Federico de Montalvo Jääskeläinen: Compulsory vaccination

Professor Diego Gracia points out with his usual success in a recent editorial (Annals of the RANM) that if there are diseases that would give to write an entire ethics treatise, Covid-19 would be a paradigmatic example. And, among the topics that would deserve a main chapter in said treaty, there would be, without a doubt, the debate on the mandatory nature of vaccines.

This pandemic has brought with it not only a lot of uncertainty, despair and suffering, but also a good number of ethical problems. Perhaps, too many for what we are capable of assuming from the serene reflection that is required to address issues that affect the most substantial principles and values, such as life, integrity or freedom.

began with the controversial debate on the prioritization of access to life support resources, continued with that of privacy and the acceptability of control over individuals and their health data, continued with the prioritization of access to vaccines, including others such as the impact on mental health of forced confinement and online training and work, and now he entertains us, those interested in bioethics and public opinion in general, with the debate on the requirement to impose, mandatory or forcibly, vaccination to those who reject it. This issue has also been clouded by the appearance of the Ómicron variant and its impact on the contagion of people already vaccinated, generating a new denial noise about the need and usefulness of vaccines.

Despite the difficulties that the situation we are experiencing presents us with in trying to find solutions to all these ethical problems, without forgetting the rights and freedoms that make up the insurmountable minimum, nor the different principles that we have developed in these decades (prudence, proportionality, protection against vulnerability, etc.), experience has shown us that, at least, our bioethics seems to be in good health. And this, perhaps, is due to the fact that bioethics began to be discussed and thought about here several decades ago, with a well-armed doctrinal and systematic body. And it was, precisely, Spain, it is fair to remember, thanks to the work of the Jesuit Francesc Abel, continued by that of another Jesuit, Father Javier Gafo, with the notable influence on them of a center of the Society, Georgetown University , one of the first states in Europe in which Bioethics was inaugurated as an area of ​​knowledge and in which it found further development. Its initial impulse continued by the recently deceased, Father Gonzalo Herranz or the already mentioned Diego Gracia, have allowed us to face, not without difficulties, but with sufficient elements to respond, the challenges that the historical moment that has touched to live

An example of the robustness of our bioethics, so essential in times of desolation, is the fact that many of the ethical debates have found a frame of reference in the doctrine of the Bioethics Committee of Spain itself, the highest expression of institutionalized bioethics, as the highest advisory body of the authorities in this matter. And so, the Committee had already prepared, a few years before the pandemic was proclaimed, reports on issues as essential now as the mandatory nature of vaccines or ethics in prioritizing health resources (both from 2016). Such a frame of reference is not accidental nor does it constitute an expression of a special premonitory capacity of the Committee and its members, but rather it is heir to the aforementioned robustness of our homeland Bioethics.

And now situated in the debate on the compulsory nature of vaccines, our bioethics has once again given an example of its worth, showing, once again, serenity in the face of the winds that seem to run through other states in our environment, very different from ours. in which denialism and populism do more noise than harm to collective health. Our generalized bioethical response to such ablation proposals is none other than to highlight their moral demand and not so much to promote a legal duty to vaccinate. It is not only that the vaccination rates achieved in Spain are much higher than those of our environment and the ‘idiots’ (a term that, as Professor Gracia reminds us, was used in Greece to refer to those who tried to go it alone and not assume the benefits and costs of social life) is much lower, but Bioethics has been able to search for the appropriate answers and vaccination as a moral obligation, not a legal one, is one more example.

And if at the beginning we quoted a great thinker, it is good to finish mentioning two others, one of them much younger, Diego S. Garrocho, who recently on this same page reminded us of the value that the humanities have in a political community and the importance of preserving them. And this, we believe, not only in general, but because the pandemic has shown us that the most human side of decision-making in health is the right path. Ethics is very profitable, because, as Adela Cortina magisterically recalled, fair actions, those that meet the legitimate expectations of those affected by them, generate trust, which is the main asset of a society. And for this, humanities studies must have a relevant role in our training curricula at all educational levels.

With Ethics one is not born. Ethics is not simply being good, but learning and developing skills, abilities and virtues for discernment and resolution of difficult conflicts in which the human being is at the center of the issue. Ethics is, as Socrates told us, behavior, but also knowledge. Because, ultimately, it is not about understanding the environment that surrounds us, but also about understanding ourselves.

Undervaluing the human and social sciences is said to be now, to a great extent, an expression of youth, due to the dazzle that the enormous advance of technology generates in it, but it ends up being, also, a loss of humanity. Stanley Cavell has already pointed out that, apart from the times we live in, there is nothing more human than the desire to deny one’s own humanity, to which we could add the desire to deny the humanities themselves. Let us respect the humanities and, among them, bioethics, not only as an expression of humanity, so necessary now, but also out of loyalty to the great bioethical legacy that our elders have left us and because, from a more pragmatic perspective, this will not be, unfortunately, , the last great public health crisis that we will probably have to face in the coming decades and for this, such a legacy will prove, once again, very fruitful.


Federico de Montalvo Jääskeläinen is president of the Spanish Bioethics Committee


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