Skip to main content
Top
Published in: Medicine, Health Care and Philosophy 4/2018

Open Access 01-12-2018 | Scientific Contribution

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

Authors: Alberto Giubilini, Thomas Douglas, Julian Savulescu

Published in: Medicine, Health Care and Philosophy | Issue 4/2018

Login to get access

Abstract

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.
Footnotes
1
We are grateful to an anonymous reviewer for raising this objection.
 
2
We are grateful to an anonymous reviewer for having drawn our attention to this implication.
 
Literature
go back to reference Aas, S. 2015. Distributing collective obligation. Journal of Ethics and Social Philosophy 9: 3. Aas, S. 2015. Distributing collective obligation. Journal of Ethics and Social Philosophy 9: 3.
go back to reference Ashford, E. 2003. The demandingness of Scanlon’s contractualism. Ethics 113 (2): 273–302.CrossRef Ashford, E. 2003. The demandingness of Scanlon’s contractualism. Ethics 113 (2): 273–302.CrossRef
go back to reference Björnsson, Gunnar. 2014. Essentially shared obligations. Midwest Studies in Philosophy 38 (1): 103–120.CrossRef Björnsson, Gunnar. 2014. Essentially shared obligations. Midwest Studies in Philosophy 38 (1): 103–120.CrossRef
go back to reference Collins, S. 2013. Collectives’ duties and collectivisation duties. Australasian Journal of Philosophy 91 (2): 231–248.CrossRef Collins, S. 2013. Collectives’ duties and collectivisation duties. Australasian Journal of Philosophy 91 (2): 231–248.CrossRef
go back to reference Dawson, Angus. 2007. Herd protection as a public good: vaccination and our obligations to others. In Ethics, Prevention, and Public Health, eds. A. Dawson, and M. Verweij, 160–187. Oxford: Clarendon Press. Dawson, Angus. 2007. Herd protection as a public good: vaccination and our obligations to others. In Ethics, Prevention, and Public Health, eds. A. Dawson, and M. Verweij, 160–187. Oxford: Clarendon Press.
go back to reference Dawson, Angus. 2011. Vaccination ethics. In Public Health Ethics. Key Concepts and Issues in Policy and Practice, ed. A. Dawson, 143–153. New York: Cambridge University Press.CrossRef Dawson, Angus. 2011. Vaccination ethics. In Public Health Ethics. Key Concepts and Issues in Policy and Practice, ed. A. Dawson, 143–153. New York: Cambridge University Press.CrossRef
go back to reference Fine, Paul, et al. 2011. “Herd immunity”: a rough guide. Clinical Infectious Diseases 52 (7): 911–916.CrossRef Fine, Paul, et al. 2011. “Herd immunity”: a rough guide. Clinical Infectious Diseases 52 (7): 911–916.CrossRef
go back to reference Flanigan, Jessica. 2014. A defense of compulsory vaccination. HEC Forum 26: 5–25.CrossRef Flanigan, Jessica. 2014. A defense of compulsory vaccination. HEC Forum 26: 5–25.CrossRef
go back to reference Giubilini, A., T. Douglas, and J. Savulescu. 2017. Liberty, fairness, and the ‘contribution model’ for non-medical vaccine exemption policies: a reply to Navin and Largent. Public Health Ethics 10 (3): 235–240. Giubilini, A., T. Douglas, and J. Savulescu. 2017. Liberty, fairness, and the ‘contribution model’ for non-medical vaccine exemption policies: a reply to Navin and Largent. Public Health Ethics 10 (3): 235–240.
go back to reference Glover, Jonathan. 1975. It makes no difference whether or not I do it. In Proceedings of the Aristotelian Society, Supplementary Volumes, 49: 171–209. Glover, Jonathan. 1975. It makes no difference whether or not I do it. In Proceedings of the Aristotelian Society, Supplementary Volumes, 49: 171–209.
go back to reference Harmsen, Irene, et al. 2013. Why parents refuse childhood vaccination: a qualitative study using online focus groups. BMC Public Health 13: 1183.CrossRef Harmsen, Irene, et al. 2013. Why parents refuse childhood vaccination: a qualitative study using online focus groups. BMC Public Health 13: 1183.CrossRef
go back to reference Held, Virginia. 1970. Can a random collection of individuals be morally responsible? Journal of Philosophy 67 (14): 471–481.CrossRef Held, Virginia. 1970. Can a random collection of individuals be morally responsible? Journal of Philosophy 67 (14): 471–481.CrossRef
go back to reference Isaacs, Tracy. 2011. Moral Responsibility in Collective Contexts. New York: Oxford University Press.CrossRef Isaacs, Tracy. 2011. Moral Responsibility in Collective Contexts. New York: Oxford University Press.CrossRef
go back to reference Kagan, Shelly. 2011. Do I make a difference? Philosophy and Public Affairs 39 (2): 105–141.CrossRef Kagan, Shelly. 2011. Do I make a difference? Philosophy and Public Affairs 39 (2): 105–141.CrossRef
go back to reference Klosko, George. 2004 (1992). The Principle of Fairness and Political Obligation. Lanham: Rowman and Littlefield. Klosko, George. 2004 (1992). The Principle of Fairness and Political Obligation. Lanham: Rowman and Littlefield.
go back to reference Lawford-Smith, Holly. 2012. The feasibility of collectives’ actions. Australasian Journal of Philosophy 90: 453–467.CrossRef Lawford-Smith, Holly. 2012. The feasibility of collectives’ actions. Australasian Journal of Philosophy 90: 453–467.CrossRef
go back to reference Luyten, Jeroen, et al. 2011. Vaccination policy and ethical challenges posed by herd immunity, suboptimal uptake, and subgroup targeting. Public Health Ethics 4 (3): 280–291.CrossRef Luyten, Jeroen, et al. 2011. Vaccination policy and ethical challenges posed by herd immunity, suboptimal uptake, and subgroup targeting. Public Health Ethics 4 (3): 280–291.CrossRef
go back to reference Navin, Mark. 2013. Resisting moral permissiveness about vaccine refusal. Public Affairs Quarterly 27 (1): 69–85. Navin, Mark. 2013. Resisting moral permissiveness about vaccine refusal. Public Affairs Quarterly 27 (1): 69–85.
go back to reference Navin, Mark. 2015. Values and Vaccine Refusal: Hard Questions in Ethics, Epistemology, and Health Care. New York: Routledge.CrossRef Navin, Mark. 2015. Values and Vaccine Refusal: Hard Questions in Ethics, Epistemology, and Health Care. New York: Routledge.CrossRef
go back to reference Otsuka, Michael. 1991. The paradox of group beneficence. Philosophy and Public Affairs 20 (2): 132–149. Otsuka, Michael. 1991. The paradox of group beneficence. Philosophy and Public Affairs 20 (2): 132–149.
go back to reference Parfit, Derek. 1984. Reasons and Persons. Oxford: Oxford University Press. Parfit, Derek. 1984. Reasons and Persons. Oxford: Oxford University Press.
go back to reference Pinkert, Felix. 2014. What we together can (be required to) do. Midwest Studies of Philosophy 23: 187–202.CrossRef Pinkert, Felix. 2014. What we together can (be required to) do. Midwest Studies of Philosophy 23: 187–202.CrossRef
go back to reference Scanlon, Tim. 1998. What We Owe to Each Other. Cambridge, MA: Harvard University Press. Scanlon, Tim. 1998. What We Owe to Each Other. Cambridge, MA: Harvard University Press.
go back to reference Schwenkenbecher, Anne. 2013. Joint duties and global moral obligations. Ratio 26: 310–328.CrossRef Schwenkenbecher, Anne. 2013. Joint duties and global moral obligations. Ratio 26: 310–328.CrossRef
go back to reference Singer, Peter. 1972. Famine, affluence, and morality. Philosophy and Public Affairs 1 (3): 229–243. Singer, Peter. 1972. Famine, affluence, and morality. Philosophy and Public Affairs 1 (3): 229–243.
go back to reference Smith, Philip, et al. 2011. Parental delay or refusal of vaccine doses, childhood vaccination coverage at 24 months of age, and the health belief model. Public Health Report 126: 135–146.CrossRef Smith, Philip, et al. 2011. Parental delay or refusal of vaccine doses, childhood vaccination coverage at 24 months of age, and the health belief model. Public Health Report 126: 135–146.CrossRef
go back to reference van den Hoven, M. 2012. Why one should do one’s bit: Thinking about free riding in the context of public health ethics. Public Health Ethics 5 (2): 154–160.CrossRef van den Hoven, M. 2012. Why one should do one’s bit: Thinking about free riding in the context of public health ethics. Public Health Ethics 5 (2): 154–160.CrossRef
go back to reference Verweij, Marcel. 2005. Obligatory precautions against infections. Bioethics 19 (4): 323–335.CrossRef Verweij, Marcel. 2005. Obligatory precautions against infections. Bioethics 19 (4): 323–335.CrossRef
go back to reference Verweij, Marcel, and A. Dawson. 2004. Ethical principles for collective immunization programs. Vaccine 22: 3122–3126.CrossRef Verweij, Marcel, and A. Dawson. 2004. Ethical principles for collective immunization programs. Vaccine 22: 3122–3126.CrossRef
go back to reference Wringe, Bill. 2010. Global obligations and the agency objection. Ratio 23 (2): 217–231.CrossRef Wringe, Bill. 2010. Global obligations and the agency objection. Ratio 23 (2): 217–231.CrossRef
go back to reference Wringe, Bill. 2016. Collective obligations: their existence, their explanatory power, and their supervenience on the obligations of individuals. European Journal of Philosophy 24 (2): 472–497.CrossRef Wringe, Bill. 2016. Collective obligations: their existence, their explanatory power, and their supervenience on the obligations of individuals. European Journal of Philosophy 24 (2): 472–497.CrossRef
Metadata
Title
The moral obligation to be vaccinated: utilitarianism, contractualism, and collective easy rescue
Authors
Alberto Giubilini
Thomas Douglas
Julian Savulescu
Publication date
01-12-2018
Publisher
Springer Netherlands
Published in
Medicine, Health Care and Philosophy / Issue 4/2018
Print ISSN: 1386-7423
Electronic ISSN: 1572-8633
DOI
https://doi.org/10.1007/s11019-018-9829-y

Other articles of this Issue 4/2018

Medicine, Health Care and Philosophy 4/2018 Go to the issue