Vaccination: moral obligation, collective responsibility, logical decision

Sep 17, 2021 Letters

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Dear Editor,

There is a range of feelings and beliefs that underpins low vaccination rates in Guyana, including fear, skepticism, and a libertarian type of defiance to public health measures. While the pandemic drags on, people are refusing to inoculate in the name of individual freedom. The recent protest and strike actions are indicative of a tug-of-war between private liberty and public health on the issue of the Government’s COVID-19 emergency measures. And it seems to me that this will become a battle with no end unless each of us recognises and acts upon our collective moral responsibility to contribute to the public health good of herd immunity.
Ethical problems often arise because of a conflict between two competing goods. One ethical problem, which arises due to the COVID-19 pandemic, is the conflict between an individual’s freedom and a public health good, such as vaccination and herd immunity. This has entrusted us with the difficult task of deciding whether to vaccinate or not—all the more so when one feels coerced to be vaccinated, the failure of which could result in some loss or restriction. One could resort to demanding one’s fundamental right to liberty and bodily integrity with respect to vaccination, asserting that it is one’s choice and one’s body. However, some individual freedoms are not absolute and can be curtailed for higher ethical values.
One could argue that the fundamental right to make free decisions is limited by Mill’s harm principle: my liberty is not absolute, but is constrained by other people’s equal liberty and their right not to be harmed by me. Some might object to the idea that we have a moral obligation to protect other members of the community against COVID-19. They might think it would be a good thing to do, but reject that there is a moral obligation to do so—let alone that there should be a legal obligation, or State coercion, to do so.
Still, some might appeal to their individual liberty to act in a manner consistent with their choice. Upending the harm principle, they might even argue that to act in a manner that protects others would violate their fundamental right to liberty and to bodily integrity. Admittedly, one could concede the point and say that, even assuming there is an individual moral obligation to protect others, does not entail a moral obligation to be vaccinated against the virus.
However, we all have some rights, which determine some moral obligations that fall upon everyone. In the case of the COVID-19 pandemic, I have a right not to harm other people by preventing the spread of the virus. This, in turn, generates a moral obligation on others not to harm me by preventing the spread of the virus. Hence, I have a duty to abstain from any action that could harm or risk harming other people, and to act in a manner that could promote certain benefits to other people.
Vaccination has an important role in protecting individuals from infectious diseases and in reducing the transmission of infections in the population through herd immunity. Achieving this public health goal requires the collective action of the population. Vaccination involves a very small cost to me and a large benefit to others. If non-vaccination harms others or risks harming others, then failing to vaccinate is as bad as actively doing something that harms or risks harming others. If a non-vaccinated person infects another, then he would be causally and morally responsible for the harm caused. Otherwise, it is very unlikely that a non-vaccinated person would infect another where herd immunity exists; but, where there is a low vaccination rate; a non-vaccinated person would not make a difference to the risk of infecting another, since someone else will and the virus continues to be transmitted in the population.
So, here’s the question: if an individual, acting on his right to individual liberty, chooses not to be vaccinated against COVID-19, who then is the bearer of the moral duty not to harm others? Is it the vaccinated individual? What if the percentage of vaccinated individuals is significantly less and the vaccination rate is alarmingly low? Would the vaccinated individuals still bear the burden of the moral duty not to harm others? Some moral obligations cannot be fulfilled by the individual alone, but by the collective acting to bear the burden, which the individual cannot bear alone. And given a low vaccination rate, no one person alone can bear the burden of not harming others.
Given all epidemiologic factors being equal, I think it is the public health good of herd immunity that can guarantee a sufficiently high level of protection from harm. No one person can bear the burden of contributing to achieving herd immunity alone. It can only be a matter of the collective acting to achieve a public health good. This entails that each of us has the moral responsibility to contribute to the realisation of the public health goal of herd immunity. There is, therefore, a principle of fairness in the contribution of the burdens of the collective obligation; and this principle entails that each of us has the moral responsibility to make our fair contribution to herd immunity through vaccination. Unless we all act upon our collective responsibility, the battle between private liberty and public health will rage on while the number of cases continues to escalate out of control.

Sincerely,
Ronald N. Emanuel

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