opposed to Australia since many of the problems afflicting New Zealand universities are universal and the returns on investment from an Australian education may not be higher.

Why going to study overseas, particularly Australia, is not necessarily a good idea

Ananish Chaudhuri

Ananish Chaudhuri is Professor of Economics at the University of Auckland and the author of “Economics: A Global Introduction.”

  • The type of managerialism and politicization afflicting New Zealand universities are present in other countries to a greater or lesser degree.
  • In spite of significant constraints New Zealand universities still provide high quality education.
  • To the extent that students and parents think about the returns on investment from higher education, it is not clear that that an Australian education is superior.
  • In terms of returns, what matters more is the discipline studied rather than the institution.

Political activism has infiltrated educational institutions everywhere

In Part 1 of this article, I argued that New Zealand universities have become excessively politicized. Social justice activism is interfering with academic freedom and the quality of the education that we are offering our students. Negative publicity around this is one of the reasons why increasingly many students are looking overseas. Still, I think at this point of time it makes sense for students to study in New Zealand.

However, we need to recognize that when we talk about high achievers leaving, we are mostly talking about the well-off who have the financial ability to pay overseas tuition.

Parents and students should be aware that the type of managerialism, social activism or problems of low morale that I discuss above are not unique to Auckland or even New Zealand. Arguably New Zealand institutions are affected more given our perennial lack of funding and the thin margins we operate on. But going overseas does not necessarily insulate one from such afflictions.

However, anecdotal evidence suggests that, in spite of this politicization, leading Australian schools are providing a student experience that is better than what is on offer at Auckland for instance, smaller classes and better pastoral care. This is almost entirely due to the fact that the good Australian schools are not hurting as much in terms of government funding as we are. This allows them to offer a better product on the whole.

NZ universities are much more homogenous than systems elsewhere. This is partly because the government uses the same funding formula for all universities here. For many New Zealand  students (and the firms hiring them), there’s not much difference between a degree from Auckland or Otago. Australia likely has more variance across institutions, which means they have a better chance at selling top-tier students on the idea of attending a “top” school, as in the US.

The NCEA system bears part of the blame. The general perception is that it is not particularly rigorous and not preparing students well for university and beyond. As a result, many schools offer Cambridge or IB in addition to NCEA but the former two are very much geared toward an overseas perspective; students doing Cambridge or IB (often coming from more privileged backgrounds) naturally gravitate toward overseas institutions.

Parents and students should still consider studying in New Zealand

By and large, parents and students consider the money spent on higher education as an investment in the students’ careers.

So, for those who have the money, is going overseas worthwhile in terms of returns to that investment?

Studying in the US or the UK, particularly the former remains prohibitively expensive. Consequently, a lot of students are gravitating toward Australia.

Australia is certainly a bigger market than New Zealand but it is still small compared to the US or Western Europe. Even in Australia, many students will eventually be looking for jobs elsewhere in the West or increasingly in the large Asian markets, China, India, Singapore, Hong Kong and South Korea.

It is not clear to me that a degree from (say) Sydney or Monash provides one a leg-up in these markets compared to Auckland.

What students and parents often also fail to grasp is that, by and large, across the industrialized West, the income returns to majors (e.g. business vs. humanities) far outweigh the returns to going to a more selective institution.

Students going to Australia do pay domestic fees, but they are not entitled to Study Link, interest free student loans or one year of free university education.

When you consider the additional expense of going to Australia, I doubt that the returns on investment outperform studying in New Zealand.

Given their very high costs, the same would be true of the US and the UK too.

This may change as New Zealand falls further behind on many measures but at this point of time, studying in New Zealand still makes more financial sense.

—ENDS—

Why are high achieving teens headed overseas and why this is not necessarily a good idea Read More »

New Zealand’s Vaccine mandates create tension between fundamental rights and the common good 

This article was published in The BFD on October 21, 2021.

Ananish Chaudhuri and Simon Thornley 

The authors are academics at the University of Auckland. 

It is widely recognized that the recent vaccine mandates go against s11 of the New Zealand Bill of Rights Act 1990 in providing citizens the right to refuse medical treatment. 

However, it is also clear that the right may be circumscribed in extenuating circumstances on considerations of public health or the common good. 

A recent High Court verdict makes this clear. A border worker sought judicial review of the vaccine mandate for those working in that sector. Ultimately, the High Court came to the conclusion that “the Court’s task in this case is to balance the benefit of the vaccine and the risk of being unvaccinated against any discrimination in relation to those affected”. The court found against the plaintiff and suggested that in this case the public health argument trumps the worker’s individual right. 

But in doing so the court also recognized that the decision was not carte blanche for such mandates. “One of the factors considered by the court was proportionality – the fact that mandatory vaccination was found to be justifiable for a relatively small group of “affected workers”, does not mean that it will necessarily be justifiable for others.” 

This brings us to the broader mandate for teachers and healthcare workers.  

Do they also pass the proportionality test? 

A recent scientific paper suggests that there is little correlation between vaccination rates and cases. This implies that vaccinated people may easily catch and pass the disease on as well. The authors write: “At the country-level, there appears to be no discernable relationship between percentage of population fully vaccinated and new COVID-19 cases in the last 7 days.”  

Further, evidence suggests that children are not at much risk of falling gravely ill from Covid. In fact, the UK Joint Committee on Vaccinations and Immunizations does not recommend universal vaccination of those younger than fifteen. The JCVI points out that while the risks of such vaccination are small, they are still “being described” and the benefits are small too. Given this there is no compelling reason to embark on a program of universal vaccination of children. NCIRS Australia reports  that a majority of children diagnosed with COVID-19 during the current outbreak, including those who caught the infection in educational settings, experienced mild or no symptoms.  

So, who is being protected by these mandates?  

We have two conflicting objectives here: the abrogation of a fundamental right against the rights of those potentially vulnerable.   

If so, then the government needs to be up-front about this and lay out a specific case in favour of this mandate.  

In the absence of such clear guidelines it is not clear why we should be willing to sacrifice a fundamental right. 

We note that in recent times the US Supreme Court has struck down two challenges to vaccine mandates. Justice Sonia Sotomayor turned down a challenge against New York while Justice Amy Coney Barrett denied a suit by students objecting to mandatory vaccines at Indiana University. 

But there are two very important differences. First, while the actual requirements vary, vaccinations are mandatory in the US. All states mandate vaccines against diphtheria, tetanus, pertussis (whooping cough), polio, measles, rubella and chickenpox and all but Iowa require vaccination for mumps.  

Second, the US Bill of Rights does not spell out the right to refuse medical treatment; neither does the 14th amendment, which formed the basis of the challenge by students at Indiana. 

New Zealand does not require mandatory vaccination; not even for measles; which is arguably a far more deadly disease than Covid-19 is. And as already noted, New Zealand’s Bill of Rights explicitly provides citizens the right to refuse medical treatment. 

But there is a broader point here.  

For a long time our government aimed at elimination. This proved elusive. Now they are reaching for vaccination mandates assuming that this will be the panacea.  

What if this next set of vaccinations prove inadequate especially as other mutant strains evolve?  

It is worth reiterating that Covid-19 has a recovery rate of nearly 99% and the overall infection fatality rates and rates of asymptomatic transmission are much lower than previously assumed. Given our lack of land borders and low population density, Covid-19 poses less of a threat to us than has been suggested by modelling that does not account for a host of contributing factors.  

Sooner or later we will need to come to terms with endemic Covid-19. No amount of coercion or abrogation of civil rights will change that fact. Realizing this sooner and making appropriate adjustments in the public health response, such as by increasing capacity in hospitals, will spare the citizens the ongoing pain and suffering from increasingly draconian measures, the latest of which is vaccine mandates.   

New Zealand’s Vaccine mandates create tension between fundamental rights and the common good  Read More »

When are anti-vaxxers not anti-vaxxers? 

This article appeared on The BFD on November 2, 2021.

Ananish Chaudhuri 

The goal of achieving 90% vaccination, if achieved at all, will not happen any soon. Very few countries in the world have achieved this target and most started vaccination efforts much earlier. Scandinavian countries have jettisoned restrictions at much lower vaccination rates. With each passing day the collateral damage is mounting.  

The majority of the those unvaccinated against Covid have been vaccinated for diseases like measles, mumps, rubella, chickenpox, or HPV. They are far from being “anti-vaxxers”. The proportion of true anti-vaxxers, those who are philosophically opposed to any vaccination, is small in New Zealand. Why are more objecting this time?  

First, the government is asking for 90% vaccination of those 12 and over. Yet according to the United Kingdom Joint Committee on Vaccinations and Immunizations (JCVI) there is little reason to call for universal vaccination of those under the age of 15.   

Second, we know that while vaccinations prevent serious illness, they do not guarantee complete immunity. Vaccinated people can transmit the disease. A recent scientific paper suggests that there is little correlation between vaccination rates and cases.  

Covid is not deadly for those under sixty-five, and for those under 50 (in the absence of other health issues) the risk is miniscule. If they fell sick with Covid this group will most likely have relatively mild symptoms. Given that the vaccines are not guaranteeing immunity and that they often come with side-effects, many are making a perfectly rational cost-benefit calculation in foregoing the vaccine. This group includes many young people who are in good health including professional athletes. 

There is a third group that are concerned with the newness of mRNA vaccines. Their fears may well be misplaced but this group is not objecting to vaccines per se, but primarily the mRNA vaccines. This group will be happy with vaccine like Novavax, which his supposed to be as effective as the Pfizer vaccine. Thus, this group is asking for choice rather than being anti-vaccine in general. 

A fourth and final group are clearly objecting to the element of coercion in all of this. The New Zealand Bill of Rights 1990 s.11 does confer upon people the right to refuse medical treatment. The government’s vaccine mandates are seen by many as violating the proportionality rule articulated by the High Court in a recent case. 

It is likely that as the pace of vaccination slows, the government will have to resort to more coercive measures to reach its goal. 

In fact, there is a valid counterargument that the government, in excluding the unvaccinated from many areas of social life, is prima facie discriminating (under s.19 of the Bill of Rights) against a minority that is merely exercising another fundamental right. This issue will most likely be settled in a court of law or if not then in the court of history. 

This is particularly salient given that New Zealand does not mandate any other vaccines; not even for diseases that kill children, such as measles.  

In any event, voluminous social science evidence suggests that there are limits to coercion; it may result in some compliance, but it is hardly conducive to long-term cooperation.  

It also seems that hubris rather than prudent policy making may be at the heart of the current initiative. If so, then this is hardly conducive to good policy making.  

According to news reports, the government has spent $4.8 billion in various support systems since the Delta outbreak in August. This money can be used to undertake a significant expansion of our healthcare facilities. The same is true of the money being invested in maintaining MIQ facilities. With numerous Covid cases in the community and people already being allowed to self-isolate, continuing MIQ seems anathema. This money too can be diverted to more productive use.  

The government could easily amend the goal to include 90% of those 50 and above. This will add very little downside while avoiding significant costs. It will allow us to open up much more quickly.  

Obviously, the risks are higher among more vulnerable communities even for younger people. But imposing a universally high vaccination rate makes little sense. Instead, an alternative would be to emphasize that for those below 50 with other health issues the risk of serious illness is much higher. This requires targeted messaging aimed at those at higher risk.  

But the current approach is creating deep divisions within our society leading to suspicion, distrust and rage. These divisions are going to be detrimental for the same vulnerable communities that the government wishes to protect. The damage to social cohesion will be difficult to repair and will adversely impact our future well-being.  

Denmark has removed all restrictions with 90% vaccination above fifty but 75% overall. Michael Bang Petersen, a psychologist advising the Danish government says that much of this success is due to the Danish government’s willingness to trust the citizens and explain what is being done and why. New Zealand is also a high trust society. The government would be well advised to follow the lead of Denmark.  

When are anti-vaxxers not anti-vaxxers?  Read More »

The questions that judges should be asking with vaccine mandates 

This article appeared on The BFD on December 2, 2021. 

Ananish Chaudhuri and Martin Lally 

Ananish Chaudhuri is Professor of Experimental Economics at the University of Auckland. Martin Lally is Director of Capital Financial Consultancy. 

Vaccine mandates for Covid-19 are proving to be controversial. Consequently, New Zealand’s recent mandates have faced court challenges already and one expects more such challenges to come; particularly since the COVID-19 Response (Vaccinations) Legislation Bill was passed under urgency in Parliament eliciting indignant responses from legal scholars and the Human Rights Commission.  

In this regard, a recent High Court case involving Christchurch based aviation security officers arguing against vaccine mandates (CIV-2021-485-509 [2021] NZHC 3012), provides a foreshadowing of the contours of this debate. In that specific case, the judge ruled against the plaintiffs and in favour of the respondents (the Minister of Covid-19 Response representing the government).  

Voluminous evidence suggests that the vaccines are relatively safe and significantly reduce the risks from covid-19 for many people. Accordingly, it is natural and sensible for the government to exhort people to get vaccinated.  

The problem lies with forcing people to get vaccinated. This is particularly salient since New Zealand does not mandate any other vaccines; not even for other highly contagious diseases such as measles. Furthermore, while the vaccine seems relatively safe, the risks of covid-19 to young healthy people are so low that they are likely at greater risk from the vaccine than the virus. 

The latest legislation makes amendments to the COVID-19 Public Health Response (Vaccinations) Order 2021 (Order) promulgated earlier which lay at the heart of the debate in the aviation security officers’ case. That order clearly limits the right to refuse medical treatment (s11 of the NZ Bill of Rights). The judge recognizes the conflict when he writes that the “issue that is raised by the applicants in this challenge is clearly a legitimate one to raise with the Court.” (para 23). The judge goes on to say: “The key question in this case is whether this limitation is demonstrably justified.” (para 30).  

The judge concludes that the Crown has satisfied the “demonstrably justified” test for border workers: “I am satisfied that the benefits of the vaccine are demonstrably high, with there being a need to take a risk minimization approach to stop an outbreak or spread of the virus at the potential entry point of the virus into New Zealand” (para 119).  

We consider that this line of reasoning is flawed in the sense of not defining the counterfactuals properly.  

First, the judge believes that the vaccination of airport border workers would materially address the harm from covid-19 because they are involved in the potential entry point of the virus into New Zealand. This might have been true prior to the arrival of the delta version in New Zealand. However, the hearing was held on October 21 and 22, and the judgment delivered on 8 November. At these points, the virus was well established in the upper half of the North Island.  

Further, by 8 November, the government was in the process of moving away from its elimination strategy because it was no longer attainable. Under these conditions, the virus was very likely to eventually spread to the entire country even if no new cases arrived in Christchurch from overseas. Accordingly, the vaccination of border workers at Christchurch airport was not going to have a material impact on the spread of the virus. Remarkably, even the judge states that “It does not appear that this outbreak can be eliminated” and that it is an “open question” whether the Order would “remain demonstrably justified when the virus is endemic in at least parts of New Zealand” (para 128).  

Second, international evidence shows that many people will willingly take the vaccine even in the absence of a mandate. In fact, at the time of writing Denmark has achieved more than 70% vaccination without any coercive interventions. Many other countries have achieved similar levels without coercion.  

Thirdly, the judge believes that vaccination “materially contributes” to reducing the risk of airport border workers transmitting the virus from an arriving passenger to other New Zealanders (para 69). Yet, the judge recognizes and concedes the importance of PPE, tests of border workers, and requirements for physical distancing, none of which the applicants have contested (para 69). Strong evidence for the effectiveness of these other measures is that there have been no known cases of delta entering New Zealand by transmission through an airport border worker. This includes the entry of delta to New Zealand in July, from an infected passenger to another person at an MIQ hotel.  

Fourthly, the judge effectively asserts that the personal cost of the Order to these workers is irrelevant to the “demonstrably justified” test. We do not agree. The need in principle to consider these costs is apparent by considering extreme cases in other situations. For example, suppose a government concluded that a virus was so serious that it ordered vaccination for all members of the population (by force if necessary) and the vaccine was likely to be fatal to people with specific medical conditions. In this case, we would expect that a judge would have to balance the cost to the individuals for whom the vaccine was likely to be fatal against the deaths that might result amongst the rest of the population if they were not vaccinated.  

The same principle must then apply in the present case. The judge might argue that the costs to the individuals in question in the present case (loss of their jobs and likely considerable difficulty in finding an alternative in an environment where many employers are requiring vaccination for new employees) were less than the benefits to society from the vaccination Order, but in doing so they would still be balancing the two considerations. Ignoring the costs (and there are substantial costs) to the vaccine objectors is not appropriate. 

In view of these points, it is not “demonstrably justified” that compelling whatever proportion of border workers who are resistant to vaccination to do so “materially contributes” to reducing the risk of the virus spreading through New Zealand. This is true even without consideration of the costs to the applicants from the Order. Consideration of the costs to them further tilts the balance away from the Order. 

This argument regarding a careful weighing of the true costs and benefits from vaccine mandates apply with equal force to others. This is particularly so in light of the fact that both the judge in this case and other judges have repeatedly stressed that coercive mandates must be “proportionate”.  

In fact, in the above-mentioned case, the judge highlights another potential inconsistency when he points out in Para 37 that the Order may violate s19 of NZ BORA, the right against discrimination.  

In this instance, the judge decides to sidestep the logical inconsistency by arguing that the applicants did not raise this issue and therefore he is not going to consider it further. But the applicants did not need to raise this in their complaint! Given that the judge realizes that the Order poses significant conflicts with s19 of NZ BORA, the judge could have, on his own accord, decided to address this question and seek a response from the Government. 

Each ruling creates a precedent. Subsequent to this ruling, the government has significantly expanded the scope of vaccination mandates via the latest legislation encompassing an ever expanding set of citizens. Increasingly more of us are coming under the purview of such mandates. 

The government, which enjoys a Parliamentary majority, does not seem to be interested either in balancing the rights of the individual against the risks to the community or on the need for a “proportionate” response. One would think that it is the job of the judiciary to do this.  

Most of us are keenly aware that the pandemic has exposed deep-seated problems in our public health system. Unfortunately, it has also exposed fundamental deficiencies in the workings of New Zealand’s systems of checks and balances.  

The questions that judges should be asking with vaccine mandates  Read More »

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