Mass-vaccination programmes and the value of respect for autonomy

Area of Science:

• Public Health Ethics
• Bioethics
• Political Philosophy

Background:

• Vaccination programs rely on widespread compliance, creating ethical challenges regarding individual autonomy.
• European countries exhibit diverse policies for vaccination objectors, ranging from compulsory compliance to exemptions.
• Current policies often treat vaccination objectors as a homogenous group, overlooking the diversity of their objections.

Purpose of the Study:

• To argue against treating vaccination objectors as a homogenous group.
• To propose criteria for distinguishing between tenable and untenable objections to vaccination based on respect for autonomy.
• To explore how 'narrative autonomy' can inform public health policies concerning vaccination.

Main Methods:

• Analysis of existing European vaccination policies for objectors.
• Application of the concept of 'narrative autonomy' to differentiate objections.
• Utilizing Marya Schechtman's concept of narrative identity, including the Articulation Constraint and Reality Constraint.
• Incorporating Anthony Laden's criteria on form and content features of identity.

Main Results:

• Not all objections to vaccination warrant accommodation when respecting autonomy.
• The concept of 'narrative autonomy' offers a framework to assess the validity of claims to refuse vaccination.
• Compatibility of objectors' arguments with shared scientific and political values is crucial for accommodating autonomy.

Conclusions:

• Vaccination objectors should not be treated as a monolithic group; their arguments require nuanced consideration.
• 'Narrative autonomy' provides a valuable ethical tool for public health decision-making regarding vaccination.
• Accommodating respect for autonomy in public health necessitates evaluating the compatibility of individual objections with societal values.