**2. Religious Belief as "Individually Authoritative"**

In a seminal lecture clarifying the nature of mystical experiences, William James famously described the convictions about the believer's claim that such experiences were "true", as individually, but only individually, "authoritative" (James 1985, p. 422). In this judgment, James sought to convey both the power and fulfillment of a quintessential affirmation of faith while simultaneously recognizing that the content of such faith articles could not only vary, but possibly stand in contradiction from individual to individual. That is, James sought to preserve the believer's right to stand unflinchingly behind a worldview that furnished life with purpose and richness while recognizing as a matter of common sense and pragmatic justice that that believer was not alone in the world; should any belief result in action, it could affect more than that one believer. From this principle, James gave voice to a key principle of the First Amendment: Individuals ought to be free to explore and benefit from a religious expression that gives their lives meaning while not being issued carte blanche to prevent others from doing the same. This principle—or compromise—arguably became a tacit dictum for the setting of policy in instances in which individual liberties ran up against the public good. The former was given a proverbial vote, but not a veto, when the well-being and flourishing of many lives stood in the balance.

The implications of this compromise are critical for setting health policy. Until recently, for example, vaccines could be required by the state in exigent circumstances to protect the population at large. According to the American Bar Association, under the U.S. Constitution's 10th Amendment and nearly 200 years of Supreme Court decisions, state governments have had the primary authority to control the spread of dangerous diseases within their jurisdictions, allowing them to assume authority to take public health emergency actions, such as setting quarantines and business restrictions (American Bar Association 2022). This constraint historically has not pertained just to public health emergencies. In normal life, too, public health and safety historically have taken precedence over individual liberties in scenarios where the two conflict. In 1922, the Supreme Court held in Zucht v. King that making accessible public education conditional on standard vaccine compliance did not violate the Fourteenth Amendment (Shachar 2022). By 1980, all fifty states had laws requiring vaccines for children to attend public schools. Naturally, there are constraints on governmental authorities in a position to declare a state emergency. Under Section 319 of the Public Health Service Act of 1944, (Roosevelt 1944) establishing the government's quarantine jurisdiction, the Secretary of the Department of Health and Human Services was given the power to declare a public health emergency "after consulting with such public health officials as may be necessary", in the event that a disease, a separate public health disorder, or even a bioterrorist attack, presented an imminent health crisis (US Department of Health and Human Services 2019). To be sure, the burden of demonstrating an emergency was high, but that is the point. In the setting of policies that can entail emergency powers, until very recently, the thresholds have been transparently understood by all parties. Our nation's legal and medical history establish a public health precedent such that a balance is struck between individual liberties, to be held intact, all other things being equal, and the public good, which in an emergency can override the government's default "hands off" approach to the setting of health policy. Leaving aside the question of trusting the right authorities when empirical judgments must be made about assessing a public health emergency, when one is, in fact, declared, it is respected.

Public buy-in, in fact, heavily relies not only on public opinion but also on clerical figures who speak for their respective communities. When polled, representatives of a crosssection of the world faiths have tended to express no canonical disposition against vaccines and immunoglobulins, with the lone exception among major sects or denominations being Christian Science (Grabenstein 2013). This is not to say that sanction for vaccine hesitancy does not exist in some congregations of various denominations. Members from Pentecostal sects such as Endtime Ministries or groups such as Christ Church or General Assembly Church of the Firstborn believe in the primacy of prayer and that the human intervention in God's work is obstructive, from which it follows that the administering of a vaccine to prevent a health outbreak is for these believers at best futile, and more likely, seen as provocative. (Linnard-Palmer and Christiansen 2021). As many as 42 groups from the Christian tradition feature teachings that could be interpreted to support the refusal of medical treatment, including in the case of children (Linnard-Palmer and Christiansen 2021; Adams and Leverland 1986; Asser and Swan 1998). However, this attitude is not representative of mainstream Christianity, where a duty to preserve life can be inferred from Gospel sources. "Pro-life" usually means being anti-exemption. In deference to the First Amendment, and as an explicit specification of Title VII, religious exemptions have been available options in such historical moments as health-related public health mandates were deemed necessary. However, these have always been regarded as exceptions to a rule for which there was remarkable ground-level support among religious insiders, exceptions, by the reckoning of the clergy themselves, which are more likely to be abused than legitimately claimed (Reiss 2014). This is important to note, if only to demonstrate the establishment of presumed limits on individual claims that went against chosen representatives of a faith. That one's exemption is *defined* as an "exemption", as opposed to a subjective preference, maintains the historical balance between individual liberties and the public good on which American public health policy has been traditionally predicated.

This point is not just pragmatic from a public-policy-making standpoint, but also one about regard for religious traditions themselves. The compromise in play since 1905, as a result of the decision in Jacobson versus Massachusetts, had been that religious claims on the basis of which one sought to opt out of public policy could not be absolute; some emergencies afforded no exceptions. But another tacit constraint on claims of religious liberty was that they had to be pursued in good faith. Here, one might draw a contrast between reservations voiced by Catholics to their schools providing support for the administering of HPV vaccines (and to Catholic institutions in general providing resources for abortion or birth control), on the one hand, and clinicians seeking religious exemptions in health care settings to COVID-19 vaccines, on the other. In 2007, The Catholic Medical Association issued a position paper that, while acknowledging the safety and effectiveness of the HPV vaccine Gardasil, opposed any form of a mandate that girls be vaccinated against HPV. (Catholic Medical Association 2007). While the Catholic Medical Association found nothing in and of itself unethical about Gardasil, it did note that given "the importance of parental involvement for raising children, and particularly in forming their children in chastity, it would be counterproductive to override their ethical objections and negate their authority on this issue". Not denying that many Catholic women were bound to have pre-marital sex despite the teachings of their faith, the group found that condoning such a mandate, even for a worthy public health cause, was tantamount to inducing a subversion of one of the tradition's central pro-life tenets of discouraging pre-marital sex. To not stand against a regulation that would *impose* such a health-protective measure, the Catholic Medical Association found, would effectively be to ask faith-adherents to forego that which they saw to be a crux of their discipleship.

What is interesting about this response is that, whether or not one buys the argument on the basis of which the regulation is rejected, one has no problem seeing that the objection is issued in good faith: public health officials are being told the truth about the motivations for hesitancy among those who are being asked to sanction this preventive health measure. By contrast, there is mounting evidence during the pandemic that the opposite has taken place with regard to individuals seeking religious representatives to sign off on ad hoc requests for religious exemptions for vaccine mandates in healthcare settings, which are petitioned on the basis of no discernable or consistent grounds. As Michelle Mello notes, we are for the first time in our history seeing clergy not only not supporting COVID-19 mandates, but at odds with their flock:

It's not that a person is failing to produce a letter from a clergy member saying, yes, I back them up on this claim. It's that clergy members have actively gone out in public and said: No, we don't bar COVID vaccination in our religion. Our religion either has nothing to say about this or we are going on record as saying in our church we want people to get COVID vaccines. It is acceptable. It's consistent with doctrine to get COVID vaccines. There is no bar here. And nevertheless, there is a person who identifies with that religious belief system who comes forward and says: Yes, but my interpretation of the Bible, of Catholic doctrine, is that I shouldn't get this vaccine. And it doesn't matter that the religious leader has said this. (Council on Foreign Relations)

Mello goes on to document the increased frequency of these contestations brought on behalf of individuals in the era of COVID-19, who, despite being at odds with official teaching on a narrow issue, are finding support among courts at all levels of appeal, up to the Supreme Court. (Council on Foreign Relations) According to Mello, the new precedent signals that something other than a "sincerely held" religious belief is being invoked, which "looks more ideological" than spiritual.

Mello's suggestion that the recent spate of religious objections to health-protective mandates in proposed legislation which are not on the basis of religious grounds is reminiscent of examples introduced by Dorit Rubenstein Reiss of individuals who strategically attended services held by denominations to which they did not belong in order to acquire sympathy they found lacking in their own congregations (Reiss 2014). The affiliations

were almost always temporary, and in some cases, the faith surfers admitted their deception. (Reiss). Without the presumed burden to share one's reasons for objecting to health protecting measures introduced by the state, the stable compromise to which Jacobson versus Massachusetts had led—while in dire health crises vaccination laws do not violate due process or the 14th amendment, requiring enforcing parties to shoulder the burden of finding a "reasonable accommodation" if they can—falls away, and with it, any deference to a "common good". The upshot is a violation of the implied constraint on the believer as identified by William James in his reference to the faith-leaper who has license to maintain a religious conviction unflinchingly, for belief is now not *only* individually authoritative but also impacting others in society. Indeed, the public health consequences of this shift are undeniable. Given the nature of how "herd immunity" works, where thresholds of protection via vaccine immunity need to be established across a population, any individual decision on whether to vaccinate impacts the health and safety of everyone. (Flescher and Kabat 2018; Yeh 2022).
