Political philosophy is not a staple of mainstream consciousness. The theories of Thomas Hobbes and John Locke rarely take priority over thoughts of carpools, soccer practice, and grocery shopping in the multitasking mind of the average parent. However, we experience the application of the philosophy of utilitarianism with far greater frequency than we may realize. Whenever we speak of “the greater good,” we invoke a utilitarian view. Whenever we take action to value the happiness or well-being of the group over that of the individual, we do so as utilitarians.
As with all philosophical theories applied in the real world, utilitarianism must meet specific criteria for its application to be sound or “good.” As utilitarianism necessarily usurps the rights of the individual, the need to meet these criteria is paramount. When utilitarianism is applied to an issue such as vaccination—which involves children, infectious diseases, and the virtual guarantee of death and debilitating side effects for some—it is of the utmost importance that vaccination policy decisions, and specifically vaccination mandates, meet the criteria to satisfy the theory.
When arguing theories, philosophers apply them to ideal worlds, in which they assume all criteria have been met. They do this so they can focus solely on the theory in the purest terms. These theoretical worlds are free of complicating factors such as corruption and human error that might affect one’s view of how the theory should be applied. Sadly, we are not afforded this same luxury in the real world, as the existence of corruption in the government cannot be refuted. For the sake of discussion, however, I will attempt to simplify the discussion as philosophers do.
A sound application of utilitarianism requires that an action or decision must deliver the greatest good for the greatest number. I should note that the greatest good does not necessarily need to be good in the sense of giving happiness or pleasure. The benefit could come in a number of other forms. For example, you might prefer to drive ninety miles per hour on the highway because it would shorten your commute and allow you to get more work done. However, your high-speed driving would also put other drivers at risk of serious injury. Utilitarians would place a higher value on the safety of all drivers on the road than on the pleasure you would obtain from a shortened commute. This is the basis for speed limits on our roads. A speed limit does not give pleasure or happiness to the group; however, it can easily be argued that it provides the greatest good to the greatest number.
Now let us arbitrarily place the speed limit at fifteen miles per hour. While this would most certainly ensure the safety of all drivers, the traffic buildup, the loss of productivity at work, and the total unhappiness of drivers as they crawled to work each day would likely outweigh the benefit of guaranteed safety. Many might reasonably argue that they would prefer to have no speed limit and drive defensively if the only alternative is a painstakingly slow commute. Although the fifteen-miles-per-hour speed limit would aim to provide the greatest good, it would fail to meet the main criterion for sound utilitarianism. An application of utilitarianism is sound only if the decision made actually delivers the greatest good to the greatest number. Any application that fails to meet this criterion necessarily results in the removal of individual rights that cannot be justified within a utilitarian argument.
The justification for mandatory vaccination in the United States is based on utilitarian logic. On many occasions, public health officials have appealed to the American public regarding the necessity of vaccination in order to ensure the safety of the “herd.” States deny unvaccinated children admission to day care and public schools not because they are at risk but because they are perceived to pose a risk to other children. Utilitarian philosophers first introduced the concept of the greater good, and it is through this principle of utilitarianism that our government justifies compulsory childhood vaccination. In light of this claim, the burden of proof lies with the government to show that compulsory childhood vaccination does, in fact, provide the greatest good for the greatest number. If vaccination mandates are not truly for the greatest good, and the government has invoked utilitarianism to justify them, then the government would have offered a fraudulent, insufficient justification.
It is indisputable that the vaccination schedule has never been tested for safety in its entirety, or in the way that it is administered. In other words, while the government reviews, licenses, and compels individual vaccines, it does not test—or require vaccine makers to test—the safety and efficacy of vaccines given simultaneously or the cumulative effects of multiple vaccines. For example, while the government reviews manufacturer prelicensure tests and recommends the hepatitis B vaccine for two-month-old infants, it has not tested that vaccine together with the other vaccines it recommends to be administered simultaneously: rotavirus, diphtheria, tetanus, pertussis, Haemophilus influenzae type b (Hib), pneumococcal, and inactivated poliovirus.1 Furthermore, despite the public’s demand and congressional bills calling for it, there has never been a controlled study comparing long-term health outcomes of vaccinated and unvaccinated populations.2 Thus it is impossible to determine the true benefits of the vaccination schedule. As it currently stands, it would be impossible to know if mandatory vaccination requirements, in fact, accomplish the greatest good for the greatest number. Because the burden has not been fulfilled, the hypothesis may not be accepted.
To obtain a better perspective of what it would take to justify that compulsory vaccination accomplishes the greatest good, we should consider the risks that the benefits of vaccination would need to outweigh. First, vaccination benefits would need to outweigh the risk of actually contracting infectious diseases, including diseases that have been virtually eradicated such as poliomyelitis, as well as diseases such as rotavirus (better known as childhood diarrhea) and hepatitis B, which is contracted from an infected parent, contaminated needle, or unprotected sexual intercourse. Second, vaccination benefits would need to outweigh the suffering caused by known and documented side effects of vaccination, such as encephalopathy (brain injury), seizure disorders, developmental delay, and death in affected children. Third, vaccination benefits would need to account for the lost productivity and wages of those who die or are harmed by vaccines, and the lost productivity and wages of their caregivers. Finally, vaccination benefits would need to outweigh the cost to the public of compensating the families of vaccine-injured children and purchasing vaccines for children otherwise unable to afford them. Outweighing all of these combined risks is a tall order by any measure. In any case, since the childhood vaccination schedule has not been tested as it is administered, we cannot know the benefits of vaccination, and therefore, whether or not the utilitarian burden can be fulfilled. As it currently stands, utilitarianism cannot justify compulsory vaccination.
At a glance, vaccinations are conventional, prevailing medical procedures that have been standard protocol for over one hundred years and compulsory for our nation’s children for over four decades. Nevertheless, it is startling to learn that while the first vaccine was compelled for adults during a smallpox epidemic, we vaccinate most of today’s children at least thirty-five to forty times and recommend seventy doses of sixteen vaccines, including one for a sexually transmitted disease within hours of birth. How could we have paid so little attention to such a startling transition?
To explain our seeming acceptance of the dramatically increased number of vaccines children receive today, I will use a famous philosophical device known as the sorites paradox, or the paradox of the heap. This construct is meant to highlight a potential problem with the use of a vague term such as “heap,” and in the case of vaccines, it highlights a potential problem with the use of the term “reasonable.” I will first illustrate the concept using the term “short” as an example.
We would all likely agree that a fully grown man who is four feet tall is short. Furthermore, we would likely agree that a man who is one millimeter taller than this four-foot-tall man is also short, because a mere millimeter’s difference cannot be what separates short from tall. Suppose that we continue this procession of short men, with each man one millimeter taller than the previous man. At the end of our very long line of fully grown men, we would find a nearly eight-foot-tall man who, based on our logic, would also be “short.” It is obvious that we must have made some sort of error.
The same is true of our vaccination schedule. Many likely would agree that a single vaccine administered during an infectious disease epidemic is “reasonable.” Furthermore, we would likely agree that the addition of one more vaccine would not suddenly make the schedule unreasonable. However, we now find ourselves “reasonably” administering seventy doses of sixteen vaccines to children, and we have the same perplexed feeling we might have when trying to explain why a man who is eight feet tall is “short.” We can no longer justify the vaccination schedule in this way. We must not judge a vaccine in relation to previously scheduled vaccines but rather on its merit as an independent entity.
My aim is not to denounce utilitarianism. I seek to examine its application to the United States’ compulsory childhood vaccination program. As Harvard Professor Michael Sandel writes in his book Justice, “The most glaring weakness of utilitarianism, many argue, is that it fails to respect individual rights.”3 I agree with this statement and, precisely for this reason, I contend that it is essential to ascertain whether the vaccination schedule our nation imposes on its children is truly for the greatest good. To accomplish the utilitarian’s greatest good, the benefits of vaccination must verifiably outweigh great costs and suffering. Whether the benefits truly yield a tremendous good is simply unknown—and without this knowledge, the utilitarian’s burden of proof is unmet, and utilitarianism cannot justify this program.
As individuals, we will always act in our own best interest to the best of our ability. Without proof that compulsory vaccination is, in fact, what brings the greatest good to the greatest number, there is no utilitarian justification for us to sacrifice our individual rights to do what we discern is best for ourselves and our children.