Contestación: About vaccination: two needed changes

AutorMaria Luisa Di Pietro - Pietro Refolo - Fermín J. González-Melado
CargoInstituto de Bioetica. Facultad de Medicina y Cirugía 'A. Gemelli
Páginas127-129

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The objective of our article1is to demonstrate how at the base of the issue on compulsory versus non compulsory vaccinations in general, and more specifically in pediatrics, there is a debate on the moral model of reference: a normative ethic (of the third

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person2) or a virtue ethic3(of the first person). We propose that it would be possible to pass from the normative ethic to the virtue ethic if we refer to the ethic of responsibility.

The concept that must change so that this can be possible is the concept of prevention. In the normative ethics, which sustains the compulsory vaccination, the concept of prevention identifies itself with the reduction of risk. In this sense, a health system can obtain a better prevention when the risk of contracting a disease is lower and in the case of vaccinations, this occurs when a higher number of individuals is vaccinated. This justifies the compulsory vaccination of the largest number of people possible.

This concept of prevention, meant as the reduction of risks, appears in the utilitarian ethics4and in the ethics that are based on the theory of rights5. We propose a different concept of preventive medicine. For us, prevention consists in favoring the acquisition of virtues (moral behaviors) that aim towards the attainment of the individual’s and the community’s health. We believe that through a first person ethic it is possible to create the alternative of a personal responsibility6that, along with a series of political laws, can assure an effective protection of all of the community and, at the same time, guarantee the responsible expression of personal autonomy.

It is clear that an individual has the right to choose to not vaccinate himself. A vaccination is a treatment applied to healthy people who are not suffering from a disease. Therefore, the medical justification is not based so much on the protection of the individual as on the protection of the community (herd immunity). The principle of the respect of individual autonomy, allows the individual to refuse a treatment and therefor also a vaccination7.

What are the reasons for which even in the situation of a pandemic, the percentage of vaccinated individuals is low8Or, in other words, why does a person refuse a vaccination that could save them in a situation of pandemic? There are various factors that have changed the perception that the population has of vaccinations9 and they can be summarized with the population’s...

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