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强制接种疫苗的困境——伦理与法律考量

The Dilemma of Compulsory Vaccinations-Ethical and Legal Considerations.

作者信息

Sela Yael, Grinberg Keren, Nissanholtz-Gannot Rachel

机构信息

Department of Nursing Sciences, Ruppin Academic Center, Emek- Hefer 4025000, Israel.

Department of Health Systems Management, Ariel University, Ariel 40700, Israel.

出版信息

Healthcare (Basel). 2023 Apr 15;11(8):1140. doi: 10.3390/healthcare11081140.

Abstract

The high childhood vaccination coverage in Israel leads to a low rate of morbidity from the diseases against which the vaccination in administered. However, during the COVID-19 pandemic, children's immunization rates declined dramatically due to closures of schools and childcare services, lockdowns, and guidelines for physical distancing. In addition, parents' hesitancy, refusals, and delays in adhering to routine childhood immunizations seem to have increased during the pandemic. A decline in routine pediatric vaccine administration might indicate that the entire population faces increased risks for outbreaks of vaccine-preventable diseases. Throughout history, vaccines have raised questions about their safety, efficacy, and need among adults and parents who feared or hesitated to vaccinate their children. Objections derive from various ideological and religious reasons or concerns about the possible inherent dangers. Mistrust in the government and/or economic or political interests also raise concerns among parents. The importance of providing vaccines to maintain public health, as opposed to the autonomy of the individuals over their body and their children, raises ethical questions. In Israel, there is no legal obligation to get vaccinated. It is imperative to find a decisive solution to this situation without delay. Furthermore, where democratically one's principles are sacred and where one's autonomy over one's body is also unquestionable, such a legal solution would not only be unacceptable but also rather impossible to enforce. It seems that some reasonable balance between the necessity to preserve public health and our democratic principles should apply.

摘要

以色列儿童疫苗接种率高,使得针对所接种疫苗的疾病发病率较低。然而,在新冠疫情期间,由于学校和托儿服务机构关闭、封锁措施以及保持社交距离的指导方针,儿童免疫接种率大幅下降。此外,在疫情期间,家长对常规儿童免疫接种的犹豫、拒绝和拖延似乎有所增加。常规儿科疫苗接种的减少可能表明整个人口面临疫苗可预防疾病爆发的风险增加。纵观历史,疫苗在那些害怕或犹豫是否给孩子接种疫苗的成年人和家长中引发了关于其安全性、有效性和必要性的问题。反对意见源于各种意识形态和宗教原因,或对可能存在的内在危险的担忧。对政府的不信任和/或经济或政治利益也引发了家长的担忧。提供疫苗以维护公众健康的重要性,与个人对自己身体和孩子的自主权相对立,引发了伦理问题。在以色列,没有接种疫苗的法律义务。必须立即找到解决这一局面的决定性办法。此外,在一个民主的国家,个人的原则是神圣的,个人对自己身体的自主权也是无可争议的,这样的法律解决方案不仅不可接受,而且很难执行。似乎应该在维护公众健康的必要性和我们的民主原则之间找到某种合理的平衡。

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