By Charlie T. Blunden
Non-vaccination is causing serious problems worldwide. Take measles as an example. The European Centre for Disease Prevention and Control say that 95% of a population must receive two doses of a measles vaccine in order to prevent transmission of the disease through the population. However, many nations are falling below this vaccination threshold: in the U.S. only 91.9% of infants and 90.7% of adolescents had received the measles, mumps, and rubella (MMR) vaccination in 2015; and in Italy, France, Greece, and Romania, 84% or less of the population were fully vaccinated in 2016.
The consequence of this lack of vaccination has been an increase in the number of cases of measles: in April 2018 alone, Italy reported 389 cases of measles, France reported 596, and Greece reported 352. None of these reports were anomalous. One key reason that vaccination rates are low is that people decide to not vaccinate themselves or their children. They have many reasons for doing this: including having false information about vaccines and misperceiving the risks and benefits of vaccination. To overcome these issues one could recommend social policies such as better education on vaccination.
However, another potential solution is mandatory vaccination: where a government enforces vaccination to maintain public health. Mandatory vaccination is often resisted on the grounds that it infringes the liberty of individuals to choose whether to vaccinate themselves or their children. For instance, Matteo Salvini, the Italian Minister of the Interior, has previously stated that parents should decide whether they vaccinate their children, in opposition to a mandatory vaccination law brought into effect in Italy in 2017 to combat high levels of measles cases, and other outbreaks of preventable disease.
Given that mandatory vaccination is normally rejected on the grounds of being an infringement of individual liberty, there is a great deal of merit in Jason Brennan’s argument that tries to show that even libertarians, who place a very high value on individual liberty and are very resistant to coercive government measures, should endorse mandatory vaccination. If Brennan’s argument succeeds, then we have an argument on hand that should be able to convince those who reject mandatory vaccination on the grounds of individual liberty that they should, in fact, endorse mandatory vaccination. This would be a great starting point for political arguments in favour of using mandatory vaccination to bring vaccination rates up to 95% in those countries where they are currently much lower.
In his paper, Brennan presents a series of cases designed to get libertarians to endorse the clean hands principle: a principle that states that ‘there is (sometimes enforceable) moral obligation not to participate in collectively harmful activities’, where a collectively harmful activity is defined as an ‘activity caused by a group or collective, where individual inputs into the harmful action are negligible.’ The cases he offers are purportedly analogous to the case of non-vaccination, and in each of his cases it is plausible that libertarians would be willing to intervene in order to coercively stop certain agents from acting in certain ways. For instance, in one of Brennan’s cases there are 10 sharpshooters who are all about to shoot an innocent child. Each sharpshooter’s bullet is sufficient to kill the child, and they will all shoot at once so that one cannot tell whose bullet was actually sufficient. Brennan contends (and it is hard to disagree) that libertarians will have the intuition that it would be wrong to be the 11th shooter if one was invited to join in with the sharpshooters: additionally, it would be permissible to use coercion to prevent someone else from being the 11th shooter. Brennan then argues that the clean hands principle is what explains the libertarian’s intuitions. If his cases are analogous to the case of non-vaccination, then the libertarian should also endorse the clean hands principle in the case of non-vaccination: and, in this case, the principle recommends mandatory vaccination.
In my paper, I argue that Brennan’s argument does not work. His cases, as they are offered in his paper, are not analogous to the case of non-vaccination: as such, they will not get libertarians to endorse the clean hands principle, and so we do not get an argument that will convince libertarians to endorse mandatory vaccination. I explain exactly what this disanalogy is, and why it makes the argument fail. Having made this negative argument, I then modify one of Brennan’s cases so that it is analogous to the case of non-vaccination. By doing this, I show what is necessary to get libertarians to adopt the clean hands principle: it has to be the case that a threshold has been passed, after which a group of agents are collectively imposing a risk of harm on everybody else. This means that in the case of non-vaccination what really matters is the vaccination threshold at which herd immunity is achieved: once the rate of vaccination goes below this threshold, libertarians should endorse mandatory vaccination.
Author: Charlie T. Blunden
Affiliations: Department of Philosophy and Religious Studies, Utrecht University, Utrecht, The Netherlands.
Competing Interests: None declared.