In this collection of newly commissioned essays, the contributors present a variety of approaches to it, engaging with historical and empirical aspects of the subject as well as contemporary philosophical work.

The public health benefits of herd immunity are often used as the justification for coercive vaccine policies. Yet, ‘herd immunity’ as a term has multiple referents, which can result in ambiguity, including regarding its role in ethical arguments. The term ‘herd immunity’ can refer to (1) the herd immunity threshold, at which models predict the decline of an epidemic; (2) the percentage of a population with immunity, whether it exceeds a given threshold or not; and/or (...) (3) the indirect benefit afforded by collective immunity to those who are less immune. Moreover, the accumulation of immune individuals in a population can lead to two different outcomes: elimination (for measles, smallpox, etc) or endemic equilibrium (for COVID-19, influenza, etc). We argue that the strength of a moral obligation for individuals to contribute to herd immunity through vaccination, and by extension the acceptability of coercion, will depend on how ‘herd immunity’ is interpreted as well as facts about a given disease or vaccine. Among other things, not all uses of ‘herd immunity’ are equally valid for all pathogens. The optimal conditions for herd immunity threshold effects, as illustrated by measles, notably do not apply to the many pathogens for which reinfections are ubiquitous (due to waning immunity and/or antigenic variation). For such pathogens, including SARS-CoV-2, mass vaccination can only be expected to delay rather than prevent new infections, in which case the obligation to contribute to herd immunity is much weaker, and coercive policies less justifiable. (shrink)

This collection of essays is presented as offering the first real philosophical and legal treatment of the Principle of Non-Combatant Immunity . Primoratz's own essay serves as a useful summary of some of the most influential attempts to rule in all, but only, combatants as legitimate military targets. However, this will feel like very familiar territory to those already working in Just War Theory, as will Uwe Steinhoff's essay, which surveys the same positions . Several of the essays are (...) expositional rather than analytical in nature, tracing the historical roots of the PNI. Whilst providing an undeniably interesting journey through early Just War thought, these parts of the volume might feel less than gripping to those looking for engaging philosophical argument.However, the collection is certainly not without such argument. Seamus Miller's essay offers a thorough and thought-provoking account of why certain groups of civilians should not be granted immunity from military force. Using the model of the forced …. (shrink)

This article underlines and draws attention to critical insights that Esposito makes regarding the prospects of rethinking community in a globalized world. Alongside Agamben and Nancy, Esposito challenges the property prejudice found in mainstream models of community. In identity politics, collective identity is converted into a form of communal property. Borders, sovereign territories, and exclusive rights are fiercely defended in the name of communal property. Esposito responds to this problem by developing what I call a “deontological communal contract” where (...) being and ethics are prioritized over having and economics. I examine this new perspective on community in relation to mainstream models found in contemporary and classical social theory. (shrink)

The statement that we are currently failing to address some of humanity’s greatest challenges seems uncontroversial—we are not doing enough to limit global warming to a maximum of 2 °C and we are exposing vulnerable people to preventable diseases when failing to produce herd immunity. But what singles out such failings from all the things we did not do when all are unintended? Unlike their individualist counterparts, collective inaction and omission have not yet received much attention in the (...) literature. collective inaction, I argue, can be attributed to a group of agents where a collective action x that the agents did not perform was collectively feasible at time t where each agent in that group had sufficient reason to contribute to performing x or others had a reasonable expectation that they would perform x. I show that, perhaps surprisingly, we can speak of collective inaction even where only one member of the group fails to act. However, where large and dispersed groups of agents are concerned, there is often no meaningful way of attributing collective failings. Still, I contend that the failure to close the global emissions gap and—in some cases—to generate herd immunity are indeed on us. (shrink)

It is widely apparent in our hyper-globalized world that the epistemologies, institutions, and practices underwriting it have reached a state of profound crisis. In the globalized world, everything is inevitably brought into proximity and correlation. Wars, natural disasters, climatic upheaval, nor political and economic turmoil, none of these can be effectively isolated, insulated, instituted, even immunized, as something apart, something that might be considered proper only to itself. This collected edition considers this crisis of the proper with a focus on (...) Italian political theorist Roberto Esposito’s work on community, immunity, and biopolitics. This collection introduces Esposito’s work to a wider English-speaking audience and provides many important contributions to the burgeoning scholarship on his political theory. Important international scholars working in this area examine and analyze his theory from a variety of perspectives, including those of biopolitics, feminism, political theory, the history of philosophy , property, community, and gift economies. The collection also includes previously untranslated essays by Esposito and Jean-Luc Nancy. This collection will be of interest to those just discovering Esposito and for those who are already familiar with his work. This book was originally published as a Special Issue of Angelaki: Journal of the Theoretical Humanities. (shrink)

This collection of essays is presented as offering the first real philosophical and legal treatment of the Principle of Non-Combatant Immunity. Primoratz's own essay serves as a useful summary of some of the most influential attempts to rule in all, but only, combatants as legitimate military targets. However, this will feel like very familiar territory to those already working in Just War Theory, as will Uwe Steinhoff's essay, which surveys the same positions. Several of the essays are expositional rather (...) than analytical in nature, tracing the historical roots of the PNI. Whilst providing an undeniably interesting journey through early Just War thought, these parts of the volume might feel less than gripping to those looking for engaging philosophical argument.However, the collection is certainly not without such argument. Seamus Miller's essay offers a thorough and thought-provoking account of why certain groups of civilians should not be granted immunity from military force. Using the model of the forced …. (shrink)

This chapter contains sections titled: Moral Justification for the Use of Deadly Force Civilian Immunity and Human Rights Violations Civilian Immunity and Culpable Omissions Terrorism and Non‐Violent Rights Violators Conclusion.

In a recent analysis of the principle of civilian immunity, Igor Primoratz asks whether the circle of legitimate targets in war might be expanded so as to include at least some civilian bystanders. However Primoratz’ formulation of the ‘responsible bystander’ argument depends for its cogency on there being natural or non-acquired positive duties, and this is controversial. Furthermore, we feel that the citizens of a government unjustly at war are primarily and specially obliged to undermine that war, and that (...) this is not simply a function of their being in the best position to do so, (which may not always be the case). Primoratz’ version of ‘responsible bystander’ cannot account for this. Here I develop an alternative formulation that does, and which is not reliant on controversial premises. I argue that to empower a government democratically is to assume a positive obligation to prevent that government from using its power to prosecute an unjust war, and that the neglect of this duty may render a significant portion of the duty-bound collective legitimate targets of necessary and proportionate violence. In closing I dispute Primoratz’ claim that this conclusion has “very little purchase on reality” or is irrelevant for practical purposes. (shrink)

The mass childhood immunization programme has traditionally been viewed as a safe and effective preventative measure by health promoters, primary health care professionals and governments. This consensus has meant that immunization has rarely been viewed as ethically problematic. A number of recent changes in the context of the delivery of health care, particularly the emphasis on consumerism and the effect of the marketization of services, makes timely an examination of ethical, social and political issues. This article examines four main grounds (...) for problematizing the mass childhood immunization programme. These are: clinical research evidence about the safety and efficacy of vaccines; the masking of wider social and political determinants of ill health; the contradictory strictures about collective and individual rights in relation to immunization; and the uniqueness of childhood immunization as a physical intrusion into a healthy body. The implications of these ethical issues are discussed in relation to informed consent and the need for a 'greenfield' review that includes the views of dissenting parents, lawyers and moral philosophers, as well as health professionals. Les promoteurs de santé, les soignants et les gouvernements ont tous traditionellement vu le programme d'immunisation globale des enfants comme sain et efficace. Cela voulait dire que l'immunisation a rarement posé un problème éthique. Pourtant, actuellement des changements dans les contextes de la distribution des soins, le consumérisme et de l'effet de la commercialisation des services de santé, exigent une revue des problèmes éthiques, sociaux et politiques. Cet article discute quatre éléments problématiques du programme d'immunisation globale: les données des recherches médicales sur la sûreté et l'efficacité des vaccins; la dissimulation des déterminatifs sociaux et politiques des maladies; les critiques contradictoires des droits individuels et collectifs concernant l'immunisation; et le caractère unique de l'immunisation des enfants comme une intrusion physique dans un corps sain. Les effets de ces questions éthiques sont repris en rapport du consentement informé et de la nécessité d'une revue 'verte' qui comprend les vues des parents dissidents, des juristes, des philsophes et des membres des professions soignantes. Das Massenimpfungsprogramm von Kindern wurde allgemein von Gesundheits behörden, medizinischem Fachpersonal und Regierungen als sichere und wirksame Vorbeugungsmassnahme betrachtet. Diese Uebereinstimmung bedeutete, dass Imp fungen selten ein ethisches Problem darstellten. Eine Anzahl von Aenderungen im Gesundheitswesen - besonders im Hinblickin auf Konsum und Marktwirtschaft im Dienstleistungsbereich - berechtigen jedoch zu einer Untersuchung der ethischen, sozialen und politischen Fragen. Dieser Artikel untersucht vier Hauptgründe, die das Massenimpfungsprogramm für Kinder in Frage stellen: Forschungsergebnisse über die Sicherheit und Wirksamkeit der Impfstoffe; die Verschleierung von andern sozialen und politischen Krankheitsursachen; die widersprüchlichen Anordnungen über kollektive und individuelle Rechte mit Bezug auf die Impfungen; und die aussergewöhnliche Art der Impfung als physische Verletzung eines gesunden Körpers. Die Bedeutung dieser ethischen Fragen werden hier diskutiert im Zusammenhang mit der informierten Vereinstimmung und der Notwendigkeit eines 'grünen' Ueberblickes, der die Ansichten andersdenkender Eltern, Rechtsanwalte, Philosophen und Gesund heitsexperten einschliesst. (shrink)

The immune system does not just fight pathogens but also engages in interactions with beneficial microbes and non-immune cells of the body to harmonize their behavior by means of cytokines, antibodies and effector cells (Dinarello, 2007; Moticka, 2015, pp. 217e226, 261e267). However, the importance of these “housekeeping” functions has not been fully appreciated (Cohen, 2000). In his new book Immunity: The Evolution of an Idea Alfred I. Tauber traces the history of fundamental ideas in immunology and refers to recent (...) advances in the field to overturn the notion that immunity is the ability of an autonomous organism to protect itself against pathogens. Indeed, as suggested by the author, the autonomy of the organism is illusive because individuals develop as holobionts: functionally integrated multispecies consortia (p. 98). Similarly, he suggests that pathogenicity also emerges from the lack of subordination of a microbe to social welfare of the holobiont rather than from context-independent properties of this organism (pp. 165, 181). Emphasizing the contextual character of the parasite and the host, Tauber redefines immunity as an active process of coordination of a cellular ecosystem, which allows this collective to navigate through challenges of the environment and to face demands of the communal living (pp. 10e16). From this point of view, the failure to modulate intercellular interactions by the immune system entails mitigating immunity and impairing resistance to infection and disease (pp. 103e104). Immunity is a groundbreaking work establishing a new framework for understanding the function and activity of the immune system. Its value also lies in the fact that it serves as an important stepping-stone towards an integrated philosophical, ecological and immunological study of our embedment in the microbial world. (shrink)

Considering the significant contribution of teachers’ professional triumph in the prosperity of students, the current study aims to investigate the existence of any relationship among three factors influencing teachers’ success: immunity, mindfulness, and engagement. Furthermore, we attempt to investigate whether English as a foreign language teachers’ immunity and mindfulness can predict their work engagement. To this end, a Likert-scale questionnaire including items on teacher immunity, mindfulness, and work engagement was distributed to 582 EFL teachers in China through (...) the WeChat application by employing a convenient sampling. To analyze the collected data, the Spearman Rho correlation index and linear multiple regression analysis are employed. The findings are that there does exist an indication of a direct relationship among EFL teachers’ immunity, mindfulness, and work engagement. Also, it is found that immunity and mindfulness can predict EFL teachers’ work engagement. The current study’s findings support the necessity of training language teachers to cope with the EFL context adversities. (shrink)

In his paper ‘A libertarian case for mandatory vaccination’, Jason Brennan argues that even libertarians, who are very averse to coercive measures, should support mandatory vaccination to combat the harmful disease outbreaks that can be caused by non-vaccination. He argues that libertarians should accept the clean hands principle, which would justify mandatory vaccination. The principle states that there is a (sometimes enforceable) moral obligation not to participate in collectively harmful activities. Once libertarians accept the principle, they will be compelled to (...) support mandatory vaccination. In my paper, I argue that the cases Brennan uses to justify this principle are disanalogous to the case of non-vaccination and that they are not compelling to libertarians. The cases Brennan offers can be explained by a libertarian using the individual sufficiency principle: which states that if an individual’s action is sufficient to cause harm, then there is a (sometimes enforceable) moral obligation not to carry out that action. I argue that this principle is more appropriate to Brennan’s examples, and more appealing to the libertarian, than the clean hands principle. In order to get libertarians to accept the clean hands principle, I present a modified version of one of Brennan’s cases that is analogous to the case of non-vaccination. Using this case, I argue that whether the clean hands principle will justify mandatory vaccination is dependent on whether the herd immunity rate in a given population is approaching a threshold after which a collective risk of harm will be imposed onto others. (shrink)

Some would argue that the more promising areas of business ethics research are "sensitive." In such areas, it would be expected that subjects, if inclined to respond at all, would be guarded in their responses, or respond inaccurately. We provide an introduction to an empirical approach -- the unmatched block count (UCT) -- for collecting these potentially sensitive data which provides absolute anonymity and confidentiality to subjects and "legal immunity" to the researcher. Interestingly, under UCT protocol researchers could not (...) divulge subjects' responses even if they were inclined to do so. Beyond that, UCTs provide complete disclosure to subjects and there is no deception. (shrink)

This reviews Simon Prosser's and Francois Recenati's (eds.) 2012 Immunity to Error Through Misidentification: New Essays.

Collections are a group of multimeric proteins mostly consisting of 9–18 polypeptides organised into either ‘bundle‐of‐tulips’ or ‘X‐like’ overall structures. Each polypeptide contains a short N‐terminal segment followed by a collagen‐like sequence and then by a C‐terminal lectin domain. A collectin molecule is assembled from identical or very similar polypeptides by disulphide bonds at the N‐terminal segment, formation of triple helices in the collagen‐like region and clusters of three lectin domains at the peripheral ends of triple helices. These proteins can (...) bind to sugar residues on microorganisms via the peripheral lectin domains and subsequently interact, via the collagen‐like triple‐helices, with receptor(s) on phagocytes and/or the complement system to bring about the killing and clearance of the targets without the involvement of antibodies. The collectins can also bind to phagocyte receptor(s) to enhance phagocytosis mediated by other phagocytic receptors. Lack, or low levels, of collectin expression can lead to higher susceptibility to infections, especially during childhood when specific immunity has not fully developed. Therefore, the collectins play important roles in the enhancement of innate immunity. (shrink)

Vaccination policy is an ethically challenging domain of public policy. It is a matter of collective importance that reaches into the most private sphere of citizens and unavoidably conflicts with individual-based ethics. Policy makers need to walk a tight rope in order to complement utilitarian public health values with individual autonomy rights, protection of privacy, non-discrimination and protection of the worst-off. Whether vaccination is voluntary or compulsory, universal or targeted, every option faces complex ethical hurdles because of the interdependence (...) of humans in infectious disease matters. In this article, we explore the following three policy questions. (i) Ethically, which policy measures should be addressed when vaccination coverage is insufficient in a population? Information campaigns, legal compulsion, or the use of financial incentives can all be effective, but also controversial policy options. (ii) Is it ethical to target vaccination programs at certain risk-groups? If such measures are necessary, we argue that policymakers will often have to decide which is more important to uphold: non-discrimination or the protection of privacy. And (iii), what is the ethical significance of adverse herd immunity effects? Some vaccination programs will improve average population health, but will at the same time increase the risk of severe morbidity and mortality for individuals in the worst-off groups of society. (shrink)

Umbilical cord blood has become the focus of intense efforts to collect, screen and bank haematopoietic stem cells in hundreds of repositories around the world. UCB banking has developed through a broad spectrum of overlapping banking practices, sectors and institutional forms. Superficially at least, these sectors have been widely distinguished in bioethical and policy literature between notions of the ‘public’ and the ‘private’, the commons and the market respectively. Our purpose in this paper is to reflect more critically on these (...) distinctions and to articulate the complex practical and hybrid nature of cord blood as a ‘bio-object’ that straddles binary conceptions of the blood economies. The paper draws upon Roberto Esposito’s reflections on biopolitics and his attempt to transcend the dualistic polarisations of immunity and community, or the private and the public. We suggest that his thoughts on immunitary hospitality resonate with many of the actual features and realpolitik of a necessarily internationalised and globally distributed UCB ‘immunitary regime’. (shrink)

In health communication, metaphor can be considered as a reasoning device to let people understand an abstract concept in terms of a concrete one (Lakoff and Johnson 1980; Bowdle and Gentner 2005). Both the positive and negative communicative effects of metaphors have been largely pointed out in a variety of medical fields, from oncology (Semino et al. 2016, 2018) to mental health (Frezza and Zoccolotti 2019). The use of metaphors in vaccine communication has been less considered, though it might be (...) crucial to let people understand vaccination as an important collective health phenomenon. A previous study (Scherer et al. 2015) focused on the communicative effects of conventional metaphors for vaccination, but not specifically on novel metaphors deliberately used to explain the concept of population immunity in vaccination. We hypothesized that metaphors used to explain vaccination as a collective phenomenon could improve the communicative aims of pro-vaccination texts in many respects, ranging from understandability to trust in expertise. We designed a study to test the hypothesis: two groups of participants were presented with a text about vaccination as a collective phenomenon, described in either literal or metaphorical terms. They were asked to evaluate the text on different communicative aspects from both an individual and a collective point of view. The results confirmed the hypothesis that metaphor is an effective reasoning device and that it also enhances the overall communicative effects of the message, in terms of understandability, persuasion, feeling of control over the health situation, trust in expertise, and uptake of experts’ advice. However, the results show that this effect is significantly nuanced in the individual vs. collective response type. (shrink)

A core idea underlying nudging is that it helps individuals to achieve their own goals, yet many nudges actually aim at collective goals or specifically target the benefit of others. An example is nudging healthcare workers to be vaccinated against influenza. I distinguish between self‐regarding nudges, which primarily benefit the nudgee, and other‐regarding nudges, which mainly benefit others, and argue that the default justificatory reason to legitimize self‐regarding nudges, namely the ‘as judged by themselves’ standard, does not apply and (...) that we need to look for other justifications. I examine several possible moral justifications to support strong other‐regarding nudges, namely beneficence, the harm principle and solidarity. (shrink)

It has long been thought that the central nervous system is able to influence the progression of disease. Furthermore, there is now overwhelming evidence that the communication pathways are bidirectional. A variety of immune system peptides are now known to be capable of transmitting information from the immune system to the central nervous system. These immunotransmitters include interleukins, interferons and thymosine peptides which have the capability of modulating slow‐wave sleep as well as the release of neuro‐ and pituitary peptides. In (...) some instances, release of these peptides during early development may have long lasting, if not permanent effects upon the normal development of neuro‐endocrine circuits. Collectively these various brain mediated events appear to contribute in various and diverse ways to defense against pathogens. It is becoming more and more apparent that certain abnormalities within the immune system may be the consequence of a neurological abnormality. The converse is also true. (shrink)

Sonja Arndt, Michael Peters, Marek Tesar Introspection is a key concept in epistemology, since introspective knowledge is often thought to be particularly secure, maybe even immune to skeptical dou...

A core idea underlying nudging is that it helps individuals to achieve their own goals, yet many nudges actually aim at collective goals or specifically target the benefit of others. An example is nudging healthcare workers to be vaccinated against influenza. I distinguish between self‐regarding nudges, which primarily benefit the nudgee, and other‐regarding nudges, which mainly benefit others, and argue that the default justificatory reason to legitimize self‐regarding nudges, namely the ‘as judged by themselves’ standard, does not apply and (...) that we need to look for other justifications. I examine several possible moral justifications to support strong other‐regarding nudges, namely beneficence, the harm principle and solidarity. (shrink)

Inflammatory mediators have an established role in inducing insulin resistance and promoting hyperglycemia. In turn, hyperglycemia has been argued to drive immune cell dysfunction as a result of mitochondrial dysfunction. Here, the authors review the evidence challenging this view. First, it is pointed out that inflammatory mediators are known to induce altered mitochondrial function. In this regard, critical care patients suffer both an elevated inflammatory tone as well as hyperglycemia, rendering it difficult to distinguish between the effects of inflammation and (...) hyperglycemia. Second, emerging evidence indicates that a decrease in mitochondrial respiration and an increase in reactive oxygen species (ROS) production are not necessarily manifestations of pathology, but adaptations taking shape as the mitochondria is abdicating its adenosine triphosphate (ATP)‐producing function (which is taken over by glycolysis) and instead becomes “retooled” for an immunological role. Collectively, these observations challenge the commonly held belief that acute hyperglycemia induces mitochondrial damage leading to immune cell dysfunction. (shrink)

Many nursing homes have an influenza vaccination policy in which it is assumed that express (proxy) consent is not necessary. Tacit consent procedures are more efficient if one aims at high vaccination rates. In this paper I focus on incompetent residents and proxy consent. Tacit proxy consent for vaccination implies a deviance of standard proxy consent requirements. I analyse several arguments that may possibly support such a deviance. The primary reason to offer influenza vaccination is that vaccinated persons have a (...) significantly reduced risk of getting the flu. This reason however cannot support the assumption that each nursing home resident is ‘better off ’ if she is vaccinated. Neither can it support tacit proxy consent policies. More promising are arguments that take the collective nature of infectious diseases into account. A potentially strong, but ultimately insufficient, argument for non‐express consent is that vaccination contributes to prevention of harm to others. Other arguments emphasise the importance of group protection: herd immunity. I discuss three collective reasons for aiming at herd immunity: solidarity, a common interest in reducing the risk of illness, and a common interest in the prevention of an influenza outbreak. The latter argument appears to be most important. An outbreak is not just detrimental to the health of residents; it is detrimental to their everyday social life as well. Outbreaks can be seen as a collective evil. My analysis shows that there are valid (though not necessarily sufficient) moral arguments for a tacit proxy consent policy. (shrink)

Some would argue that the more promising areas of business ethics research are "sensitive." In such areas, it would be expected that subjects, if inclined to respond at all, would be guarded in their responses, or respond inaccurately. We provide an introduction to an empirical approach -- the unmatched block count (UCT) -- for collecting these potentially sensitive data which provides absolute anonymity and confidentiality to subjects and "legal immunity" to the researcher. Interestingly, under UCT protocol researchers could not (...) divulge subjects' responses even if they were inclined to do so. Beyond that, UCTs provide complete disclosure to subjects and there is no deception. (shrink)

Reproductive genetic technologies allow parents to decide whether their future children will have or lack certain genetic predispositions. A popular model that has been proposed for regulating access to RGTs is the ‘genetic supermarket’. In the genetic supermarket, parents are free to make decisions about which genes to select for their children with little state interference. One possible consequence of the genetic supermarket is that collective action problems will arise: if rational individuals use the genetic supermarket in isolation from (...) one another, this may have a negative effect on society as a whole, including future generations. In this article we argue that RGTs targeting height, innate immunity, and certain cognitive traits could lead to collective action problems. We then discuss whether this risk could in principle justify state intervention in the genetic supermarket. We argue that there is a plausible prima facie case for the view that such state intervention would be justified and respond to a number of arguments that might be adduced against that view. (shrink)

A neo-phenomenological and atmospherological approach, mainly based on a first-person perspective, seems perfectly entitled to consider subjective and collective well-being as the starting point for a philosophical reflection. The question is, however, whether and how well-being, also as an atmosphere, can be really investigated and verified. The paper examines many traditional roblems hindering the research and suggests to analyze well-being from a pathic-atmospheric point of view. It therefore focuses especially on the idea of “flow”, wonders how much our well-being (...) depends on the felt-bodily resonances triggered by atmospheric situations, considers the probable parallels between the aesthetic-phenomenologic notion of “atmosphere” and the sociological one of “climate”, finally, underlines the need of an atmospheric competence that is able to partly immunize against today’s widespread manipulative atmospherization. (shrink)

We argue that individuals who have access to vaccines and for whom vaccination is not medically contraindicated have a moral obligation to contribute to the realisation of herd immunity by being vaccinated. Contrary to what some have claimed, we argue that this individual moral obligation exists in spite of the fact that each individual vaccination does not significantly affect vaccination coverage rates and therefore does not significantly contribute to herd immunity. Establishing the existence of a moral obligation to (...) be vaccinated despite the negligible contribution each vaccination can make to the realisation of herd immunity is important because such moral obligation would strengthen the justification for coercive vaccination policies. We show that two types of arguments—namely a utilitarian argument based on Parfit’s Principle of Group Beneficence and a contractualist argument—can ground an individual moral obligation to be vaccinated, in spite of the imperceptible contribution that any single vaccination makes to vaccine coverage rates. We add a further argument for a moral obligation to be vaccinated that does not require embracing problematic comprehensive moral theories such as utilitarianism or contractualism. The argument is based on a “duty of easy rescue” applied to collectives, which grounds a collective moral obligation to realise herd immunity, and on a principle of fairness in the distribution of the burdens that must be borne to realise herd immunity. (shrink)

The recent decrease in public confidence in the measles, mumps and rubella vaccine has important implications for individuals and public health. This article presents moral arguments relating to conflicts between individual autonomy and collective responsibilities in vaccination decisions with a view to informing and advising health professionals and improving the effectiveness of education policies in avoiding resurgence of endemic measles. Lower population immunity, due to falling uptake, is hastening the need for greater public awareness of the consequences for (...) the population. Vaccination refusals go hand in hand with responsibilities owed to future generations and society in not knowingly contributing to preventable harms. Issues such as parents’ rights are considered and balanced against: collective responsibilities for public health; permissibility of ‘free-riding’; conflicting duties of health professionals; and possible enforcement of vaccination. It is suggested that the arguments may form a persuasive tool for the practice of health professionals involved in informing and supporting parents’ vaccination decisions. (shrink)

This article explores the effects of our technological way of war, for the first time driving toward total combatant immunity, on the psyche of combatants and the ethos of a warrior. It is a plea for the preservation of a warrior spirit, or at least a warrior class, that views war in a philosophical and personal manner. The article posits that without a sense of the tragic, without a personal test of will and skill often at great individual risk, (...) we can find no real meaning in war. It argues that the warrior dimension of immunity in warfare has somehow altered our experience of war, yet the effects of this ‘virtual war’ are still ambiguous – we do not yet know whether executing warfare through long-distance video desensitizes the ‘remote warrior’ or enhances his/her experience of killing. We do not yet know how combatants ‘commuting’ to war from home and being transported 7000 miles into battle through this ‘miracle’ of technology will handle the consequences of what the nation is asking them to do. We kn.. (shrink)

First published in 1998. Routledge is an imprint of Taylor & Francis, an informa company.

This paper argues that professionals who make boundary-related decisions should be guided by relationship-based practice. In our roles as service users and professionals, drawing from our lived experiences of professional relationships, we argue we need to move away from distance-based practice. This includes understanding the boundary stories and narratives that exist for all of us – including the people we support, other professionals, as well as the organisations and systems within which we work. When we are dealing with professional boundary (...) issues, we should centre relationship-building skills that are central to many other aspects of our work. Skills that foster relationships at all levels – between professionals, service users, and services – need to be revalued. Our final recommendation is to create, develop, and foster safer spaces within and outside of organisations, as well as inter-professionally, for the discussion and exploration of boundary-related issues and practice. We are interested in hearing from those with experiences of being marginalised by boundaries so that they can inform a reshaping of our collective ideas around boundary related practices. To foster relationship-based practices in organisations, we have outlined several recommendations here; however, we recognize that these do not go far enough, and that collective action is needed to inform systemic change. (shrink)

Introduction: The paper investigates the impact of the use of metaphors in reasoning tasks concerning vaccination, especially for defeasible reasoning cases. We assumed that both metaphor and defeasible reasoning can be relevant to let people understand vaccination as an important collective health phenomenon, by anticipating possible defeating conditions. -/- Methods: We hypothesized that extended metaphor could improve both the argumentative and the communicative effects of the message. We designed an empirical study to test our main hypotheses: participants (N = (...) 196, 78% females; Meanage = 27.97 years, SDage = 10.40) were presented with a text about vaccination, described in either literal or metaphorical terms, based on uncertain vs. safe reasoning scenarios. -/- Results: The results of the study confirmed that defeasible reasoning is relevant for the communicative impact of a text and that an extended metaphor enhances the overall communicative effects of the message, in terms of understandability, persuasion, perceived safety, and feeling of control over the health situation, collective trust in expertise and uptake of experts' advice. However, the results show that this effect is significantly nuanced by the type of defeasible reasoning, especially in the case of participants' trust in expertise and commitment to experts' advice. -/- Conclusion: Both communicative and defeasible reasoning competences are needed to enhance trust in immunization, with possible different outcomes at an individual and collective level. (shrink)