Mandatory Vaccine Refusal Using Ethical Theories
Our lives are littered with problems, some have simple solutions but many especially the ones that pertain to our health or to the health of our families are extremely difficult to solve. Health is the most important thing that someone possesses, or in the words of Ghandi “It is health that is real wealth not pieces of gold and silver. ” So when one has to make a decision about wealth they have the liberty to lose some, but when deciding about one’s health no one wants to lose some. The solution to such a sensitive problem is not as easy as choosing between A and B, there is far more to it!
Many times an option that may be beneficial to an individual is not entirely accessible, affordable, or logical, so sacrifices have to be made! This is where such problems become extremely difficult to solve. Does one make a decision that benefits them or everyone as a whole? Does one accept and respect the decision made by a health care practitioner, or does one decide on their own? Furthermore, looking back at what happened in Dublin twelve years ago, can one allow a parent to deny their child access to the MMR vaccine, the lack of which happened to be the root cause in the case leaving three infants deceased?
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This paper will aim to justify that it is ethically not permissible for a guardian to refuse the MMR vaccine for their child, as it not only poses a risk for the child alone but also for all susceptible children in the community. This justification will be reinforced using two ethical theories that nullify the refusal of administration of the vaccine by a guardian, the first theory that will be exhausted will be Act Utilitarianism and further reinforced using W. D.
Ross’s Ethical Pluralism theory. Act utilitarianism (AU) is a fairly straightforward theory with an obligation to equality and impartiality. It comprises of mainly utility and disutility, or in simple terms utility equates to happiness or something worth pursuing and disutility equates to unhappiness or something worthy of avoidance. What act utilitarianism aims for as a theory is to ultimately “maximize utility or minimize disutility of the greatest number of people. (Thomas, Waluchow) Reaching to maximize and minimize simultaneously is not a requirement but if possible it is simply a bonus. In relation to judge if it is ethically permissible for a guardian to refuse MMR vaccination to their child using act utilitarianism, it is clear that according to this theory it is simply not permissible to refuse vaccination. The main concept of the theory is to maximize the utility of the greatest number of people or to minimize disutility of the greatest number of people.
By not vaccinating their child the child is not only at risk but also poses a legitimate health risk to other children in the community. In Dublin the percentage of vaccination fell 20% leading to the death of three children and 100’s of hospitalizations. By not vaccinating the guardian contradicts act utilitarianism, as not vaccinating does not maximize the utility which in this case would be positive health of the individual child and the children of the community but rather maximizes the disutility which is the increase in negative health effects of the children.
Furthermore, “act utilitarianism is impartial, everyone’s pleasures matter, whether it be man, woman, child, or a minority” (Wood) by opting to not vaccinate a child, the pleasures of everyone will be effected negatively. What happened in Dublin in the year 2000 could once again be repeated. This would negatively impact the lives of everyone living in any community. Whereas if the vaccination is administered only the sole guardian’s pleasure would be affected, the guardian would feel uncomfortable as they would mistakenly believe that the MMR has negative side effects which could harm the child.
Another ethical theory refuting the permissibility for a guardian to refuse the MMR vaccine for their child would be W. D. Ross’s – Ethical pluralism. This theory is at the same time very similar to act utilitarianism and very different as well. Where act utilitarianism is a system of checks and balances that aims to ultimately produce happiness or maximize utility, ethical pluralism does so by being pluralistic.
It is “a theory of obligation which recognizes several, irreducible moral relationships and principles” (Thomas, Waluchow) and “provides a list of prima facie duties which provide a helpful classification of some of the various duties and morally significant relationships recognized in our everyday moral thinking. ”(Thomas, Waluchow) So in an uncomplicated way it has a simple guideline known as the prima facie that helps you bestow a weight to relationships while following a simple set of rules. In regards to this paper out of the six prima facie only three will be articulated.
The first prima facie that will be articulated is the fourth prima facie which lists “duties to improve the condition of others; duties of beneficence. ”(Thomas, Waluchow) If a guardian were to deny the administration of the MMR vaccine to their child it would harm the child and other children in the community. The act of refusing vaccination for a child would heavily contradict the fourth prima facie. The practice of beneficence would also be ignored as the individuals administering the vaccine would not be able to practice the act of good while actually allowing harm.
The fifth prima facie lists “duties to improve our own condition; duties of self-improvement. ”(Thomas, Waluchow) A guardian refusing the administration of the MMR to their child would not be improving their own condition rather bringing upon the possibility of deterioration. A child that is not vaccinated with MMR is more likely to fall ill of the measles and mumps, if the child falls ill the guardian will be suffering along with the child. The last prima facie states “duties not to injure others; duties of non-maleficence. (Thomas, Waluchow) An unvaccinated child not only increases the risk of disease conception in the child but also increases the risk of outbreak of the disease in other children of the community. If guardians were to refuse the vaccination in a community this would ultimately lead to a repeat of Dublin 2000, where it was not a sole child falling ill but hundreds Through the points discussed using the act utilitarianism and ethical pluralism theories many questions still arise as to the gaps in the theories.
As we see act utilitarianisms is very simple and is “forward looking” it does not encompass the moral relationships a person has. However ethical pluralism asks us to look backwards, to see what has happened in the past. The combination of both theories allows us to answer the question of refusal of MMR vaccination by looking at the past, in the past when vaccination percentages fell, incidents sharply increased.
Lastly, if one were to question act utilitarianism as monistic theory that is quite one dimensional we can see that Ross’s ethical pluralism is quite pluralistic it embodies what act utilitarianism lacks. In conclusion, the correlation between act utilitarianism and ethical pluralism is quite evident. Both theories aim to benefit a society as a whole while causing little to no harm. The fact that the MMR is a completely safe vaccine that serves only one purpose, which is the prevention against potentially lethal virus’s.
It is therefore right to justify that it is ethically not permissible for a guardian to refuse the MMR vaccine for their child. For a guardian to prevent a child from accessing a vaccine that may save the child life is simply absurd. Works cited Thomas, John E. , and Wilfrid J. Waluchow. Well and Good: Case Studies in Biomedical Ethics. Toronto: Broadview, 1998. Print. Wood, Heath. “Utilitarianism. ” Utilitarianism. University of Colorado, n. d. Web. 17 Oct. 2012. <http://spot. colorado. edu/~heathwoo/Phil220/utilitarianism. html>.