The moral obligation to be vaccinated: utilitarianism, contractualism, and collective easy rescue

We argue that individuals who have access to vaccines and for whom vaccination is not medically contraindicated have a moral obligation to contribute to the realisation of herd immunity by being vaccinated. Contrary to what some have claimed, we argue that this individual moral obligation exists in...

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Bibliographic Details
Published in:Medicine, health care, and philosophy health care, and philosophy, 2018-12, Vol.21 (4), p.547-560
Main Authors: Giubilini, Alberto, Douglas, Thomas, Savulescu, Julian
Format: Article
Language:English
Subjects:
Conflict, Psychological
Education
Ethical Theory
Ethics
Humans
Immunity, Herd
Immunization
Medical ethics
Medical Law
Medical philosophy
Moral Obligations
Morality
Patient Acceptance of Health Care
Philosophy
Philosophy of Biology
Philosophy of Medicine
Philosophy, Medical
Public health
Scientific Contribution
Theory of Medicine/Bioethics
Utilitarianism
Vaccination - ethics
Vaccines
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Summary:We argue that individuals who have access to vaccines and for whom vaccination is not medically contraindicated have a moral obligation to contribute to the realisation of herd immunity by being vaccinated. Contrary to what some have claimed, we argue that this individual moral obligation exists in spite of the fact that each individual vaccination does not significantly affect vaccination coverage rates and therefore does not significantly contribute to herd immunity. Establishing the existence of a moral obligation to be vaccinated (both for adults and for children) despite the negligible contribution each vaccination can make to the realisation of herd immunity is important because such moral obligation would strengthen the justification for coercive vaccination policies. We show that two types of arguments—namely a utilitarian argument based on Parfit’s Principle of Group Beneficence and a contractualist argument—can ground an individual moral obligation to be vaccinated, in spite of the imperceptible contribution that any single vaccination makes to vaccine coverage rates. We add a further argument for a moral obligation to be vaccinated that does not require embracing problematic comprehensive moral theories such as utilitarianism or contractualism. The argument is based on a “duty of easy rescue” applied to collectives, which grounds a collective moral obligation to realise herd immunity, and on a principle of fairness in the distribution of the burdens that must be borne to realise herd immunity.
ISSN:1386-7423
1572-8633
DOI:10.1007/s11019-018-9829-y