Nihlén Fahlquist Jessica
Centre for Research Ethics and Bioethics, Uppsala University, Sweden.
Scand J Public Health. 2018 Mar;46(2):182-188. doi: 10.1177/1403494817727162. Epub 2017 Aug 28.
This paper analyses vaccination policy from an ethical perspective, against the background of the growing hesitancy towards e.g. the measles vaccine.
The paper is normative and analyses ethical aspects of risk communication in the context of vaccination. It is argued that ethical analysis of risk communication should be done at the level of the message, the procedure and the effects. The paper takes examples from the Swedish context, linking the current lack of trust in experts to the 2009 vaccination policy and communication promoting the H1N1 vaccine Pandemrix.
During the Swedish H1N1 vaccination policy in 2009, the message was that the vaccine is safe. However, a group of adolescents developed narcolepsy as a side effect of the vaccine. Taking this into account, it becomes clear that the government should communicate risks and benefits responsibly and take responsibility for individuals affected negatively by populational health interventions.
To communicate respectfully entails not treating vaccine sceptics as ill-informed or less educated, but instead taking the concerns of the vaccine hesitant, who potentially could change their minds, as a starting-point of a respectful discussion. There will inevitably be individuals who suffer from side effects of justifiable population-based health promotion activities. However, the public should be able to trust the message and count on the government to take responsibility for individuals affected by side effects. This is important for normative reasons, but is additionally likely to contribute to restored and maintained trust.
本文在例如对麻疹疫苗的犹豫情绪日益增长的背景下，从伦理角度分析疫苗接种政策。
本文具有规范性，分析了疫苗接种背景下风险沟通的伦理方面。有人认为，应在信息、程序和效果层面进行风险沟通的伦理分析。本文以瑞典的情况为例，将当前对专家缺乏信任与2009年推广甲型H1N1疫苗“帕拉米韦”的疫苗接种政策及沟通联系起来。
在2009年瑞典甲型H1N1疫苗接种政策期间，传达的信息是该疫苗是安全的。然而，一组青少年出现了发作性睡病这一疫苗副作用。考虑到这一点，很明显政府应负责地传达风险和益处，并对受群体健康干预负面影响的个人负责。
进行尊重性沟通意味着不要将疫苗怀疑者视为信息不足或受教育程度低的人，而是将可能改变想法的疫苗犹豫者的担忧作为尊重性讨论的起点。不可避免地会有个人遭受合理的基于群体的健康促进活动的副作用。然而，公众应该能够信任这些信息，并指望政府对受副作用影响的个人负责。这出于规范性原因很重要，而且此外还可能有助于恢复和维持信任。
