Kantian ethics and the vaccine mandate

The life-altering COVID-19 pandemic wreaked havoc on the world. Now, the vaccine rollout brings the ethical dilemma of vaccine mandates for certain population groups such as healthcare workers, to the forefront 

To improve our understanding and facilitate discussion about the subsequent moral course of action, we can turn back to an age-old ethical theory crafted by German philosopher Immanuel Kant: Kantian ethics. 

Despite its occasionally contradictory and overzealous nature, Kantian ethics has left a lasting legacy rooted in four grounding principles: duty, universalizable maxim, treating others as ends-in-themselves, and rational autonomy. In the book Introduction: Ethical Theories and Medical Ethics, author Gregory Pence outlines these four principles. 

The first element emphasizes motive rather than consequences: one’s actions should fulfill moral duty instead of compassion. 

To describe the second element, a maxim is a rule that connects an act to the motivation behind that act. In Kantian ethics, a maxim should be universal: a rule that can be “acted on by all others.” 

The third element states that everyone has infinite moral worth. This principle also highlights the importance of always being truthful and allowing patients to make informed decisions. 

Finally, the last element emphasizes rational acts of free will: people should make autonomous decisions free from societal pressures. 

Despite these deceptively straightforward principles, Kantian ethics contradicts itself at times and has persistent problems. For one, Kantian ethics never proved successful in resolving conflicts between opposing universalizable maxims. 

In addition, it is not always possible, or practical, to treat someone as though they had infinite value. Often, especially in emergencies, hospitals and healthcare personnel are forced to triage patients, which directly contradicts the idea of treating everyone until the end. 

However, Kantian ethics have contributed insightful concepts to medical ethics. Notably, they can help us understand the boundaries of medical experimentation and the subsequent outrages when they are crossed. An example would be the research done by Nazi physicians during World War II. Arguably, the most significant legacy left behind by Kantian ethics is the emphasis on “autonomous will.”

Someone subscribing to the Kantian ethical system would not support the COVID-19 vaccination mandate for healthcare workers because the idea of a mandate goes against the main legacy of the ethical system. A mandate, by definition, is an order or command. Free will, or “autonomous will,” does not match the connotation or denotation of the word. It is, in fact, a direct contrast to the word “mandate.” 

For this reason, a follower of Kantian ethics most likely would not support a mandate of any sort, vaccination or otherwise. 

However, in this case, it is possible that Kantian ethics followers would instead suggest that healthcare workers receive the COVID-19 vaccine not because they are forced or mandated to, but because it is their duty to do so to protect their patients and families. This policy is firmly within the ideas of the first and last element of Kantian ethics: duty and autonomy. 

According to Kant, one should do something because it is the right thing to do, not because they feel like doing so. In other words, personal desires or societal pressures do not and should not  contribute any decision-making. 

Perhaps, this should be the approach to the current situation: educate and train healthcare workers in a way that compels them to forgo vaccine hesitation and choose to become vaccinated out of their free will. Only time will tell what the most effective and efficient solution to this dilemma will be.

~ Saathvika Divit `25