COVID Vaccines Are Ordinary Means & Thus Morally Obligatory (National Catholic Bioethics Quarterly)

Back in the spring, I posted two pieces in a series. In one, I argued that by a usual definition of “ordinary means,” widely (almost universally) recommended vaccines, including COVID vaccines, are ordinary means. In the second, I posted snippets from a piece by a Catholic scientist and philosopher who wrote about the duty to vaccinate if one follows Catholic Social Doctrine.

I was recently alerted to another article in the National Catholic Bioethics Quarterly titled “Is COVID-19 Vaccination Ordinary (Morally Obligatory) Treatment?” They begin, “In this article, we will address [the] disputed points and defend an affirmative answer to the question of whether vaccination for COVID-19 falls within the definition of being an ordinary—and thereby morally obligatory—treatment.” Unfortunately, this piece by Fr. James McTavish and Jason Eberl is behind a paywall. I can, however, post a summary and select quotations from it for your reading. (I recommend those who have access read the main article as it has more details.)

The History of Vaccines in Catholic Theology

Vaccines & Ethical Issues
Vaccines & Ethical Issues (University of Melbourne CC BY-ND 3.0 AU)

They note, “The Catholic Church has never formally opposed vaccination and, for reasons we will articulate below, considers this preventive health measure to be a good act.” Then they have a section covering the history of discussion about fetal cell lines and vaccines. (I dealt with the history here, and it is well known, so I will not repeat it.)

They conclude this first section with the 2020 CDF document and note: “Having clearly concluded that it is morally licit to receive any of the available COVID-19 vaccines, it does not necessarily follow that there is an obligation to be vaccinated.” They note some specific things about the language of the infamous paragraph 5 in that 2020 CDF document (“practical reason makes evident that vaccination is not, as a rule, a moral obligation and that, therefore, it must be voluntary.”):

There are, however, some key ambiguities in the language the CDF uses [in paragprah 5]. First, there are two ways in which something could be a rule: absolutely or prima facie. Understanding the CDF as asserting an absolute rule would contradict Pope Francis’s exhortation, “I believe that morally everyone must take the vaccine. It is the moral choice because it is about your life but also the lives of others.” The Pope and the CDF would be in alignment if we understand “as a rule” in a prima facie sense, meaning that, under ordinary circumstances, vaccination is not a moral obligation; however, the current pandemic has arguably created a “state of exception” in which moral rules, though not abrogated, may be applied in different ways. In this case, another moral rule—the requirement to safeguard one’s health and promote the common good—overrides the prima facie rule against vaccination being a moral obligation. Second, the term voluntary is inherently ambiguous as it could mean either that one should not be coerced in any way to be vaccinated or that one should not be held down and jabbed against their will. While the currently implemented mandates could be construed as coercive, they are not forcing anyone to be vaccinated against their will; one could avoid vaccination by, for example, resigning from their job, refusing to dine in a restaurant, or traveling in a manner that does not require vaccination.

So although there is a general rule, it need not apply in every case and this may be a case where it does not apply according to what the Pope has said repeatedly.

Ordinary & Extraordinary Means

They go through a long history of how this teaching developed. Some highlights:

  • Thomas Aquinas’s exhortation to exercise proper stewardship over one’s body: “It is prescribed that a human being sustains his body, for otherwise he murders himself. . . . Therefore, one is bound to nourish his body, and we are bound likewise with respect to all other things without which the body cannot live.”
  • In the 1950s, theologians like Gerald Kelly defined ordinary treatments as “all medicines, treatments, and operations, which offer a reasonable hope of benefit and which can be obtained and used without excessive expense, pain, or other inconvenience.”
  • In 1957, Pope Pius XII, in an address to address to Catholic physicians and anesthesiologists, stated, “Normally one is held to use only ordinary means—according to circumstances of persons, places, times, and culture—that is to say, means that do not involve any grave burden for oneself or another. A stricter obligation would be too burdensome for most people and would render the attainment of the higher, more important good too difficult.”
  • The 2018 Ethical and Religious Directives for Catholic Health Care Services of the United States Conference of Catholic Bishops (USCCB): “A person has a moral obligation to use ordinary or proportionate means of preserving his or her life. Proportionate means are those that in the judgment of the patient offer a reasonable hope of benefit and do not entail an excessive burden or impose excessive expense on the family or the community.”

“Summarizing this long tradition, there are three keys elements to consider in the discernment of whether a treatment is ordinary or not: benefit, burden, and cost.”

  1. “Overall, the currently approved vaccines are deemed beneficial for the vast majority of the population and there is ample evidence of the risks from lack of vaccination.”
  2. “Medically speaking, the process of vaccination is not excessively burdensome. There will be a slight burden related to the discomfort of receiving an injection, as well as the need to travel to a vaccination center and the time it takes to receive the vaccine. Further, there may be discomforting side effects as the vaccine prompts a response from one’s immune system, and there is also a small risk of a serious adverse reaction to the vaccine.”
  3. “When it comes to cost, it depends on the specific vaccine and the country one is in. Countries that have made the vaccines freely available must weigh the economic costs, especially if they are a low- or middle-income country. But compared with the cost of treating a case of COVID-19 infection, with potential hospital admission, acute respiratory support, and potential long-term effects on various organ systems, the cost of the vaccine is evidently worthwhile. This is especially the case when considering the cost in lives from hospitals experiencing surges of patients. A report from the Annals of Internal Medicine showed that almost 25 percent of the excess mortality—that is, deaths not directly from COVID-19 infection—seen during the early months of the pandemic can be attributed to health systems being overwhelmed.”

They conclude: “This preliminary analysis of COVID-19 vaccination reveals that it is beneficial, not too burdensome, and relatively cheap. Thus, it fits the main criteria for an ordinary treatment… Nonetheless, we consider the obligatoriness of vaccination to arise not from the mere fact that it could be considered ordinary but from the fact that to be vaccinated is a good act.”

Vaccination is Good Act

They begin with a series of quotations:

  • “Receiving the COVID-19 vaccine ought to be understood as an act of charity toward the other members of our community. In this way, being vaccinated safely against COVID-19 should be considered an act of love of our neighbor and part of our moral responsibility for the common good.” USCCB chairs of doctrine and pro-life
  • “The Catholic Church strongly supports vaccination and regards Catholics as having a prima facie duty to be vaccinated, not only for the sake of their own health but also out of solidarity with others, especially the most vulnerable.” English Bishops
  • Vaccines are “A direct act of care for life.” Vatican commission

After this inductive reasoning, they state: “We contend that vaccination is ethically obligatory, not so much because it is ordinary, although our analysis above shows that it is, but rather because it is a good act. In the same way we are obliged to help the poor, to feed the hungry, and perform other corporal works of mercy.”

Conclusion: Vaccines Are Ordinary Means & thus Morally Obligatory

McTavish and Eberl conclude with a long section on overcoming vaccine hesitancy, which can be summarized as trying to convince, more than coerce, to help people see the good of vaccination first and only insist on mandates if that fails. I hope my contributions to the topic have helped with that.

I think McTavish and Eberl are generally good in their assessment. I came to an almost identical conclusion in the spring and two others wrote the same about other vaccines before covid. I would recommend you read the rest if you have access (if you are really interested but don’t have access, email one of them as academic authors can give people PDFs of their articles for free). However, I think there is a point their argument could be improved upon: the point that although the Vatican foresees some Catholics skipping MMR because it is grown on fetal cell lines, it has never said this about vaccines only tested on fetal cell lines and in fact, directly avoided it in the 2020 CDF document and other places it has spoken of the issue of fetal cell line testing.

Overall, vaccines are ordinary care and thus generally morally obligatory for most people. Obviously, if you have a health issue where most doctors recommend against vaccination, that is an exception. However, that means vaccination is morally obligatory for the vast majority of Catholics.

Note: all quotes with emphasis have that emphasis in the McTavish and Eberl article.

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  1. Father Matthew, I am an occasional reader of your blog (mostly when linked from NewAdvent), and have generally appreciated what I find there. So it is with dismay that I came tonight after a long absence and found this article claiming the Covid vaccinations to be morally obligatory. Surely someone of your research skills and reasoning ability (both of which I have reason to sincerely respect) would not be unaware of the ever-worsening track record of severe and often-deadly adverse reactions to these vaccines (myocarditis being a prominent one), in proportion far outnumbering the adverse reactions to any previously approved vaccines, and would from there be able to reason to the recognition that such a track record invalidates any claim that these covid vaccines should be *more* morally obligatory than much-safer earlier vaccines that it seems you are willing to acknowledge as falling under the “general rule” of non-obligatoriness quoted in your article. I personally know two people in my direct contacts who experienced severe adverse reactions to the covid vaccine. Neither died, but that’s twice as many people as I personally know who have been injured by any other vaccine, ever. And it doesn’t include people not in my immediate direct contacts, but in my awareness more peripherally as having suffered or even died from it.

    Surely you aren’t unaware of the the jawdropping uptick in total deaths and disabilities in the healthiest age-range of the population that has caused dismayed comment from even a vaccine-supporting insurance representative who pointed out that the numbers are throwing off all their actuarial risk tables (but no need to rely on his testimony, anyone can crunch the numbers that he was calling attention to), an uptick that is correlated NOT with the height of the covid crisis itself, but rather with the rollout of the covid vaccines. Surely you aren’t unaware of the startling fact that the vaccines aren’t even claimed to prevent infection but only reduce severity of infection, and that they in fact are proving to fail in far too many cases even to accomplish that, and there is even evidence indicating they increase susceptibility. Surely you aren’t unaware of the new diagnosis of “SAD” sudden adult death syndrome, when has that ever been a thing, let alone such a common thing as it’s becoming? Please do not take my word for it on all this. Please look up these matters for yourself and you will see they are true. It does take a bit of digging into primary sources of information to discern this truth, because it is not being duly highlighted by media nor other typical secondary sources nor certainly not by the manufacturers, because for them it is *very* inconvenient truth, but that digging is not too difficult to do with a bit of time and an internet connection; yes, the information is buried, but not deeply. Please do look into these things, Father!

    1. If you could provide a peer-reviewed (or at least reasonably solid) source showing that risk of adverse reactions is in the same ballpark as the risk from not getting vaccinated, I would like to read it. I have yet to find anything that does not make obvious errors get anywhere near that. The best estimates I have are in the range of 2-3 million lives saved in the USA by COVID vaccinations and even the most extreme claims about vaccine injury, which I can see misinterpreting the data, don’t reach anywhere near that. We stopped the Johnson & Johnson Vaccine over a possible risk that was in the range of killing or permanently disabling 1 in a million that in the end turned out not to be even that significant. I’m open to evidence that at least gets basic statistics and immunology rihgt.

  2. I’m sorry, Father. I do not intend to do that legwork for you today. Forgive me for this stance, but it is ingrained in me as a teacher (my day job) not to outright give the answer to someone who has failed to get it right the first time. Hints of the answer, yes, but not the answer. That would be like cutting open the chrysalis to let out the butterfly (that refers to the story about the man who wanted to help the struggling butterfly emerge faster, but found out the thing never could fly after that, because it needed the struggle in order to develop its wings). My note above is plenty detailed enough for you to use the keywords in it and find the answers for yourself.

    I assure you it is worth your time. There are very relevant facts “hiding in plain sight” in this whole Covid matter. “Emperor’s New Clothes” is an appropos story to call to mind. Experts (or just plain witnesses) who should be listened to are being loudly “talked over.” “Experts” whom we are supposedly supposed to respect are contradicting themselves in what they say at different times and places and it’s well worth comparing what they say in an interview to one audience to what they have said less prominently but still publicly-accessibly to another audience. Or comparing their words to their actions. It’s also worth looking at from where they get their funding or wealth, and at organizations or entities they’ve associated with in the past. It’s also worth looking hard at other places funding is _going_ and how that could just possibly influence the supposed baseline “data” upon which well-meaning but naive people then base various statistical conclusions.

    Vaccines in general are very often (indeed, speaking very broadly across history, I’ll go so far as to say almost always) a very good thing, saving many, many lives. I am immensely grateful they were invented. But, like absolutely any good thing (even common H2O, ever read that hilarious warning about the dangers of “dihydrogen monoxide”?), vaccines are susceptible to, in some cases, being changed dramatically from very good to very destructive by any number of factors, including mistakes or misjudgment or misapplication, or, yes, malice.

    Contamination by aborted fetal tissue is *far* from the only way a particular vaccine can become problematic. In the case of these Covid vaccines, it’s the very least problematic thing about them. In fact, I would call it a great (and all too convenient) distraction from the real issues. Ignore it. Look into the rest. Deeply and carefully.

    These Covid vaccines are *not* in the “very good thing” category. That has become abundantly clear.

    (By the way, as to your closing remark about statistics, I agree with you on the need to be VERY careful about them, and about people who are particularly fond of using them. Mark Twain has a pithy quote attributed to him about that matter. ;))

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