An Argument for Compulsory Vaccination: The Taxation Analogy

I argue that there are significant moral reasons in addition to harm prevention for making vaccination against certain common infectious diseases compulsory. My argument is based on an analogy between vaccine refusal and tax evasion. First, I discuss some of the arguments for compulsory vaccination that are based on considerations of the risk of harm that the non-vaccinated would pose on others; I will suggest that the strength of such arguments is contingent upon circumstances and that in order to provide the strongest defence possible of compulsory vaccination, such arguments need to be supplemented by additional arguments. I will then offer my additional argument for compulsory vaccination: I will argue that in both cases of vaccine refusal and of tax evasion individuals fail to make their fair contribution to important social and public goods, regardless of whether each individual contribution ‘makes a difference’. While fairness considerations have sometimes been used to support a moral duty to vaccinate, they have not been appealed to in order to argue for a legal duty to vaccinate. I will suggest that this is due, among other things, to a misapplication of the principle of the least restrictive alternative in public health. Finally, I will address nine possible objections to my argument.     

Right, Equality, and the Fairness Obligation

The principle of fairness holds that individuals (beneficiaries) who benefit from a cooperative scheme of others (cooperators) have an obligation to do their share in return for their benefit. The original proponent of this principle, H. L. A. Hart suggests ‘mutuality of restrictions’ as a moral basis because it is fair to mutually restrict the freedom of both beneficiaries and cooperators; so called the fairness obligation. This paper explores ‘mutuality of restrictions’, which is interpreted as a right-based and an equality-based justification of the fairness obligation. It is not argued whether both ways of justifying the obligation makes a success, but that they are in need of presupposing that there is a duty for beneficiaries to do their share in return for their benefit. This suggests turning to a duty-based justification of the fairness obligation.     

How to Release Oneself from an Obligation: Good News for Duties to Oneself

In some cases, you may release someone from some obligation they have to you. For instance, you may release them from a promise they made to you, or an obligation to repay money they have borrowed from you. But most take it as clear that, if you have an obligation to someone else, you cannot in any way release yourself from that obligation. I shall argue the contrary. The issue is important because one standard problem for the idea of having duties to oneself relies on the impossibility of self-release. The argument (the ‘Release Argument’) is that a duty to oneself would be a duty from which one could release oneself, but that this is an absurdity, and so there can be no duties to oneself. This argument is to be rejected because a duty from which one can release oneself is perfectly possible, and such release occurs quite properly from time to time.     

POLITICAL OBLIGATION AND THE PARTICULARITY PROBLEM

Natural duty theorists of political obligation try to base a moral duty to obey the law on some natural duty, such as the duty to promote justice. Their critics say they confront an insurmountable obstacle in the particularity problem: Since natural duties do not bind us to some persons and institutions more strongly than to others, they cannot support a duty to one particular state or society. I solve the particularity problem, by developing a version of the political obligation thesis, giving a natural duty argument for it and showing that the particularity problem does not arise for the argument. I reply to some likely objections to my view.     

Using game theory to examine incentives in influenza vaccination behavior

The social good often depends on the altruistic behavior of specific individuals. For example, epidemiological studies of influenza indicate that elderly individuals, who face the highest mortality risk, are best protected by vaccination of young individuals, who contribute most to disease transmission. To examine the conditions under which young people would get vaccinated to protect elderly people, we conducted a game-theory experiment that mirrored real-world influenza transmission, with "young" players contributing more than "elderly" players to herd immunity. Participants could spend points to get vaccinated and reduce the risk of influenza. When players were paid according to individual point totals, more elderly than young players got vaccinated, a finding consistent with the Nash equilibrium predicting self-interested behavior. When players were paid according to group point totals, however, more young than elderly players got vaccinated-a finding consistent with the utilitarian equilibrium predicting group-optimal behavior-which resulted in higher point totals than when players were paid for their individual totals. Thus, payout structure affected whether individuals got vaccinated for self-interest or group benefit.     

Why the Duty to Self-Censor Requires Social-Media Users to Maintain Their Own Privacy

Revelations of personal matters often have negative consequences for social-media users. These consequences trigger frequent warnings, practical rather than moral in nature, that social-media users should consider carefully what they reveal about themselves since their revelations might cause them various difficulties in the future. I set aside such practical considerations and argue that social-media users have a moral obligation to maintain their own privacy that is rooted in the duty to self-censor. Although Anita L. Allen provides a paternalist justification of the duty that supports my position that social-media users are obligated to self-censor what they reveal about themselves, I justify the obligation through considerations that are more palatable to liberals than is paternalism. I accomplish this by arguing that the failure to self-censor often creates for others undue burdens that individuals are obligated morally not to create. In particular, social-media revelations often create undue burdens for those, such as employers and university personnel, who are obligated morally to respect individuals’ privacy in their decision-making processes. I also demonstrate that this argument is not for a broad duty to self-censor, but, rather, for a narrow duty that applies to particular circumstances such as certain uses of social media.

     

Making Attentive Citizens: The Ethics of Democratic Engagement,Political Equality,and Social Justice

Much discussion of the ethics of participation focuses on electoral participation and whether citizens are obligated or can be coerced to vote. Yet these debates have ignored that citizens must first pay attention to politics and make up their minds about where they stand before they can engage in any form of participation. This article considers the importance for liberal democracy of citizens paying attention to politics, or attentive citizenship. It argues that the democratic state has an obligation to cultivate interest in politics and that this obligation authorizes means up to and including some forms of coercion. The argument is that when citizens are inattentive to politics, it undermines political equality and social justice because it undermines what John Rawls called the fair value of the political liberties. The importance of these ends for liberal democratic states requires them to take steps to promote attentive citizenship.     

Response to Erich Loewy: commentary

The capacity to suffer, the vulnerability with respect to suffering, confers on all animals with that capacity (not just human beings) a prima facie right not to be caused suffering. Nurturing in order to stave off such suffering is the first act of the community toward the individual, primarily in infancy. Hence for Loewy, autonomy, the gradual growth of self-determination in individuals, is grounded in a broader moral commitment of the community, that of beneficence. This is the critical point in his argument, for it represents a wholesale critique of modern libertarianism. Libertarians, in contrast to Loewy's argument, seem to ground the nature of the community in the prima facie right of autonomy. For Loewy, the community not only has an obligation to refrain from harming individuals (nonmaleficence), but it also has an active duty to ameliorate and prevent, as far as possible, the suffering of its members. Thus, if there is a social contract, it is one of nurturing one another to overcome the vulnerability of suffering, not primarily one of protecting autonomy. This is most significant for clinical ethics as well. Once the primary obligation to ameliorate suffering is no longer necessary, when the individual loses or does not have the primary moral worth prompted by the capacity to suffer, then secondary and symbolic obligations emerge. Loewy is thereby able to suggest a "calculus" of moral worth, wherein our obligations to individuals in a permanent vegetative state or to anencephalics (almost always the individual will have lost the capacity to suffer through some cerebral event) must be weighed against other primary obligations. Although Loewy admits that grounding clinical ethics in the capacity to suffer might be "thin," it nevertheless prompts serious discussion about the nature of the "good" in good clinical ethics decisions.     

论病人的“选医权”

选医权是病人的一项基本权力,它能消除医患间事实上的不平等,具有公平的法律价值,能够保证起点公平、过程公平和结果公平。在实施选医权的过程中,病人要正确行使权力,不能滥用权力,履行自己应尽的义务;医院和医生必须为保证病人选医权履行相应的义务。     

GOD, WAR, AND CONSCIENCE

Many military officers believe that they morally ought to obey legal orders to fight even in unjust wars: they have a moral obligation to exercise indiscriminate obedience to legal orders to fight. I argue that officers should not be required to exercise indiscriminate obedience: certain theistic commitments to which many citizens and officers adhere prohibit indiscriminate obedience to legal orders to fight. This theistic argument constitutes adequate reason not to require officers to exercise indiscriminate obedience. However, this raises a further question: namely, whether it is appropriate to rely on such a theistic argument when shaping the moral requirements of military officership. I argue that citizens and officers have good reason to make public decisions solely on religious grounds and so are free to follow my theistic argument when shaping the requirements of military officership.     

伦理豁免刍议

伦理豁免,是在一定的伦理尤其是亲属关系(一定程度上包括朋友关系)中,在究竟是履行伦理的义务、还是履行法律的义务之间,人们陷入紧张冲突甚至两难的情况下,被法律赋予一定的特殊权利,得依法免除法定的义务、责任甚至罪责。中华伦理、中华法系以伦理豁免来解决伦理、法律的矛盾,有宝贵的理论和实践;其中蕴涵的基本价值是,通过维护伦理,从根本上维护社会秩序。伦理豁免对今天解决伦理、法律之两难,仍是宝贵的智慧。     

Embryos, individuals, and persons: an argument against embryo creation and research

One strategy for arguing that it should be legally permissible to create human embryos, or to use of spare human embryos, for scientific research purposes involves the claim that such embryos cannot be persons because they are not human individuals while twinning may yet take place. Being a human individual is considered to be by most people a necessary condition for being a human person. I argue first that such an argument against the personhood of embryos must be rationally conclusive if their destruction in public places such as laboratories is to be countenanced. I base this argument on a popular understanding of the role that the notion of privacy plays in abortion law. I then argue that such arguments against personhood are not rationally conclusive. The claim that the early embryos is not a human individual is not nearly as obvious as some assert.     

“追名弃利”：权力动机与社会存在对亲社会行为的影响

目前关于权力动机的研究主要关注权力动机的阴暗面, 但是对权力动机的积极面尚不清楚。本研究从公平与合作行为的角度出发, 分别采用最后通牒博弈和公共物品博弈任务, 探讨不同权力动机水平个体在内隐(眼睛线索)或外显(他人在场)社会存在下的亲社会行为是否不同。结果发现, 在眼睛线索或他人在场条件下, 相对于低权力动机者, 高权力动机者表现出更高的公平与合作水平。然而当没有社会存在线索时, 高低权力动机者的亲社会行为没有显著差异。结果提示高权力动机者出于名誉和地位的策略考虑, 也会表现出积极的亲社会行为。     

Betrayal aversion: When agents of protection become agents of harm

A form of betrayal occurs when agents of protection cause the very harm that they are entrusted to guard against. Examples include the military leader who commits treason and the exploding automobile air bag. We conducted five studies that examined how people respond to criminal betrayals, safety product betrayals, and the risk of future betrayal by safety products. We found that people reacted more strongly (in terms of punishment assigned and negative emotions felt) to acts of betrayal than to identical bad acts that do not violate a duty or promise to protect. We also found that, when faced with a choice among pairs of safety devices (air bags, smoke alarms, and vaccines), most people preferred inferior options (in terms of risk exposure) to options that included a slim (0.01%) risk of betrayal. However, when the betrayal risk was replaced by an equivalent non-betrayal risk, the choice pattern was reversed. Apparently, people are willing to incur greater risks of the very harm they seek protection from to avoid the mere possibility of betrayal.     

Samaritanism and Civil Disobedience

In this paper, I defend the existence of a moral duty to disobey the law and engage in civil disobedience on the basis of one of the grounds of political obligation—the Samaritan duty. Christopher H. Wellman has recently offered a ‘Samaritan account’ of state legitimacy and political obligation, according to which the state is justified in coercing each citizen in order to rescue all from the perilous circumstances of the state of nature; and each of us is bound to obey the law, as the state demands, because we each have a responsibility to help rescue others when this assistance is not unreasonably costly. Though Wellman recognizes that there can be reasons for disobeying the law and resisting injustice in otherwise legitimate states, he overlooks the possibility that at least some of these reasons could be Samaritan in nature, grounded in the duty to rescue people from peril. As I shall argue, the Samaritan duty supports obligations to disobey the law, when the law prohibits Samaritan rescues, and to engage in civil disobedience, when unjust laws and practices contribute to endangering people. The discussion proceeds as follows. After a brief overview of the Samaritan duty, I articulate my case for Samaritan duties to disobey the law, and duties to engage in civil disobedience when unjust laws, institutions, or practices enable what I call ‘persistent Samaritan perils’. I then examine and respond to several objections to my account: first, that the costs of law-breaking are unreasonable, and thus cannot be morally required; second, that individuals’ particular acts of protest and civil disobedience do not appear to make any difference to the rescue, and thus cannot be required; third, that I stretch the Samaritan duty beyond recognition; and fourth, that the Samaritan duty binds us to help people in need or peril anywhere, not particularly at home. I consider in conclusion the advantages and limits of my account of citizens’ Samaritan duties in the face of injustice.     

On being a whistleblower: the Needleman case

We believe that members of the scientific community have a primary obligation to promote integrity in research and that this obligation includes a duty to report observations that suggest misconduct to agencies that are empowered to examine and evaluate such evidence. Consonant with this responsibility, we became whistleblowers in the case of Herbert Needleman. His 1979 study (Needleman et al., 1979), on the effects of low-level lead exposure on children, is widely cited and highly influential in the formulation of public policy on lead. The opportunity we had to examine subject selection and data analyses from this study was prematurely halted by efforts to prevent disclosure of our observations. Nevertheless, what we saw left us with serious concerns. We hope that the events here summarized will contribute to revisions of process by which allegations of scientific misconduct are handled and that such revisions will result in less damage to scientists who speak out.     

A Moral Predicament in the Criminal Law

Abstract

This essay is about the difficulties of doing criminal justice in the context of severe social injustice. Having been marginalized as citizens of the larger community, those who are victims of severe social injustice are understandably alienated from the dominant political institutions, and, not unreasonably, disrespect their authority, including that of the criminal law. The failure of equal treatment and protection and the absence of anything like fair and decent life prospects for the members of the marginalized populations erode the basis for its allegiance to demands of the political community. The criminal law thus occupies a problematic normative position with respect to lawbreakers in this population; in many cases, it finds itself in the position of convicting them for crimes for which the political community itself bears some significant responsibility. The attempt to administer criminal justice therefore faces a serious moral predicament; on the one hand, criminal law has a right and an obligation to protect citizens against serious crimes; on the other hand, because of its responsibility for the plight of many defendants, the dominant society is itself implicated in the wrongdoing in question. This paper tries to characterize the predicament in a perspicuous way and to suggest ways of proceeding in its face.     

On Being a Whistleblower: The Needleman Case

We believe that members of the scientific community have a primary obligation to promote integrity in research and that this obligation includes a duty to report observations that suggest misconduct to agencies that are empowered to examine and evaluate such evidence. Consonant with this responsibility, we became whistleblowers in the case of Herbert Needleman. His 1979 study (Needleman et al., 1979), on the effects of low-level lead exposure on children, is widely cited and highly influential in the formulation of public policy on lead. The opportunity we had to examine subject selection and data analyses from this study was prematurely halted by efforts to prevent disclosure of our observations. Nevertheless, what we saw left us with serious concerns. We hope that the events here summarized will contribute to revisions of process by which allegations of scientific misconduct are handled and that such revisions will result in less damage to scientists who speak out.     

Determinants of Flu Vaccination among Nurses: The Effects of Group Identification and Professional Responsibility

Five hundred and thirty-one nurses completed a questionnaire assessing knowledge about the flu and flu vaccination, professional group identification, perception of the flu vaccination as a professional duty, previous year's vaccination status, intention to receive vaccination in the following year, and the extent to which motivation to accept vaccination is primarily for self-protection or for patient protection. Results showed that knowledge about the flu and flu vaccination constitutes a major reason for rejecting immunisation. Group identification also constitutes an independent predictor of vaccination. Furthermore, the effect of identification on willingness to receive the vaccination was partially mediated by perceived professional responsibility: the more nurses identified with their group, the more they perceived vaccination as a professional duty and, as a consequence, the more likely that they (a) had been vaccinated the previous year, (b) intended to be vaccinated in the following year, and (c) were motivated to be vaccinated for patient protection (but not for self-protection).     

The Roles of Altruism,Free Riding,and Bandwagoning in Vaccination Decisions

Because vaccines can reduce the ability to transmit a contagious disease to others as well as the ability to contract a disease, the decision to vaccinate might be motivated in part by patients′ tendencies to act altruistically or, alternatively, to free ride on the vaccination decisions of others. We hypothesized that altruism and free riding motivate decisions to obtain vaccination, that individuals can be persuaded by the way questions are framed to free ride or to act altruistically, and that some individuals make vaccination decisions by "jumping on the bandwagon" and doing what most other people do. Four-hundred and seventy-two subjects answered whether they would agree to be vaccinated against a contagious disease under six different hypothetical scenarios. Regression analysis provides evidence that altruism (p < .001), free riding (p < .001), and bandwagoning (p < .001) are significant motivators in the decision to undergo vaccination. Frames stressing the opportunity to free ride increase free riding. Frames stressing altruism do not increase altruism. If generalizable to other settings, these results suggest that public health programs to increase vaccine usage should stress high vaccination rates.