Vaccinate for the greater good: A Christian ethical perspective
Discussions of compulsory vaccination, for the greater or common good, are usually treated as a public policy, legislation, or in ethical terms, as utilitarian or functional practice. Anyone, two or all three of these approaches is/are for the benefit of the majority, yet the views and interests of minority groups must not be overlooked in the national interest.
Weighed in favour of the public good, public health and checks and balances are vital in order to avoid abuse of the most vulnerable. Even as we work towards achieving herd immunity for COVID-19, drastic measures must be taken. The disruption of and increased loss of lives by the pandemic indicate that compulsory vaccination in the public interest ought not to be ruled out of public discourse. Public policy, which may not be converted to law, as in the case of the current arrangement for the vaccination of children, has its place outside of a dire emergency.
Laws and their enforcement in Cuba, give effect to compulsory vaccination and have resulted in up to 50 percent of their population receiving at least one dose. This is not to suggest Jamaica adopts the ideology of our neighbor but may wish to move closer to the position of the Republic of Southern Africa, which, though not compulsory, indicates that individual rights may be restricted for the common good. Such a perspective keeps in mind the public or common good, especially with the well-established practice that Jamaican students must provide a vaccination card to prove that they have been fully vaccinated, in order to attend early childhood and other educational institutions. Let us not forget that vaccination against measles, rubella, mumps, etc, though largely a 20th-century phenomenon, through a robust public policy promulgated in 1984, support was provided for practices in favour of public good in the eradication of these diseases.
Legislation for the greater good has been known to prevent infectious diseases. This is one reason behind the Public Health (Immunization) Regulations, 1986, of the Public Health Act of 1974. These regulations find resonance in chapter 20 of the constitution, which makes provision for a public declaration by the governor-general in the context of pestilence or pandemic. The declaration requires the support of a two-thirds majority from both Houses of Parliament to address the plague and therefore anticipates national consensus around the issue. This accord is nothing short of a beneficent action for the common good, and in a crisis such as this COVID-19 pandemic, it is a step that is urgently needed. Indeed, now is the time to affirm our Jamaicanness and come together to address what the constitution describes as “a period of public disaster…as a result of the occurrence of …outbreak of pestilence [and] infectious disease.”
In addition to the aforementioned, recent reports coming out of the Bar Association that there is no ruling in the local courts which overtly or covertly prevents the authorities from implementing a vaccine policy, for the greater good, in the workplace and for public gatherings is very useful. In a report in this newspaper of 31 August, the president of the Jamaica Bar Association is quoted as saying there is no law at present that prevents or prohibits the government from making vaccination for COVID-19 compulsory.
From an ethical perspective, the pursuit of the common good through compulsory vaccination can be argued using the utilitarian theory of ethics. Its roots go back to the work of the English philosopher Jeremy Bentham (1748-1832) whose theory speaks to our duty to self, family, group/tribe and nation. In this way, the action of each person is to be measured not just as a benefit to self but more so as advantageous to the greater or national good. Christians know of this goodness as one person acting for all (Rom 5:12). It is akin to Jesus feeding the multitudes, healing the sick, casting out demons, correcting acts of injustices in the temple and the affirmation by Pilate of one man dying for all (John 11:50). Jesus epitomizes this altruistic action as a sign that a loving God is committed to die on a cross for the sake of the wellbeing or salvation of all (John 3:16).
Critics of this functional approach to ethical duty say it thrives on a slippery slope. That is, it runs the risk of group oppression on vulnerable individuals who affirm freedom of conscience on matters of religion, ideas, etc in order to act or not to act. Large-scale practices of racism that resulted in ongoing racial and gender injustices are just two examples of cases in which a powerful majority renders neutral the rights of minorities. Also, recent attempts by politicians to persuade skeptics to get vaccinated, including monetary compensation led some persons to increase their cynicism of political leaders as bearers of good news.
To address the dilemma, advocates of this ethical approach invite us to think about the issue from two perspectives. The first is the use of instrumental harm in which physical injury is deliberately and intentionally deflected on others for the benefit of the majority. This was the case of the Tuskegee clinical trial for syphilis in the 1930s in which 600 Black men with the virus were not treated and were not allowed to give informed consent to participate in the study.
Another study in South Africa highlighted the fact that during the apartheid era Black people with gunshot or stab wounds were not operated on and neither were they allowed informed consent to participate in the study to see how they responded physiologically. Indeed, the evidence from the World Health Organization (WHO) and the Centre for Disease Control (CDC) is that clinical trials for the SARS COVID, which go back to 2002, are consistent with standard ethical practices for research and so should not be linked with instrumental harm.
A second perspective of this ethical practice is impartial or beneficent care for everyone. This concern goes to the heart of the idea of the greater or common good or what Jesus referred to as life in abundance (John 10:10). It is impartial or disinterested love, in that there is no ulterior motive of monetary gain, prestige or power. Rather it is for the national good, with the goal of preserving and sustaining all life, especially that of the most vulnerable.
With respect to vaccines for COVID-19, at the outset of the pandemic, we were told persons 70 yrs and older were most at risk. Now that new variants are emerging and the word is that the vaccines are efficient and efficacious in the context of high morbidity and mortality, even among the young, the greater good is at stake and radical actions, including compulsory vaccination must not be ruled out. To this end, the issue of compulsory vaccination must be brought to the forefront as a practice of impartial beneficence and as an important issue that our lawmakers should take into account in the national interest.
Garth Minott is Deputy President of the United Theological College of the West Indies.
