Personal and Communal Ethical Factors
In determining the moral positions of the two sides of the debates surrounding mandatory vaccination, personal and communal ethical factors should be explored. One personal factor is individual beliefs and values. Advocates of compulsory vaccination may think that immunization is the only way to stop the pandemic, while opponents can believe in vaccine ineffectiveness, conspiracy theories, or religious exemptions. Safety concerns are another personal factor affecting people’s moral position. Mandatory vaccination cannot be ethically justified if there is insufficient evidence of vaccine safety (World Health Organization [WHO], 2021). Therefore, opponents of compulsory immunization may be morally right if there is a lack of data proving that inoculations do not present health risks.
Communal factors that have to be considered include societal well-being and necessity and proportionality. Given necessity and proportionality, mandatory vaccination would be ethically justified only if it is required for achieving the public good and the attained health benefits are significant (WHO, 2021). Regarding societal well-being, proponents of mandatory vaccination may be morally right because their views are focused on the benefits for society.
Kantian ethics is based on the categorical imperative, meaning universal moral laws that should be followed in all circumstances. The first principle of Kantian ethics is to “Act only according to that maxim by which you can at the same time will that it should become a universal law” (Rachels & Rachels, 2019, p. 137). It can be applied to both opponents and proponents of mandatory vaccination. Advocates would vaccinate, thus making vaccination a universal law that everyone should follow. Opponents, in contrast, would refuse to vaccinate and, therefore, make vaccine refusal morally right. If those objecting to vaccination do not agree that everyone should refrain from getting inoculated, they will prove their position is unethical.
Kantian ethics has another important principle concerning individual autonomy. It requires treating people “always as an end and never as a means only” (Rachels & Rachels, 2019, p. 146). From this perspective, mandatory vaccination is unethical because it prevents people from using their own judgment and restricts their free will. However, while granting people individual autonomy, Kant suggested that they should act as rational beings, meaning that they would adhere to the first principle (Rachels & Rachels, 2019). It has been argued that objection to immunization is morally wrong because few people would agree that everyone should abstain from getting vaccinated. Therefore, a Kantian would assume that rational individuals would not oppose vaccination. Thus, from a Kantian ethics perspective, mandatory vaccination is unethical because it restricts personal autonomy. At the same time, individuals are morally obliged to get vaccinated because this action is more likely to be accepted as a universal law than abstaining from immunization.
Giubilini, A. (2021). Vaccination ethics. British Medical Bulletin, 137(1), 4-12. Web.
In this article, Giubilini (2021) discusses how the concept of herd immunity as a public good and the ethical principles of “least restrictive alternative,” “harm prevention,” and “fairness” affect vaccination policies. The “least restrictive alternative” refers to policies that limit individual freedom less than other available options. Although such policies protect personal autonomy, Giubilini argues that “preventing harm or risk of harm to others is normally taken to be a sufficient ground for liberty restrictions” (p. 9). Additionally, Giubilini points out that, since herd immunity is a public good, people should not become free-riders and have to contribute to public well-being “regardless of whether the individual contribution ‘makes a difference’” (p. 10). I agree that personal liberty can sometimes be restricted when it comes to ensuring society’s safety. This article made me understand that, when determining the moral position of vaccination opponents, I should pay more attention to harm prevention and fairness of the contribution to the public good.
González-Melado, F. J., & Di Pietro, M. L. (2020). The vaccine against COVID-19 and institutional trust. Enfermedades Infecciosas y Microbiología Clínica. Advance online publication. Web.
In this article, González-Melado and Di Pietro (2020) argue that a responsibility-based “first-person” model should be applied to vaccination policies, but for this model to be effective, governments should improve institutional trust. Researchers write that mandatory immunization is grounded on the normative “third-person” ethics and is regarded as “an attack on individual autonomy” (p. 3). They oppose this model and argue that voluntary vaccination is more ethical because it is based on personal responsibility. González-Melado and Di Pietro emphasize that individuals refuse to vaccinate because they are afraid of potential health risks. The authors argue that if the governments improve people’s trust in public institutions, their fears will be eliminated, and they will get vaccinated, driven by their moral obligation. I think that González-Melado and Di Pietro rely too much on individuals’ responsibility and the governments’ ability to evoke people’s trust. Although autonomy is important, reducing risks for the whole society seems to be more crucial.
Gostin, L. O., Salmon, D. A., & Larson, H. J. (2021). Mandating COVID-19 vaccines. Journal of the American Medical Association, 325(6), 532-533. Web.
In this article, Gostin et al. (2021) argue that mandatory vaccination should be limited to achieve a balance between individual autonomy and society’s well-being. Gostin et al. write that the government generally supports immunization mandates because of their benefits for the public. Regarding COVID-19, the authors emphasize the significance of vaccination for healthcare facilities, educational institutions, and businesses. High vaccination rates are vital for public safety, but mandates would override personal autonomy. Therefore, the solution that Gostin et al. propose is “limited vaccine mandates with public support, in special high-risk or high-value settings, and with longer-term safety data” (p. 533). This article has helped me understand that a compromise should be reached between individual autonomy and societal well-being. I agree that mandatory vaccination of the most vulnerable populations can solve this ethical dilemma because it provides a compromise between personal freedom and public safety.
Kowalik, M. (2021). Ethics of vaccine refusal. Journal of Medical Ethics. Advance online publication. Web.
In this article, Kowalik (2021) argues that individuals do not have a moral obligation to get vaccinated. Kowalik defends personal freedom as “a necessary condition of a life worth living” (p. 2) and says that potential vaccination benefits for the public do not provide a reasonable necessity for restricting individual autonomy. This is because, in Kowalik’s view, vaccines “discriminate against healthy, innate characteristics of every human” (p. 5). The author claims that mandatory vaccination would force healthy people to subject themselves to the risk of side effects, thus endangering their own well-being for the sake of others. I think that Kowalik assumes an ethical egoist position in making his argument because he openly states that people should not consider the risks they pose to others by refusing to vaccinate. I cannot entirely agree with this opinion because it disregards the well-being of society.
Savulescu, J. (2021). Good reasons to vaccinate: mandatory or payment for risk? Journal of Medial Ethics, 47, 78-85. Web.
In this article, Savulescu (2021) suggests four criteria that can justify mandatory vaccination. They include a gravity of the threat to public health, safety and effectiveness of the inoculation, superior cost/benefit profile compared to alternatives, and proportionality of coercion. Savulescu also argues that until the safety of the vaccine against COVID-19 is well-established, offering payment for immunization is better than compulsory vaccination. Savulescu objects to the claim that payment for immunization is unethical due to “undue influence” and “exploitation.” According to Savulescu, payment will not override personal autonomy if people are educated about reasonable risks because it will ensure that they will “make as autonomous and authentic a decision as possible” (p. 83). This article is important because it raises the question of whether paying for getting vaccinated is more ethical than mandatory immunization. I believe that the proposed solution in which people are free to return the given money to show their solidarity is the most ethical option because it can benefit society and preserve personal autonomy.