“Common good” is the state’s obligation when it comes to vaccination, writes Chris Maxon.
Durban - The traditional Chinese culture, Confucianism, like ubuntu has a non-individualist conception of what it is to be human. It conceives of people fundamentally as members of social groups – specifically, the family, the clan, the political community and the state.
Recently, the notion of “community” or “common good” has assumed an increasingly important role in the public health discourse.
Discussions of individual informed and community consent, and of community engagement and participation in vaccination campaigns, have taken centre stage.
It was our ever-vigilant news media that ran the story of a mother who indicated her intention to sue the departments of Education and Health for giving her daughter a cervical cancer vaccine without her permission.
In the US, amid a measles outbreak, the news media were awash with debates on whether the state can vaccinate without consent.
It took one Jennifer Cauzza, a charter-school leader in Southern California, to aptly point out that “the measles outbreak is more than just a health and science lesson. It has become a civics lesson, too”.
Neighbouring schools in this part of California were reported to have sent unvaccinated students home after suspected measles cases were reported, prompting similar public debates at one school, which hadn’t had any measles cases at its various locations.
Cauzza heard from parents who stood by their decision not to vaccinate their children.
Other parents adamantly argued that those children not vaccinated threatened their own immunised offspring, not to mention the overall health of the school.
Returning to our shores, it has become a health workers challenge to deal with such sentiments and parents who refuse to grant permission for their children to be vaccinated against human papilloma virus (HPV), or others, during the public health vaccination campaigns. Even the English celebrity chef Jamie Oliver knows: “The public health of children should not be left to luck or chance.”
The key threads running through much discourse in public health are the extent to which the interests of the community might justify state interventions that impose limits upon the freedom of individuals and the extent to which individuals have moral obligations to contribute to or protect the community.
As the Health Department forges ahead with the campaign to prevent young girls from acquiring cervical cancer in their later years, we cannot ignore the voices of those who continue to refuse to grant consent for their girls to be vaccinated.
This is because there are, clearly, different understandings of what constitutes a “common good”.
The fact is, cervical cancer remains the most deadly form of cancer among women in South Africa.
About 6 000 women are diagnosed with it every year, and about half die. The statistics show that too many young women die of cervical cancer. Cervical cancer is affecting HIV-positive women at a younger age than the average population.
Usually cervical cancer develops between the ages of 45 and 54, but with a co-infection of HIV, it is developing as early as 35 years of age.
While some may argue that this is communist ideology, we cannot but also emphasise the significance of a specific “good” that is shared and beneficial for all (or most) members of society.
While these campaigns have good intentions, the challenges raised by parents in reality contend that public health concerns should reach beyond the dichotomy between individualism and collectivism.
I would argue that the Confucian approach to public health is relevant to health care today. For example, Newsweek columnist Robert J Samuelson wrote: “We face a choice between a society where people accept modest sacrifices for a common good or a more contentious society where groups selfishly protect their own benefits.”
Health and medical care have long been objects of moral concern and controversy. Both the impetus and desire to interpret health care as a commodity are understandable given the traditional reliance upon markets as the primary means by which goods and services are distributed and the primary framework within which goods and services are interpreted.
As a country, we have long demonstrated our commitment to ensuring that our most vulnerable citizens – women and girls – receive health care and we continue to uphold that commitment today in a number of ways.
While many may find pleasure in their right to debate this matter, we must always keep in mind that a good society recognises the equal dignity of its members and, indeed, must respond accordingly to such avoidable human suffering – especially a society as unequal as our own.
While some may believe that our society does not have a moral obligation to meet every conceivable health-related need of every citizen, some of us believe that we must ensure that citizens – especially the vulnerable members like young girls – have the requisite ability to meet their health needs for preventive care.
We may arrive at different conclusions about whether or not it is the right of parents to refuse their children getting the HPV or measles vaccine.
We must also recognise that our primary conclusion may lead to different intuitions about how the state best approaches fulfilling its “common good” obligation.
But we cannot be hindered from concluding that it is imperative that our public health care ensures that all of its citizens have access to medical care when they need it.
* Chris Maxon is a government spokesman. He writes in his personal capacity.
** The views expressed here are not necessarily those of Independent Media.
Daily News