Ethics of Public Health Policies Public health concerns necessarily introduce a tension between the individual and the greater good, which may have different resolutions depending on the ethical perspective that one uses to assess them. As a society, the United States has determined that certain public health policies so promote the greater good that they should be considered even if they infringe upon private liberties, or, in some cases, pose a threat to individual health or welfare. One widely discussed example of this type of policy is universal healthcare or affordable healthcare for the impoverished; others are forced to subsidize healthcare costs for those who can least afford it because it is believed to be in the best interest of overall public health. However, some public health policies are even more controversial. Vaccinations to prevent the spread of communicable illnesses, particularly childhood vaccinations, may be one of the most controversial public health policies. Although childhood vaccinations have been demonstrated to reduce childhood mortality, there are health risks associated with vaccines that can make requiring vaccinations a difficult ethical issue. What type of vaccination policy a country should have may depend on whether the country approaches the issue from a utilitarian, distributive justice, or paternalistic perspective.

Childhood Vaccinations

Childhood vaccinations consist of a series of vaccines to prevent certain childhood illnesses, given at a certain schedule, so that, by the time a child enters into the public school system, he or she is fully vaccinated. There are some risks associated with vaccines and some small percentage of children have adverse reactions to those vaccines. Moreover, for children who are high risk, vaccines may not be recommended or may be postponed from the usual childhood schedule. The result is that, in order to provide maximum effectiveness, most children should be vaccinated, which provides herd immunity even to children...

Vaccines have been proven as an effective and life-saving preventative health measure. However, falsified research linking childhood vaccinations to Autism resulted in a substantial portion of people refusing to vaccinate their children, and helped lead to the resurgence of childhood diseases, such as measles, which had been virtually eradicated in the United States.
While the risk from vaccinations may have been grossly overstated, the reality is that there is some risk associated with vaccines. This risk seems to directly conflict with the principles of autonomy. Autonomy refers to the right to self-determination regarding heath decisions and discourages conduct that would prevent people from taking autonomous action (Anonymous, 2011). As a result, whether it is acceptable to force or compel people to vaccinate their children in order to promote overall public health remains one of the most controversial ethical issues in public health.

Utilitarianism

The utilitarian perspective supports not only a vaccination policy, but also compulsory vaccinations with very few exceptions. In utilitarianism, "the morally justifiable act is that which produces the greatest amount of value over disvalue" (Anonymous, 2011). Furthermore, the relative worth is determined by the consequences of actions, not the intentions behind those actions. Because vaccinations provide herd immunity in addition to individual immunity and do result in lower death rates from communicable diseases, vaccinations clearly provide the greatest amount of value over disvalue for the community, as a whole. Moreover, the individual risk from vaccinations is relatively small, while the potential reward can literally be life-saving, suggesting that promoting a vaccination policy, even at an individual level, would fit within the utilitarian perspective.

Distributive Justice

The theory of distributive justice may seem to have little to do with vaccination…