By Kyle Ferguson and Arthur Caplan.
The pandemic has given us a new addition to our vocabulary: the phrase “vaccine nationalism.” It is rhetorically powerful. Political figures, journalists, and scholars have rapidly taken up and used the phrase. And even though it is vague enough to allow users to project different meanings upon it, “vaccine nationalism” is typically used in a pejorative or accusatory sense. It is used to name a tragic obstacle to justice in the global distribution of coronavirus vaccines. In this way, the issue of coronavirus-vaccine justice is currently often framed as a conflict between the obligations of justice and the obstacle of vaccine nationalism.
We think this is the wrong way to frame the issue. In our article, “Love thy neighbour? Allocating vaccines in a world of competing obligations,” we argue that, rather than a conflict between obligations and obstacles, the issue involves conflicts of duty. That is to say, we think that some degree of vaccine nationalism is a matter of moral responsibility. In our view, some form of vaccine nationalism will be a component of, not an obstacle to, justice.
To reframe the issue, we make three moves:
First, we argue that vaccine nationalism can spring from moral obligations, that there are genuine moral reasons for leaders or nation-states to prioritize and take care of their own. Here, we suggest that to belong to a nation is to belong to a community. Members of nations are bound together by associative ties and stand in morally meaningful relations to one another. Within those webs of relations, people occupy certain roles that bring special obligations, including the duty to take care of one’s own. So, there are moral reasons to allocate vaccines in nationally self-interested way, reasons that too often are dismissed out of hand. Too often, the special obligations of community membership are denied the status of moral reasons. Instead, they get demoted, often without argument, to the level of brute facts, or worse, brutish biases.
Second, since the issue is usually framed as “justice” versus “vaccine nationalism,” and since we think vaccine nationalism can be a component of just global distribution, we give a name for the alternative position. So, we introduce the phrase “vaccine cosmopolitanism.” Vaccine cosmopolitanism treats sub-global community membership as morally irrelevant. On this view, the only relevant citizenship is one’s being a citizen of the world. Because other community memberships are irrelevant, it is unjust for nation-states to prioritize their own. Allocation schemes ought to disregard potential recipients’ national identities, and instead focus on traits like healthcare-worker status, age, or comorbidities.
Third, we identify points of conflict between cosmopolitan and communitarian commitments, which means distinguishing between the kind of vaccine nationalism we find acceptable and the kinds we find abhorrent. To do so, we borrow from the Oxford philosopher W. D. Ross (1877–1971). Ross distinguishes between general obligations of benevolence, which we owe to anyone, and the special obligations we have to certain someones (e.g., co-members of our communities), which we owe because of our relations, roles, or particular commitments. We suggest that a defensible form of vaccine nationalism recognizes cosmopolitan duties of benevolence and the equal worth of persons across the globe. But it also recognizes the weight of the special obligations of community. The challenge of justly allocating coronavirus vaccines is the challenge of duly considering, appreciating, and fulfilling both types of obligation.
Rather than obligations versus obstacles, the real conflict is between two sorts of obligation: cosmopolitan obligations, on the one hand, and special obligations, on the other. In the end, we don’t say how to balance these competing obligations. Instead, we stress that there is a balancing act to perform.
Authors: Kyle Ferguson, Arthur Caplan
Affiliations: Division of Medical Ethics, NYU Grossman School of Medicine
Competing interests: None declared.