Brownstone Institute
Kheriaty vs. University of California
From the Brownstone Institute
Shortly after I published the Wall Street Journal piece arguing that university vaccine mandates were unethical, the University of California, my employer, promulgated its vaccine mandate. I decided then it was time to put a stake in the ground: I filed a lawsuit in federal court challenging the constitutionality of the university’s vaccine mandate on behalf of COVID-recovered individuals. It was already clear from many robust studies that natural immunity following infection was superior to vaccine-mediated immunity in terms of efficacy and duration of immunity.
At the time I was an unlikely candidate to challenge the prevailing vaccination policies. I was deeply embedded in the academic medical establishment, where I had spent my entire career. In my capacity as a psychiatric consultant on the medical wards and in the emergency department, I had suited up in PPE (personal protective equipment) to see hundreds of hospitalized COVID patients, witnessing the worst that this illness can do. Nobody needed to explain to me how bad this virus could be for some individuals, especially the elderly with co-occurring medical conditions who were at significant risk of bad outcomes when infected.
I contracted the virus in July 2020, and despite my efforts to self-isolate, passed it to my wife and five children. Living and breathing COVID for a year, I eagerly awaited a safe and effective vaccine for those that were still not immune to this virus. I happily served on the Orange County COVID-19 Vaccine Task Force, and I advocated in the Los Angeles Times that the elderly and sick be prioritized for vaccination, and that the poor, disabled, and underserved be given ready access to vaccines.
I had worked every day for over a year to develop and advance the university’s and state’s pandemic mitigation measures. But as the prevailing COVID policies unfolded, I became increasingly concerned, and eventually disillusioned. Our one-size-fits-all coercive mandates failed to take account of individualized risks and benefits, particularly age-stratified risks, which are central to the practice of good medicine. We ignored foundational principles of public health, like transparency and the health of the entire population. With little resistance we abandoned foundational ethical principles.
Among the most glaring failures of our response to COVID was the refusal to acknowledge the natural immunity of COVID-recovered patients in our mitigation strategies, herd-immunity estimates, and vaccine-rollout plans. The CDC estimated that by May 2021, more than 120 million Americans (36 percent) had been infected with COVID. Following the Delta-variant wave later that year, many epidemiologists estimated the number was close to half of all Americans. By the end of the Omicron wave in early 2022, that number was north of 70 percent. The good news — almost never mentioned — was that those with previous infection had more durable and longer-lasting immunity than the vaccinated. Yet the focus remained exclusively on vaccines.
As I argued in a coauthored article, medical exemptions for most vaccine mandates were too narrowly tailored, constraining physicians’ discretionary judgment and seriously compromising individualized patient care. Most mandates only allowed medical exemptions for conditions included on the CDC’s list of contraindications to the vaccines — a list that was never meant to be comprehensive. CDC recommendations should never have been taken as sound medical advice applicable to every patient.
Further exacerbating this problem, on August 17, 2021, all licensed physicians in California received a notification from the state medical board with the heading “Inappropriate Exemptions May Subject Physicians to Discipline.” Physicians were informed that any doctor granting an inappropriate mask exemption or other COVID-related exemptions “may be subjecting their license to disciplinary action.” In what was perhaps a deliberate omission, the “standard of care” criteria for vaccine exemptions was never defined by the medical board. In my eighteen years as a licensed physician, I had never previously received any such notice, nor had my colleagues.
The effect was chilling: since physicians naturally interpreted “other exemptions” to include vaccines, it became de facto impossible to find a doctor in California willing to write a medical exemption, even if the patient had a legitimate contraindication to the COVID vaccines. One of my patients was told by his rheumatologist he should not get the COVID vaccine, since he was at low risk from COVID and in this physician’s judgment his autoimmune condition elevated his risks of vaccine adverse effects.
This patient, who was subjected to a vaccine mandate at work, immediately asked this same physician for a medical exemption. The doctor replied, “I’m sorry, I cannot write you an exemption because I’m afraid I might lose my license.” I heard many stories of similar egregious violations of medical ethics under these repressive mandates and the enforcement regime that bolstered them.
As the vaccines rolled out in 2021, I spoke to many students, faculty, residents, staff, and patients who were aware of these basic immunological facts and were asking legitimate questions about vaccine mandates. Many correctly saw no medical or public health justification for subjecting themselves to the risks of the novel vaccines when they already had superior natural immunity. Others had moral concerns but did not qualify for a religious exemption, because religion was not central to their conscience-based objections.
They felt intimidated, disempowered, and vulnerable in the face of immense pressure to go along. Many physicians and nurses were afraid to speak up in the climate of coercion. Public health officials ignored inconvenient scientific findings, suppressed reasonable questions, and bullied into silence any skeptical physicians or scientists. Institutions promulgating mandates stigmatized and punished those who refused to comply. I had never seen anything like this in medicine.
Why did I file a lawsuit in federal court against my own employer? I had nothing to gain personally by this and a lot to lose professionally. I decided I could not stand by and watch the ethical disaster unfold around me without attempting to do something. In my position as Director of Medical Ethics at UCI, I had a duty to represent those whose voices were silenced and to insist upon the right of informed consent and informed refusal.
In the end, my decision to challenge these mandates came down to this question: How could I continue to call myself a medical ethicist if I failed to do what I was convinced was morally right under pressure? Projecting ahead to the required medical ethics course I taught to first and second-year medical students at the beginning of each year, I could not imagine lecturing on informed consent, moral courage, and our duty to protect patients from harm if I had failed to oppose these unjust and unscientific mandates. I simply would not have woken up each day with a clear conscience.
The university did not take kindly to my legal challenge, as you might imagine. Administrators allowed no grass to grow under their feet before responding to this dissident within the ranks. I had petitioned the court for a preliminary injunction to put the vaccine mandate on hold while the case was litigated in court. The judge declined this request, and the following day the university placed me on “investigatory leave” for alleged noncompliance with the vaccine mandate. Instead of waiting for the federal court to decide my case, the university immediately banned me from working on campus or working from home.
I was given no opportunity to contact my patients, students, residents, or colleagues and let them know I would suddenly disappear. An email from one of the deans, sent after I had left the office for the day, informed me that I could not return to campus the following day.
As I drove away from campus for the last time that day, I glanced at the sign on the corner near the hospital. The sign, which had been up for months, read in large block letters, HEROES WORK HERE.
Republished from the author’s Substack
Author
From the Brownstone Institute
By 
Who Controls the Administrative State?
President Trump on March 20, 2025, ordered the following: “The Secretary of Education shall, to the maximum extent appropriate and permitted by law, take all necessary steps to facilitate the closure of the Department of Education.”
That is interesting language: to “take all necessary steps to facilitate the closure” is not the same as closing it. And what is “permitted by law” is precisely what is in dispute.
It is meant to feel like abolition, and the media reported it as such, but it is not even close. This is not Trump’s fault. The supposed authoritarian has his hands tied in many directions, even over agencies he supposedly controls, the actions of which he must ultimately bear responsibility.
The Department of Education is an executive agency, created by Congress in 1979. Trump wants it gone forever. So do his voters. Can he do that? No but can he destaff the place and scatter its functions? No one knows for sure. Who decides? Presumably the highest court, eventually.
How this is decided – whether the president is actually in charge or really just a symbolic figure like the King of Sweden – affects not just this one destructive agency but hundreds more. Indeed, the fate of the whole of freedom and functioning of constitutional republics may depend on the answer.
All burning questions of politics today turn on who or what is in charge of the administrative state. No one knows the answer and this is for a reason. The main functioning of the modern state falls to a beast that does not exist in the Constitution.
The public mind has never had great love for bureaucracies. Consistent with Max Weber’s worry, they have put society in an impenetrable “iron cage” built of bloodless rationalism, needling edicts, corporatist corruption, and never-ending empire-building checked by neither budgetary restraint nor plebiscite.
Today’s full consciousness of the authority and ubiquity of the administrative state is rather new. The term itself is a mouthful and doesn’t come close to describing the breadth and depth of the problem, including its root systems and retail branches. The new awareness is that neither the people nor their elected representatives are really in charge of the regime under which we live, which betrays the whole political promise of the Enlightenment.
This dawning awareness is probably 100 years late. The machinery of what is popularly known as the “deep state” – I’ve argued there are deep, middle, and shallow layers – has been growing in the US since the inception of the civil service in 1883 and thoroughly entrenched over two world wars and countless crises at home and abroad.
The edifice of compulsion and control is indescribably huge. No one can agree precisely on how many agencies there are or how many people work for them, much less how many institutions and individuals work on contract for them, either directly or indirectly. And that is just the public face; the subterranean branch is far more elusive.
The revolt against them all came with the Covid controls, when everyone was surrounded on all sides by forces outside our purview and about which the politicians knew not much at all. Then those same institutional forces appear to be involved in overturning the rule of a very popular politician whom they tried to stop from gaining a second term.
The combination of this series of outrages – what Jefferson in his Declaration called “a long train of abuses and usurpations, pursuing invariably the same Object” – has led to a torrent of awareness. This has translated into political action.
A distinguishing mark of Trump’s second term has been an optically concerted effort, at least initially, to take control of and then curb administrative state power, more so than any executive in living memory. At every step in these efforts, there has been some barrier, even many on all sides.
There are at least 100 legal challenges making their way through courts. District judges are striking down Trump’s ability to fire workers, redirect funding, curb responsibilities, and otherwise change the way they do business.
Even the signature early achievement of DOGE – the shuttering of USAID – has been stopped by a judge with an attempt to reverse it. A judge has even dared tell the Trump administration who it can and cannot hire at USAID.
Not a day goes by when the New York Times does not manufacture some maudlin defense of the put-upon minions of the tax-funded managerial class. In this worldview, the agencies are always right, whereas any elected or appointed person seeking to rein them in or terminate them is attacking the public interest.
After all, as it turns out, legacy media and the administrative state have worked together for at least a century to cobble together what was conventionally called “the news.” Where would the NYT or the whole legacy media otherwise be?
So ferocious has been the pushback against even the paltry successes and often cosmetic reforms of MAGA/MAHA/DOGE that vigilantes have engaged in terrorism against Teslas and their owners. Not even returning astronauts from being “lost in space” has redeemed Elon Musk from the wrath of the ruling class. Hating him and his companies is the “new thing” for NPCs, on a long list that began with masks, shots, supporting Ukraine, and surgical rights for gender dysphoria.
What is really at stake, more so than any issue in American life (and this applies to states around the world) – far more than any ideological battles over left and right, red and blue, or race and class – is the status, power, and security of the administrative state itself and all its works.
We claim to support democracy yet all the while, empires of command-and-control have arisen among us. The victims have only one mechanism available to fight back: the vote. Can that work? We do not yet know. This question will likely be decided by the highest court.
All of which is awkward. It is impossible to get around this US government organizational chart. All but a handful of agencies live under the category of the executive branch. Article 2, Section 1, says: “The executive Power shall be vested in a President of the United States of America.”
Does the president control the whole of the executive branch in a meaningful way? One would think so. It’s impossible to understand how it could be otherwise. The chief executive is…the chief executive. He is held responsible for what these agencies do – we certainly blasted away at the Trump administration in the first term for everything that happened under his watch. In that case, and if the buck really does stop at the Oval Office desk, the president must have some modicum of control beyond the ability to tag a marionette to get the best parking spot at the agency.
What is the alternative to presidential oversight and management of the agencies listed in this branch of government? They run themselves? That claim means nothing in practice.
For an agency to be deemed “independent” turns out to mean codependency with the industries regulated, subsidized, penalized, or otherwise impacted by its operations. HUD does housing development, FDA does pharmaceuticals, DOA does farming, DOL does unions, DOE does oil and turbines, DOD does tanks and bombs, FAA does airlines, and so on It goes forever.
That’s what “independence” means in practice: total acquiescence to industrial cartels, trade groups, and behind-the-scenes systems of payola, blackmail, and graft, while the powerless among the people live with the results. This much we have learned and cannot unlearn.
That is precisely the problem that cries out for a solution. The solution of elections seems reasonable only if the people we elected actually have the authority over the thing they seek to reform.
There are criticisms of the idea of executive control of executive agencies, which is really nothing other than the system the Founders established.
First, conceding more power to the president raises fears that he will behave like a dictator, a fear that is legitimate. Partisan supporters of Trump won’t be happy when the precedent is cited to reverse Trump’s political priorities and the agencies turn on red-state voters in revenge.
That problem is solved by dismantling agency power itself, which, interestingly, is mostly what Trump’s executive orders have sought to achieve and which the courts and media have worked to stop.
Second, one worries about the return of the “spoils system,” the supposedly corrupt system by which the president hands out favors to friends in the form of emoluments, a practice the establishment of the civil service was supposed to stop.
In reality, the new system of the early 20th century fixed nothing but only added another layer, a permanent ruling class to participate more fully in a new type of spoils system that operated now under the cloak of science and efficiency.
Honestly, can we really compare the petty thievery of Tammany Hall to the global depredations of USAID?
Third, it is said that presidential control of agencies threatens to erode checks and balances. The obvious response is the organizational chart above. That happened long ago as Congress created and funded agency after agency from the Wilson to the Biden administration, all under executive control.
Congress perhaps wanted the administrative state to be an unannounced and unaccountable fourth branch, but nothing in the founding documents created or imagined such a thing.
If you are worried about being dominated and destroyed by a ravenous beast, the best approach is not to adopt one, feed it to adulthood, train it to attack and eat people, and then unleash it.
The Covid years taught us to fear the power of the agencies and those who control them not just nationally but globally. The question now is two-fold: what can be done about it and how to get from here to there?
Trump’s executive order on the Department of Education illustrates the point precisely. His administration is so uncertain of what it does and can control, even of agencies that are wholly executive agencies, listed clearly under the heading of executive agencies, that it has to dodge and weave practical and legal barriers and land mines, even in its own supposed executive pronouncements, even to urge what might amount to be minor reforms.
Whoever is in charge of such a system, it is clearly not the people.
Author
From the Brownstone Institute
By
“People are reacting because they hear things about me that aren’t true, characterizations of things I have said that are simply not true. When they hear what I have to say, actually, about vaccines, everybody supports it.”
Robert F. Kennedy, Jr. has been confirmed as Secretary of the US Department of Health and Human Services.
Within hours, my news feed was populated with angsty articles hand-wringing about the future of vaccines under Kennedy, whom legacy media and the establishment are certain would confiscate life-saving vaccine programs, raising the spectre of mass waves of illness and death.
In particular, this quote from Senator Mitch McConnell (R-KY), the only Republican who voted against Kennedy’s confirmation, appeared over and over again:
“I’m a survivor of childhood polio. In my lifetime, I’ve watched vaccines save millions of lives from devastating diseases across America and around the world. I will not condone the re-litigation of proven cures, and neither will millions of Americans who credit their survival and quality of life to scientific miracles.”
Yet, I could not find one piece of mainstream coverage of this quote that mentioned the astonishing fact that 98% of polio cases in 2023, the most recent year for which we have full data, were caused by the polio vaccine.
You read that correctly. In 2023, 12 wild polio cases were recorded (six in Afghanistan, six in Pakistan), with a further 524 circulating vaccine-derived cases, mostly throughout Africa. This trend is in keeping with data from the previous several years.
An important contextualising detail, wouldn’t you think?
The cause of this polio resurgence is that the world’s poor are given the oral polio vaccine (OPV), which contains a weakened virus that can replicate in the gut and spread in feces, causing vaccine-derived outbreaks.
People in rich countries get the inactivated polio vaccine (IPV), which does not contain live virus and therefore does not carry the risk of spreading the very disease it’s vaccinating against.
The World Health Organization (WHO) and vaccine-promoting organisations say that the way out of the problem is to vaccinate harder, as the argument goes that outbreaks only occur in under-vaccinated communities.
This may be well and good, but the total omission of the fact from media coverage that the goalposts have shifted from eradicating wild polio (not yet complete but nearly there, according to the WHO) to eradicating vaccine-derived polio (the main problem these days) underscores that this is why hardly anyone who knows anything trusts the media anymore.
A member of my extended family has polio. It’s nasty and life-altering and I wouldn’t wish it on anyone.
That’s why I would hope that any vaccines given would be safe – contracting polio from the supposedly preventative vaccine is the worst-case scenario, second only to death.
This is Kennedy’s expressly stated aim.
“When people actually hear what I think about vaccines, which is common sense, which is vaccines should be tested, they should be safe, everyone should have informed consent,” he said at his confirmation press conference.
“People are reacting because they hear things about me that aren’t true, characterisations of things I have said that are simply not true.
“When they hear what I have to say, actually, about vaccines, everybody supports it.”
Grown-ups who support vaccines can walk and chew gum. From the point of view of the public health establishment, the polio vaccine has prevented millions of cases and has nearly eradicated the disease.
At the same time, the world’s poorest are afflicted with polio outbreaks which we can work to prevent, and the safety of all polio vaccine products on the market should be subject to the rigorous standards applied to all other medicines.
Unless you think that poor people don’t matter, in which case the status quo might suit you fine.
Republished from the author’s Substack
Author
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