Verweij Marcel F, Houweling Hans
Department of Social Sciences, Section Communication, Philosophy and Technology, Wageningen University, The Netherlands.
Health Council of the Netherlands, The Netherlands.
Vaccine. 2014 Dec 12;32(52):7163-6. doi: 10.1016/j.vaccine.2014.10.008. Epub 2014 Oct 22.
Given the ethical aspects of vaccination policies and current threats to public trust in vaccination, it is important that governments follow clear criteria for including new vaccines in a national programme. The Health Council of the Netherlands developed such a framework of criteria in 2007, and has been using this as basis for advisory reports about several vaccinations. However, general criteria alone offer insufficient ground and direction for thinking about what the state ought to do. In this paper, we present and defend two basic ethical principles that explain why certain vaccinations are the state's moral-political responsibility, and that may further guide decision-making about the content and character of immunisation programmes. First and foremost, the state is responsible for protecting the basic conditions for public health and societal life. Secondly, states are responsible for promoting and securing equal access to basic health care, which may also include certain vaccinations. We argue how these principles can find reasonable support from a broad variety of ethical and political views, and discuss several implications for vaccination policies.
鉴于疫苗接种政策的伦理层面以及当前公众对疫苗接种信任面临的威胁，政府遵循明确的标准将新疫苗纳入国家计划非常重要。荷兰健康委员会于2007年制定了这样一个标准框架，并一直以此为基础撰写有关几种疫苗接种的咨询报告。然而，仅靠一般标准为思考国家应该做什么提供的依据和指导是不够的。在本文中，我们提出并捍卫两项基本伦理原则，这两项原则解释了为什么某些疫苗接种是国家的道德政治责任，并且可能进一步指导关于免疫计划内容和性质的决策。首先也是最重要的，国家有责任保护公众健康和社会生活的基本条件。其次，国家有责任促进并确保平等获得基本医疗保健，这也可能包括某些疫苗接种。我们论证了这些原则如何能从广泛的伦理和政治观点中获得合理支持，并讨论了对疫苗接种政策的若干影响。
