Is compulsory vaccination ethically defensible?
The debate on compulsory vaccination is open, and it is interesting to hear a variety of voices in order to form one's own opinion. The publication by the Australian ontologist Michael Kowalik , devoted to the ethics of vaccine refusal , is important to take into account in this respect, because it examines the question outside the medical or legal field.
The unvaccinated are decried, stigmatised and discriminated against by whole sections of society (media , governments and ordinary citizens ). They are fiercely attacked, demonised for their lack of civic-mindedness and held responsible for what the champions of vaccination call an “epidemic of the unvaccinated” . The “health pass” as a means of “soft” coercion is now in force in many States in Europe, and the debate on compulsory vaccination is already raging in some countries, with encouragement from the President of the European Commission, Ursula von der Leyen , despite the WHO's reservations.
Vaccination: a civic duty?
Supporters of vaccination believe that, barring medical contraindications, everyone has a duty to get vaccinated, for the good of immunocompromised or at-risk people, or simply because “the benefits of universal vaccination for public health are such” that refusing the injection becomes irrational or “unethical”. They argue for a “low incidence of side effects” and “effective prevention of serious diseases”. From this perspective, vaccination becomes the panacea that saves us from the worst of “catastrophes”, and the spectre of non-vaccination would on its own justify recourse to discrimination and coercion.
Risk prevention: does the end justify the means?
Michael Kowalik explains in his publication that the individual's “bodily autonomy” must prevail over the idea of a necessary “reduction or elimination of the risks it poses to the lives of others”. All the more so since nearly all our actions are sources of potential risks for others.
According to the author, the violation of individual freedoms cannot be legitimised solely by the concern to prevent the “catastrophe” that the disease represents. In other words, restrictions on individual freedom must be “reasonably necessary for maintaining what gives life its full value”, bearing in mind that freedom (including the freedom to accept or refuse a preventive treatment after having assessed its merits) is itself the keystone of a life worth living, and that as such “it deserves to be preserved”.
“Bodily autonomy underpins our existence as conscious rational beings”. It is so essential that a “permanent violation of this bodily autonomy” constitutes nothing less than a “partial destruction of the being”. That is why the contribution to collective immunity (induced by vaccination) “must fully compensate for the harm that coercion inflicts on the person's bodily autonomy”. And that is a tall order, given the potentially irreversible nature of the medical act performed. The idea that medical coercion could be legitimised is therefore ruled out.
Michael Kowalik notes an “unequal distribution of the harm suffered, in terms of the side effects of vaccination”: some people will be left with lifelong after-effects or will experience serious medical complications, while others will not feel any effects. In any case, the potential risks associated with vaccination are such that it is ethically unthinkable to force individuals to put their lives at stake for the good of the community.
Reciprocity
Since the injection is not risk-free, “the moral obligation incumbent on us to get vaccinated implies that we are bound to reduce the risks to the health of others by agreeing to place an increased or unknown risk on our own health”. It follows that “if I must accept an increased risk to my person in order to protect others, it is fair that others in turn accept an increased risk to themselves” (resulting, for example, from my choice not to get vaccinated) to reduce the risk to my person, says the author.
Coercion is not ethical
Apart from the fact that it unduly infringes bodily autonomy, compulsory vaccination involves “an arsenal of discriminatory measures intended to improve, in the interest of public health, the natural state of our immune system” - one of our “healthy, innate biological characteristics”. Yet any form of coercion or discrimination is unethical as soon as it “aims to facilitate, encourage or normalise an unwanted modification of our healthy, innate biological characteristics”.
No legitimacy
Compulsory vaccination therefore establishes “discrimination against the healthy, innate biological characteristics of the individual”. Consequently, no legitimacy can be conferred on it, whatever the circumstances (emergencies and epidemics) or the existence “of hypothetical medically risk-free vaccines”. Moreover, “there is no more a moral obligation to get vaccinated than there is a sound ethical basis for justifying discrimination against unvaccinated people”. Let that be known!
By Sylvie Huygen, citizen journalist at BAM!
ethicist philosopher, specialising in particular in ontology and metaphysics.
Kowalik, Michael, Ethics of Vaccine Refusal (February 26, 2021). Journal of Medical Ethics (2021) DOI: 10.1136/medethics-2020-107026, Available at SSRN: https://ssrn.com/abstract=3793981
https://bam.news/en/investigation/episode-4-4-all-the-misery-in-the-world
https://www.arte.tv/fr/videos/106947-004-A/une-epidemie-de-non-vaccines-desintox/
https://www.thelancet.com/journals/lanpub/article/PIIS2468-2667(21)00273-5/fulltext
https://www.politico.eu/article/who-cautions-against-mandatory-vaccination/
Quotations from English-language sources are translated back here from the French.
