Ethics of vaccine refusal

2021 ◽  
pp. medethics-2020-107026
Author(s):  
Michael Kowalik

Proponents of vaccine mandates typically claim that everyone who can be vaccinated has a moral or ethical obligation to do so for the sake of those who cannot be vaccinated, or in the interest of public health. I evaluate several previously undertheorised premises implicit to the ‘obligation to vaccinate’ type of arguments and show that the general conclusion is false: there is neither a moral obligation to vaccinate nor a sound ethical basis to mandate vaccination under any circumstances, even for hypothetical vaccines that are medically risk-free. Agent autonomy with respect to self-constitution has absolute normative priority over reduction or elimination of the associated risks to life. In practical terms, mandatory vaccination amounts to discrimination against healthy, innate biological characteristics, which goes against the established ethical norms and is also defeasible a priori.

Vaccines ◽  
2021 ◽  
Vol 9 (2) ◽  
pp. 113
Author(s):  
Meta Rus ◽  
Urh Groselj

Although vaccination is recognised as the top public health achievement of the twentieth century, unequivocal consensus about its beneficence does not exist among the general population. In countries with well-established immunisation programmes, vaccines are “victims of their own success”, because low incidences of diseases now prevented with vaccines diminished the experience of their historical burdens. Increasing number of vaccine-hesitant people in recent years threatens, or even effectively disables, herd immunity levels of the population and results in outbreaks of previously already controlled diseases. We aimed to apply a framework for ethical analysis of vaccination in childhood based on the four principles of biomedical ethics (respect for autonomy, nonmaleficence, beneficence and justice) to provide a comprehensive and applicable model on how to address the ethical aspects of vaccination at both individual and societal levels. We suggest finding an “ethical equilibrium”, which means that the degree of respect for parents’ autonomy is not constant, but variable; it shall depend on the level of established herd immunity and it is specific for every society. When the moral obligation of individuals to contribute to herd immunity is not fulfilled, mandatory vaccination policies are ethically justified, because states bear responsibility to protect herd immunity as a common good.


2021 ◽  
Vol 11 (3-4) ◽  
pp. 153-162
Author(s):  
Martin O’Malley ◽  
Jürgen Zerth ◽  
Nikolaus Knoepffler

Abstract Vaccine scarcity and availability distinguish two central ethics questions raised by the Covid-19 pandemic. First, in situations of scarcity, which groups of persons should receive priority? Second, in situations where safe and effective vaccines are available, what circumstances and reasons can support mandatory vaccination? Regarding the first question, normative approaches converge in prioritizing most-vulnerable groups. Though there is room for prudential judgement regarding which groups are most vulnerable, the human dignity principle is most relevant for prioritization consideration of both medical and non-medical issues. The second question concerning mandates is distinct from considerations about persons’ individual moral duty to receive vaccines judged reasonably safe and critical for individual and public health. While there is consensus regarding the potential normative support for mandated vaccination, the paternalistic government intervention of vaccine mandates requires a high bar of demonstrated vaccine safety and public health risk. We discuss stronger and weaker forms of paternalism to deal with the Covid-19 pandemic from an “integrative” approach that integrates leading normative approaches. We argue against a population-wide compulsory vaccination and support prudential measures to 1) protect vulnerable groups; 2) focus upon incentivizing vaccine participation; 3) maintain maximum-possible individual freedoms, and 4) allow schools, organizations, and enterprises to implement vaccine requirements in local contexts.


Biology ◽  
2021 ◽  
Vol 10 (6) ◽  
pp. 463
Author(s):  
Narjiss Sallahi ◽  
Heesoo Park ◽  
Fedwa El Mellouhi ◽  
Mustapha Rachdi ◽  
Idir Ouassou ◽  
...  

Epidemiological Modeling supports the evaluation of various disease management activities. The value of epidemiological models lies in their ability to study various scenarios and to provide governments with a priori knowledge of the consequence of disease incursions and the impact of preventive strategies. A prevalent method of modeling the spread of pandemics is to categorize individuals in the population as belonging to one of several distinct compartments, which represents their health status with regard to the pandemic. In this work, a modified SIR epidemic model is proposed and analyzed with respect to the identification of its parameters and initial values based on stated or recorded case data from public health sources to estimate the unreported cases and the effectiveness of public health policies such as social distancing in slowing the spread of the epidemic. The analysis aims to highlight the importance of unreported cases for correcting the underestimated basic reproduction number. In many epidemic outbreaks, the number of reported infections is likely much lower than the actual number of infections which can be calculated from the model’s parameters derived from reported case data. The analysis is applied to the COVID-19 pandemic for several countries in the Gulf region and Europe.


2011 ◽  
Vol 26 (S1) ◽  
pp. s63-s63
Author(s):  
M. Reilly

IntroductionRecent studies have discussed major deficiencies in the preparedness of emergency medical services (EMS) providers to effectively respond to disasters, terrorism and other public health emergencies. Lack of funding, lack of national uniformity of systems and oversight, and lack of necessary education and training have all been cited as reasons for the inadequate emergency medical preparedness in the United States.MethodsA nationally representative sample of over 285,000 emergency medical technicians (EMTs) and Paramedics in the United States was surveyed to assess whether they had received training in pediatric considerations for blast and radiological incidents, as part of their initial provider education or in continuing medical education (CME) within the previous 24 months. Providers were also surveyed on their level of comfort in responding to and potentially treating pediatric victims of these events. Independent variables were entered into a multivariate model and those identified as statistically significant predictors of comfort were further analyzed.ResultsVery few variables in our model caused a statistically significant increase in comfort with events involving children in this sample. Pediatric considerations for blast or radiological events represented the lowest levels of comfort in all respondents. Greater than 70% of respondents reported no training as part of their initial provider education in considerations for pediatrics following blast events. Over 80% of respondents reported no training in considerations for pediatrics following events associated with radiation or radioactivity. 88% of respondents stated they were not comfortable with responding to or treating pediatric victims of a radiological incident.ConclusionsOut study validates our a priori hypothesis and several previous studies that suggest deficiencies in preparedness as they relate to special populations - specifically pediatrics. Increased education for EMS providers on the considerations of special populations during disasters and acts of terrorism, especially pediatrics, is essential in order to reduce pediatric-related morbidity and mortality following a disaster, act of terrorism or public health emergency.


2021 ◽  
Vol 43 (2) ◽  
pp. 112-124
Author(s):  
Kevin S. Doyle

Drug overdose deaths in the United States have reached unprecedented levels in recent years and continue to rise. Counselors are uniquely positioned to respond to this crisis but may be reluctant or not equipped to do so due to a variety of factors, including scope of practice concerns. Responding to this crisis, however, is a clinical necessity and an ethical imperative for all practicing counselors, regardless of specialty area. A review of proposed responses at the macro/systemic, professional, and personal levels is presented, with concrete examples within each level, to assist counselors in identifying and implementing professional activity, advocacy, and engagement to address the unprecedented national public health emergency. Specific considerations for advocacy and for clinical practice are proposed to further assist counselors and motivate action.


2021 ◽  
Author(s):  
Valentin Ritschl ◽  
Fabian Eibensteiner ◽  
Erika Mosor ◽  
Maisa Omara ◽  
Lisa Sperl ◽  
...  

BACKGROUND On January 30, 2020, the World Health Organization (WHO) Emergency Committee declared the rapid worldwide spread of Coronavirus Disease 2019 (COVID-19) a global health emergency. By December 2020, the safety and efficacy of the first COVID-19 vaccines had been demonstrated. However, global vaccination coverage rates have remained below expectations. Mandatory vaccination is now being controversially discussed and has been enacted in some developed countries, while the vaccination rate is very low in many developing countries. We used the Twitter survey system as a viable method to quickly and comprehensively gather international public health insights on mandatory vaccination against COVID-19. OBJECTIVE The purpose of this study was to understand better the public's perception of mandatory COVID-19 vaccination in real-time utilizing Twitter polls. METHODS Two Twitter polls were developed to seek the public's opinion on the possibility of mandatory vaccination. The polls were pinned to the Digital Health and Patient Safety Platform's Twitter timeline for one week in mid-November 2021, three days after the official public announcement of mandatory COVID-19 vaccination in Austria. Twitter users were asked to participate and retweet the polls to reach the largest possible audience. RESULTS Our Twitter polls revealed two extremes on the topic of mandatory vaccination against COVID-19. Almost half of the respondents (49% [1,246/2,545]) favour mandatory vaccination, at least in certain areas. This attitude is in contrast to the 45.7% (1,162/2,545) who categorically reject mandatory vaccination. 26.3% (621/2,365) of participating Twitter users said they would never get vaccinated, which is reflected by the current vaccination coverage rate. Concatenating interpretation of these two polls needs to be done cautiously as participating populations might greatly differ. CONCLUSIONS Mandatory vaccination against COVID-19 (in at least certain areas) is favoured by less than 50%, whereas it is vehemently opposed by almost half of the surveyed Twitter users. Since (social) media strongly influences public perceptions and views through and social media discussions and surveys specifically susceptible to the "echo chamber effect", the results can be seen as a momentary snapshot. Therefore, the results of this study need to be complemented by long-term surveys to maintain their validity.


Author(s):  
H.M. Snyder ◽  
M.C. Carrillo

An estimated 47 million people worldwide are living with dementia in 2015 and this number is expected to triple by 2050. There is a clear urgency for therapies and / or interventions to slow, stop or prevent dementia. Amounting evidence suggests strategies to reduce risk of development dementia may be of growing import for reducing the number of individuals affected. The Alzheimer’s Association believes, from a population based perspective that: (1) Regular physical activity and management of cardiovascular risk factors (e.g. diabetes, obesity, smoking and hypertension) have been shown to reduce the risk of cognitive decline and may reduce the risk of dementia; (2) A healthy diet and lifelong learning/cognitive training may also reduce the risk of cognitive decline. The current evidence underscores the need to communicate to the broader population what the science indicates and to do so with diverse stakeholders and consistent messaging. There has never been a better time to define and distribute global messaging on public health for dementia.


2017 ◽  
Vol 2 (Suppl. 1) ◽  
pp. 1-8
Author(s):  
Denis Horgan ◽  
Walter Ricciardi

In the world of modern health, despite the fact that we've been blessed with amazing advances of late - the advent of personalised medicine is just one example - “change” for most citizens seems slow. There are clear discrepancies in availability of the best care for all, the divisions in access from country to country, wealthy to poor, are large. There are even discrepancies between regions of the larger countries, where access often varies alarmingly. Too many Member States (with their competence for healthcare) appear to be clinging stubbornly to the concept of “one-size-fits-all” in healthcare and often stifle advances possible through personalised medicine. Meanwhile, the legislative arena encompassing health has grown big and unwieldy in many respects. And bigger is not always better. The health advances spoken of above, an increased knowledge on the part of patients, the emergence of Big Data and more, are quickly changing the face of healthcare in Europe. But healthcare thinking across the EU isn't changing fast enough. The new technologies will certainly speak for themselves, but only if allowed to do so. Acknowledging that, this article highlights a positive reform agenda, while explaining that new avenues need to be explored.


1901 ◽  
Vol 47 (197) ◽  
pp. 362-362
Keyword(s):  
A Priori ◽  

Dr. W. Watson (Edinburgh) writes in reference to Dr. Ireland's study of Nietzsche, that Nietzsche's acute sense of smell is very characteristic. He regards it as a reversion to a lower type. But specially Dr. Watson says, “The weakness of his sexual instinct is childlike. He seems to have combined the intellect of a man with the morality of a child. Does such a combination often accompany non-developed sexual instincts? It ought to do so a priori.”


2018 ◽  
Vol 30 (4) ◽  
pp. 393-419 ◽  
Author(s):  
Siegwart Lindenberg ◽  
Linda Steg ◽  
Marko Milovanovic ◽  
Anita Schipper

The most investigated form of moral hypocrisy is pragmatic hypocrisy in which people fake moral commitment for their own advantage. Yet there is also a different form of hypocrisy in which people take a moral stance with regard to norms they endorse without thereby also expressing a commitment to act morally. Rather they do it in order to feel good. We call this hedonic moral hypocrisy. In our research, we posit that this kind of hypocrisy comes about when people’s overarching goals are shifted in a hedonic direction, that is, in the direction of focusing on the way one feels, rather than on moral obligation. Hedonic shifts come about by cues in the environment. People are sometimes sincere when expressing a moral stance (i.e. they mean it and also act on it), and sometimes, when they are subject to a hedonic shift, they express a moral stance just to make them feel good. This also implies that they then decline to do things that make them feel bad, such as behaving morally when it takes unrewarded effort to do so. In two experimental studies, we find that there is such a thing as hedonic moral hypocrisy and that it is indeed brought about by hedonic shifts from cues in the environment. This seriously undermines the meaning of a normative consensus for norm conformity. Seemingly, for norm conformity without close social control, it is not enough that people endorse the same norms, they also have to be exposed to situational cues that counteract hedonic shifts. In the discussion, it is suggested that societal arrangements that foster the focus on the way one feels and nurture a chronic wish to make oneself feel better (for example, in the fun direction through advertisements and entertainment opportunities, or in the fear direction by populist politicians, social media, economic uncertainties, crises, or wars and displacements) are likely to increase hedonic hypocrisy in society.


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