Vaccine hesitancy is not always voluntary
Samuel Roach1, Qut Brisbane 1Qut, Brisbane, QLD, Australia
Abstract
The common justifications for delaying and refusing vaccination show that people experiencing vaccine hesitancy are often prioritising health above other interests. Consider an individual who refuses vaccination because they believe vaccines are poisonous. We can infer that this individual is prioritising their health, as they have refused vaccination out of a concern for their health. The way this individual prioritises their interests is therefore identical to someone who endorses vaccination. Their counterintuitive behaviour is attributable to a mistaken belief.
This group is distinct to those who acknowledge the benefits of vaccines, but delay or refuse vaccination because they prioritise other interests above health, as in the case of a conscientious objector. The distinction between these groups is significant, as the latter is making a voluntary decision, while the former is making an involuntary decision.
Feinberg’s conceptualisation of voluntariness can be used to assess whether a decision is involuntary. Feinberg contends that a decision is involuntary when through ignorance or mistake, ‘one chooses something other than what one means to choose’. Vaccine hesitancy is therefore involuntary if an individual prioritises health, but chooses to delay or refuse vaccination due to a mistaken belief.
As the individual prioritises health, they mean to choose a course of action that protects their health. However, their mistaken belief causes them to delay or refuse vaccination, which jeopardises their health. They are therefore choosing something other than what they mean to choose. This observation highlights that mistaken beliefs can act as an internal constraint on voluntary decision-making.
Biography
Sam Roach is a lecturer in the School of Law at QUT. He is a committee member of the Australasian Association of Bioethics and Health Law and a Chief Investigator in the Australia Centre of Health Law and Research. Sam’s doctorate examines the role of law in preventing vaccine hesitancy.