Pugh Jonathan, Wilkinson Dominic, Kerridge Ian, Savulescu Julian
University of Oxford, The Oxford Uehiro Centre for Practical Ethics, Oxford, UK.
University of Sydney, School of Public Health and Royal North Shore Hospital, Sydney, Australia.
J Law Biosci. 2022 Mar 16;9(1):lsab036. doi: 10.1093/jlb/lsab036. eCollection 2022 Jan-Jun.
In early 2021, cases of rare adverse events were observed in individuals who had received the Astra Zeneca COVID-19 vaccine. Countries around the world differed radically in their policy responses to these observations. In this paper, we outline the ethical justification for different policy approaches for managing the emerging risks of novel vaccines in a pandemic. We begin by detailing the precautionary approach that some countries adopted, and distinguishing ethical questions regarding the management of known and unknown risks. We go on to outline the harms of adopting a highly precautionary approach in a pandemic context, and explain why an appropriate policy approach should accommodate the benefits as well as the risks of vaccination. In the final section, we outline three policy approaches that can accommodate the different benefits of vaccination, whilst taking into account the harms of precaution. Whilst we do not set out to defend one particular policy approach, we explain how different moral theories lend different degrees of support to each of these different approaches. Our analysis elucidates how fundamental value conflicts in public health ethics played out on the global stage of vaccine policy.
2021年初，在接种了阿斯利康新冠疫苗的人群中观察到了罕见不良事件病例。世界各国对这些观察结果的政策反应截然不同。在本文中，我们概述了在大流行中管理新型疫苗新出现风险的不同政策方法的伦理依据。我们首先详细阐述一些国家采用的预防方法，并区分有关已知和未知风险管理的伦理问题。接着，我们概述在大流行背景下采取高度预防方法的危害，并解释为什么适当的政策方法应兼顾疫苗接种的益处和风险。在最后一部分，我们概述了三种政策方法，这些方法可以兼顾疫苗接种的不同益处，同时考虑到过度预防的危害。虽然我们并非旨在捍卫某一种特定的政策方法，但我们解释了不同的道德理论如何为这些不同方法提供不同程度的支持。我们的分析阐明了公共卫生伦理中的基本价值冲突在全球疫苗政策舞台上是如何展现的。
