Make immunisation mandatory
The federal government has announced a ‘no jab, no pay’ plan with bipartisan support. Medical ethicist Dr Alberto Giubilini says making child immunisation mandatory would be a better policy than withholding welfare payments.
The federal government’s newly announced ‘no jab, no pay’ policy will end the conscientious objector exemption on children’s vaccination for access to the childcare and family tax benefits. This is likely to increase vaccination rates and improve public health, but it is not the answer.
Not to vaccinate one’s child is a wrong choice. It is wrong from a medical point of view, because vaccines are safe.
It is wrong from the point of view of the care due to one’s child, because the child might fall ill when illness is easily preventable.
It’s also wrong from an ethical point of view, because not vaccinating a child risks harming not only the child but members of the community who cannot be vaccinated for medical reasons, such as those undergoing chemotherapy.
It would be a mistake, however, to think that this policy will solve all the problems. Those who do not need the childcare benefits will continue not to vaccinate their children, and those who rely on childcare benefit will feel coerced into making a choice that they do not want to do.
Considering this coercive element that many parents would feel anyway, making vaccination mandatory is a better solution.
Coercion can sometimes be acceptable, or the lesser of two evils, when a significant public interest in health is at stake. For example, people are put in quarantine to protect public health and this is commonly accepted.
The idea of ‘conscientious’ objection to vaccinating one’s children is to be rejected. Conscience is often used as if it were a magic word. By appealing to conscience, people claim all sorts of rights.
But these alleged and vague rights cannot be granted when a significant public interest is at stake. We should stop calling opposition to vaccines conscientious objection. This means nothing.
Many parents are simply scared of vaccines because they are not adequately informed.
Concerns were raised in the 1990s after a study published in an authoritative scientific journal suggested a correlation between vaccination and increased risk of autism. That study was subsequently proved flawed and the journal retracted it, but it instilled fear and anxiety among many people. Such fear and anxiety have not gone away yet.
There is a solid consensus in the scientific community that vaccines are safe. It is important that people are adequately informed.
Some people have an ethical opposition to vaccines. They have the idea that it is preferable that their children fall ill and recover naturally.
But nature itself has no mind to healing or benefiting people. Letting nature do its course represents a risk for the child and for those in the community who, for medical reasons, cannot be vaccinated.
This blind reliance on the healing power of nature is anti-scientific and ideological. It risks posing a high risk on the community and, as such, cannot be accepted, no matter whether we call it conscientious or something else.
There would, of course, need to be exceptions in the case of children who, for medical reasons, cannot be vaccinated.
For all the others, if the government wants to take a substantial step in the interest of everybody’s health, mandatory vaccination is preferable to a system based on incentives or punishments.
Dr Alberto Giubilini is based at the Centre for Applied Philosophy and Public Ethics (CAPPE). He specialises in medical ethics and bioethics, and his research interests include human enhancement, medical end-of-life decisions, reproductive ethics, bioethical conflicts, and moral psychology. Dr Giubilini obtained his Ph.D. in Philosophy at the University of Milan in 2010, with a dissertation on the concept of autonomy in medical end-of-life decisions, and previously he was PhD Visiting Student at the Faculty of Philosophy at the University of Cambridge for 8 months in 2007 and 2008. He is currently a research associate on an Australian Research Council Discovery Grant, ‘Moral Conservatism, Human Enhancement and the “Affective Revolution” in Moral Psychology’ (2013-15).
Max Thomas
April 18, 2015 at 3:42 am
Mandatory immunisation
Thanks for your piece on immunisation Alberto. I agree entirely that 'conscientious objection' does not apply. However, would you care to comment on what sanctions might be used in cases where education and persuasion aren't effective. We don't want to punish or ostracise children for the 'sins' of their parents. But if we pass laws to make immunisation or anything else mandatory, sanctions must be provided for breaches, otherwise respect for the law is diminished.