I am going to address the vaccine mandates, since it is such a controversial topic right now. It is not an issue of whether we are legally able to require vaccination. According to Gostin et al. (2021), mandatory vaccine mandates are legal, since the federal case of Jacobson v Massachusetts upheld mandatory vaccinations as a condition for children to attend school in 1905. They also indicate that adult mandatory vaccination is very rare and usually limited to specific situations such as working in healthcare or attending post-secondary educational institutions (Gostin et al., 2021).
The author of my article “May I Please See your Proof of Vaccination: Ethical Decision-Making About Vaccination Mandates” is in public service management at DePaul University, writing about mandatory vaccination and public restrictions thereof (Friedrich, 2021). She refers to the need to reach a immunity rate of about 70% to reach herd immunity (the level of immunity in which spread will be unlikely, even in the unvaccinated) and discusses two similar pandemics, polio and smallpox, and the approaches used then to achieve a similar goal. She then applies an ethical framework to this, developed by the Markkula Center for Applied Ethics at Santa Clara University and includes the following elements: “recognize the ethical issue, get the facts, evaluate alternative actions, make a decision and test it, act and reflect on the outcome” (Friedrich, 2021, p. 43). The issue is requiring proof of vaccination to do certain activities such as indoor gathering and travel allows the vaccinated to participate in activities that are reasonably safe given their status and without increasing their risk due to the presence of a large number of the unvaccinated being present, but at the same time creates a class system where two groups of citizens have different freedoms and rights. In gathering the data, the author acknowledges that one cannot see all unvaccinated people as “refusers” (Friedrich, 2021).
It comes back to the view of people as sinners or victims, as described by Mechanic & Tanner (2007). If the unvaccinated are seen as refusing the vaccine and being unwilling to trust science, then it is easy to ignore their position in this. If they are seen as victims, which might include the children, people with certain comorbidities, and those allergic to components of the vaccine who can’t get vaccinated, minorities with a past of victimization in research by our government and by science, those with a history of trauma that makes them more susceptible to conspiracy theories or anti-vaccine movements, and people who have not had access to receive a vaccine yet, then it becomes quite difficult to create this caste system for freedom.
Friedrich (2021) makes some important points about the ethical approaches to this. According to the different ethical values (utilitarian, rights, justice, common good, virtue), virtue and common good ethics seem like the best ones to apply to the situation, as equal treatment is impossible, and each groups’ rights would directly oppose the others. Doing all or none would harm one group or the other indiscriminately and without exception. It effectively makes those without a choice collateral damage. According to the common good and virtue approach, restrictions such as masks could be used in certain high-risk situations such as airline travel and in healthcare facilities, and exemptions could be made for the vaccinated to go unmasked with proof of vaccination (or by the honor system) in lower risk scenarios such as in-person therapy appointments or going to a museum. This could also be applied to mandatory vaccination in certain high-risk fields. Friedrich posits that healthcare fields have an ethical duty to protect patients through vaccination, especially given that the clientele is vulnerable by definition. Other areas of employment do not have regular contact with vulnerable populations, or sometimes even the public, and mandatory vaccination does not make sense in those cases. This “would not only balance the least harm and the most good, but also best serve the overall common good” (Friedrich, 2021, p. 44).
References
Friedrich, S. (2021). May I please see your proof of vaccination?: Ethical decision-making about vaccination mandates. International Forum of Teaching & Studies, 17(2), 41–47.
Gostin, L. O., Salmon, D. A., & Larson, H. J. (2021). Mandating COVID-19 vaccines. JAMA, The Journal of the American Medical Association, 325(6), 532.
Mechanic, D., & Tanner, J. (2007). Vulnerable people, groups, and populations: societal view. Health Affairs (Project Hope), 26(5), 1220–1230. https://doi.org/10.1377/hlthaff.26.5.1220.
RuralEdMed 