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Is It Unethical to Refuse a COVID-19 Vaccine?

Columns appearing on the service and this webpage represent the views of the authors, not of The University of Texas at Austin.

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Unless someone has an unusual medical condition that would render vaccination contraindicated, the short answer is yes, it is unethical to refuse to vaccinated against COVID-19.

I am not a doctor, nor a philosopher studying normative questions of whether a particular course of action is ethical or unethical. However, I do study behavioral ethics — the science of moral decision making — which provides several reasons people might choose not to be vaccinated. None of them good.

Studies show that people are irrationally optimistic, tending to believe that the car wrecks, cancers and divorces that happen to other people are not going to happen to them. Why get vaccinated if you just know that you won’t get COVID-19? Since March, I have watched countless interviews with people lying in hospital beds who explained how utterly shocked they were that they had contracted the coronavirus.

People also have a tendency to be overly confident regarding their abilities. “The human mind is an overconfidence machine,” writes columnist David Brooks in his book “The Social Animal: The Hidden Sources of Love, Character and Achievement.” Why get the vaccine if you are sure that medical experts are wrong?

In America, we’ve had an unfortunate tendency to divide into contentious groups. People tend to take their cues as to how to act from those in their in-group, a phenomenon called the conformity bias. For the past four years, there’s been the Trump team and the never-Trump team. Why would you get vaccinated if your team believes that we have already “turned the corner” or that COVID-19 is going to “just go away”?

People love being right and hate being wrong. Their brains frequently help them preserve their self-image by rejecting new evidence that contradicts their preexisting beliefs. When cult leaders predict the end of the Earth and then the end doesn’t come, followers often become even more fervent believers because their egos can’t stand admitting they’ve been wrong. If this phenomenon of belief persistence has enabled some to believe that COVID-19 is no big deal despite hundreds of thousands of deaths, why get vaccinated?

And people feel more blameworthy if their actions lead to bad consequences than if their inactions do, so they often tend toward inaction.

Those opposed to vaccinations — who irrationally fear the side effects of drugs on their child but know that the disease being vaccinated against is also harmful — often choose not to vaccinate. They would feel more responsible if their child suffered from the supposed side effects because they made the choice to vaccinate. But if they choose to do nothing, the bad consequences that follow from their inaction seem less their fault. Both courses involved a choice followed by consequences, but the choice not to vaccinate seems the less blameworthy path.

Simply put, there are many failures of human rationality, and they can lead to indefensible moral choices.

Consider this hypothetical: Your young daughter collapses for no apparent reason. After examination, a cardiologist strongly recommends immediate surgery for a heart condition. The surgery is not without risk, but the surgeon indicates the risks of not operating are far greater.

The following are such bad reasons not to elect to have the surgery that many would deem them immoral: 1. “She’s OK; my family has always been healthy.” 2. “My online research tells me that the cardiologist is wrong.” 3. “A lot of my friends believe the president when he says, ‘I don’t think science knows, actually.” 4. “Something bad might happen during the surgery if I approve it, and I’d never forgive myself.”

People who don’t get vaccinated need to muster the moral imagination to think of how that decision will fail to protect those who are vulnerable in our communities. If skeptics don’t get vaccinated, they will undermine herd immunity, causing more people to die. And that is immoral. Enduring the mostly minor side effects expected from the vaccines is part of the contribution that people are reasonably expected to make for the common good.

Robert Prentice is director of the Ethics Unwrapped program in the Center for Leadership & Ethics at The University of Texas at Austin.

A version of this op-ed appeared in USA Today.

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