Sunday, April 11, 2021

Is there a way to make vaccine passports ethically acceptable? | Coronavirus


It’s the great British summer, lockdown is lifted and you’ve finally been fully vaccinated. You’re filled with a huge sense of relief. Vaccines are a game changer, not only because they drastically reduce your chances of getting ill with Covid-19, but because, as the evidence is beginning to show, they prevent the spread of the virus in the first place. Now you can finally have a drink in a bar without the uncomfortable feeling that you’re putting yourself and others at risk. But what if the person ordering drinks next to you and the bartender haven’t been vaccinated? Well, at least your elderly relative has had their jabs a while back – that gives you peace of mind. But what if the person responsible for their everyday care has refused the vaccine? No matter, the UK population at large is close to developing herd immunity. But what about all the people arriving in the UK daily from other countries – are they vaccinated?

Vaccine passports are supposed to be an answer to these worries: the government issues immunity certificates to those who have been inoculated, which would in turn allow them to take part freely and safely in various activities forbidden to those who don’t have them. The moral justification for such a policy seems similar to the justification for lockdown measures: John Stuart Mill’s harm principle. The 19th-century English philosopher was a liberal; freedom was one of the moral and political values he cherished the most, yet he recognised that it should have limits. Mill’s harm principle suggests the government is justified in curtailing our freedom when our behaviour harms others. Most people approve of lockdowns because they recognise the moral reasoning behind them: our freedom has to be limited to prevent others from getting ill and possibly dying. By the same logic, if not being vaccinated means posing a greater threat to others, it seems vaccine passports would be justified. At least in theory.

As the political philosopher Jonathan Wolff explained to me recently, this was the exact approach he took the first time he was asked to give government policy advice, looking at gambling regulation with the Home Office some years ago: look at what Mill’s harm principle would suggest, apply it to the case in hand, done! But this top-down, theory-to-practice approach ends up ignoring the complexities of real life. A better approach, Wolff came to believe, would be to start from the particulars of the situation and go from there. So let’s consider those particulars.

Vaccine passports already exist. Some countries require new arrivals to present a yellow fever certificate before they are allowed in. That seems fair. Each country has the right, and even duty, to protect its inhabitants from imported infections, especially if it has struggled to get a disease under control. But even such a seemingly sensible policy can end up being discriminatory in ways that are morally unpalatable. In 1987, as a reaction to the HIV/Aids epidemic, the US began refusing visas to people who had tested positive, a practice that ended under Barack Obama. Few of us would be comfortable with such a policy today. Might a Covid vaccine passport result in similar types of discrimination? It will almost certainly mean those from poorer countries, who don’t have access to the vaccine yet, won’t be able to travel freely. That might be a moral cost we are willing to pay for the sake of our safety and reopening of our economy, but we ought to acknowledge its existence and find ways to avoid it.

Things begin to look even trickier when we start thinking about requiring people to present vaccine certificates to enter a restaurant or return to work. Again, at an abstract level this makes sense: if you’re putting others at risk, the government can place limits on your freedom, and if you are not vaccinated you are more likely to be infectious. But the particulars of each country could complicate things. We know that in places like the US and the UK, some people from black, Asian and minority ethnic backgrounds are more likely to be vaccine-hesitant. They tend to trust the medical establishment less – and a case like the Tuskegee study, in which black men in the US were not told they had syphilis, makes you understand why. If banning people without vaccine certificates from restaurants, bars and the workplace ended up discriminating against BAME people, that would be morally unacceptable. Despite this, we might want to make exceptions for cases where the risk of harm is very high, like when the unvaccinated person’s workplace is a care home or hospital.

One question we should ask when a well-intentioned policy could end up having undesirable ethical consequences is: “Is there an alternative?” In the case of international travel, mandatory quarantines on arrival are already practised (see Australia and New Zealand), so that could be offered as an alternative to those who haven’t been vaccinated. In the case of access to leisure activities, testing could be offered as an alternative (as is under consideration for England). A negative test result of course is not a guarantee that someone isn’t infectious, but then again, the same applies to having been vaccinated. In the workplace, practices such as mask-wearing, social distancing and regular testing could again be alternative ways of keeping others safe.

A different way of framing vaccine passports is as an incentive for people to get jabs – “get vaccinated and we’ll give you your freedoms back” – or, in the language of government slogans, “Get a Jab, Save Lives, Go to the Pub”. But this approach is needlessly confrontational and has less moral force. It’s one thing to argue that the state doesn’t have the right to curtail your freedoms once you’re vaccinated and pose less of a threat to others, another to be given an ultimatum: “get a vaccine or we’ll keep you locked down”. The aim might be the same, but the moral reasoning behind it is crucially different.

Once people have their jab, they pose much less of a risk to others. Following Mill’s principle, it would therefore be unjust to continue curtailing their freedoms. Vaccine passports might be one way of making this possible. But we must not allow this to lead to unjust discrimination; alternative options should be made available for a summer – and beyond – that everyone can enjoy.

Alexis Papazoglou is host of the podcast The Philosopher & The News

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