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27 Apr 2021

Policies

What’s wrong with vaccine passports?

Even if the answer turns out to be ‘nothing’, it’s worth asking such questions. Socrates famously suggests the unexamined life is not worth living, and when teaching political theory I update this as: ask lots of questions. Political theory helps us identify what factors matter, and what information we need to come to practical conclusions.

Here, I step through some philosophical questions and explore why vaccine passports are controversial.

Let’s start with voluntary informed consent – a key principle of medical ethics. UK Church leaders argue vaccine passports are unethical, since they make a mockery of informed consent.

You must be vaccinated to access benefits, potentially to go abroad, to go to the pub, or even to get a job (Justice Secretary Robert Buckland has suggested current law theoretically allows new contracts to require vaccination). Do these conditions really allow for voluntary consent to vaccination, or is this coercive?

May states coerce citizens? One answer is ‘no’. Max Weber’s sociological definition of the state is a monopoly of the use of force –  here, coercion defines the state.

But this is an account of authority-in-practice, warts and all. ‘What may the state do?’ is a central question of political philosophy, and it asks about the legitimacy, and limits, of state power.

State authority always chafes against individual autonomy. There are always limits to what I may do when we live together: as the saying goes, my freedom to swing my fist ends at your nose.

If we think that states lack legitimate authority over citizens because it is unacceptable that states unavoidably limit individual autonomy, this is philosophical anarchism (Robert Paul Wolff). This happens when we prioritise individual autonomy at all costs.

Philosophical anarchism is only an evaluation of the possibility of legitimate state authority: it couldn’t be further from the Sex Pistols’ Anarchy in the UK.

Good political theory pays attention to the real world: real people tend to go about obeying states and thinking states ought to be obeyed. Weird, huh?

So let’s try a different angle. If we think about individual autonomy, then we’ve seen that vaccine passports seem coercive. Is coercion always bad?

Some coercion is justified. States coerce citizens all the time: pay your taxes, wear a seatbelt, don’t steal. Is it bad that the state follows agreed rules to collect funds for shared goods like healthcare, enforces accident prevention measures, or upholds the criminal law? Of course not.

Coercion might be justified to prevent harm to others. Vaccinated individuals are less likely to infect those who cannot be vaccinated on medical grounds; and when we curtail spread, we reduce opportunities for new variants.

Vaccine passports are not about the autonomy of citizens who decline vaccination, they are about protecting the right to life of vulnerable citizens who cannot be vaccinated.

Here’s another good philosophical question: what do we mean by autonomy anyway? It’s important to make sure we mean the same thing.

In Western political thought, we begin from the individual and work outwards. What can she do by herself? What rights does she have against others who might stop her? What duties do her rights imply for others?

Conversely, many non-Western accounts of autonomy begin from a group, since human beings are social creatures living in communities.

When was the last time you really did something by yourself? Probably less recently than you think, unless you knit your own socks, generate your own electricity, and grow your own food.

This difference in emphasis brings up an important point: if we’re uncomfortable with vaccine passports because they harm autonomy, maybe the problem is with the way we’re thinking about autonomy.

After all, Covid-19 has highlighted how much we rely on others, from delivery drivers and supermarket staff to healthcare professionals and vaccine researchers. Autonomy can include what we individually achieve with help, and what we do together.

Let’s try another question: is nudging citizens towards vaccination – by making social activities contingent on holding a passport – really coercion?

Individual choices against vaccination have costs. Those who decline the vaccine lack protection against contracting, and transmitting, Covid-19. Vaccine passports impose additional social costs: exclusion from desired activities.

Left libertarian scholars argue that even if a choice is costly, cost doesn’t diminish our freedom to pursue it, or remove the possibility that we will do so.

Richard Thaler and Cass Sunstein, authors of nudge theory, argue nudging cannot be coercive since no options are forbidden.

So where are we overall? Are vaccine passports justified? We’ve examined what we think we know: states ought not to coerce citizens (they already do); vaccine passports undermine autonomy (only on a limited individualistic view); choice limitation is coercive (or is it just costly?). But even if this is justified coercion, autonomy isn’t the only value.

Will vaccine passports protect those most vulnerable, or will they create second-class citizens? At first glance, this might seem irrelevant in wealthy states where citizens are promptly offered free vaccination.

Not so fast: we should worry if entrenched social injustices – the cross-cutting effects of intergenerational poverty, underinvestment in local services, exclusion, discrimination – leave some groups more vulnerable to the effects of Covid-19 than others.

This second-class status concern is clearer on a global scale, since the citizens of many states lack vaccine access. The British Medical Journal has raised sustainable development and ethical concerns, and called for international standardisation of vaccine passporting measures, since Covid-19 is a global problem.

These questions require empirical answers, but these are complex problems. Sometimes we must act with limited information because we cannot be paralysed by indecision.

Pandemics demand swift, decisive action. But, following Socrates, we should recognise what we do not know when deciding, and stand ready to adapt as our understanding develops.

By Dr Helen Brown Coverdale, Lecturer, in Political Theory, University College London Department of Political Science.

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