Giubilini Alberto, Douglas Thomas, Savulescu Julian
Oxford Martin School and Wellcome Centre for Ethics and Humanities, University of Oxford, Oxford, UK.
Oxford Uehiro Centre for Practical Ethics, University of Oxford, Littlegate House, St Ebbes St, Oxford, OX1 1PT, UK.
Med Health Care Philos. 2018 Dec;21(4):547-560. doi: 10.1007/s11019-018-9829-y.
We argue that individuals who have access to vaccines and for whom vaccination is not medically contraindicated have a moral obligation to contribute to the realisation of herd immunity by being vaccinated. Contrary to what some have claimed, we argue that this individual moral obligation exists in spite of the fact that each individual vaccination does not significantly affect vaccination coverage rates and therefore does not significantly contribute to herd immunity. Establishing the existence of a moral obligation to be vaccinated (both for adults and for children) despite the negligible contribution each vaccination can make to the realisation of herd immunity is important because such moral obligation would strengthen the justification for coercive vaccination policies. We show that two types of arguments-namely a utilitarian argument based on Parfit's Principle of Group Beneficence and a contractualist argument-can ground an individual moral obligation to be vaccinated, in spite of the imperceptible contribution that any single vaccination makes to vaccine coverage rates. We add a further argument for a moral obligation to be vaccinated that does not require embracing problematic comprehensive moral theories such as utilitarianism or contractualism. The argument is based on a "duty of easy rescue" applied to collectives, which grounds a collective moral obligation to realise herd immunity, and on a principle of fairness in the distribution of the burdens that must be borne to realise herd immunity.
我们认为，那些能够接种疫苗且不存在医学上接种禁忌的个人，有道德义务通过接种疫苗来为实现群体免疫做出贡献。与一些人所声称的相反，我们认为，尽管每一次个体接种对疫苗接种覆盖率的影响并不显著，因此对群体免疫的贡献也不大，但这种个体道德义务依然存在。确立接种疫苗（包括成人和儿童）的道德义务的存在很重要，尽管每次接种对实现群体免疫的贡献微不足道，因为这种道德义务将加强强制接种疫苗政策的正当性。我们表明，有两类论证——即基于帕菲特群体利益原则的功利主义论证和契约主义论证——可以确立接种疫苗的个体道德义务，尽管任何一次单一接种对疫苗接种覆盖率的贡献微不足道。我们还补充了一个关于接种疫苗道德义务的论证，该论证不需要接受功利主义或契约主义等有问题的全面道德理论。这个论证基于适用于集体的“轻松救援义务”，它确立了实现群体免疫的集体道德义务，以及基于在为实现群体免疫而必须承担的负担分配中的公平原则。
