The Compassionate and the Moralizer

Published: March 5, 2021

By Jim Lichtman
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Two stories about the coronavirus vaccine caught my attention.

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In a recent letter to New York Times ethicist, Kwame Anthony Appiah, one reader writes:

I work for a hospital, but in an administrative job. I do not interact with patients. I have worked from home since March. I am not at high risk for contracting Covid-19 based on my age, occupation and lack of health issues. I practice social distancing, I wear my mask in the limited situations in which I go out (to the grocery store, to the Post Office, to get takeout). I live alone and mostly keep to myself and stay home. Because I work for a hospital, I am eligible to receive the vaccine…

“Is it ethical for me to get the vaccine now? Part of me feels as if I’m skipping the line, but part of me feels as if this isn’t my decision and at a certain point it’s about getting as many people vaccinated as quickly as possible.”

“Any system,” Appiah responds, “that makes a reasonable attempt to be efficient and equitable in achieving the goal of reducing the harm done by the pandemic is acceptable, despite the questionable outcomes produced in particular cases. We’ve generally decided to treat employment in health care as a simple, useful proxy for a class of people who are part of our critical infrastructure…”

Examining the issue using the Josephson decision-making process offers a little more objective clarity.

  1. An ethical decision-maker considers the interests and well-being of all likely to be affected by their decisions.
  2. An ethical decision-maker makes decisions characterized by their core, ethical values of Respect, Trustworthiness, Responsibility, Fairness, Citizenship and Caring.
  3. If it is clearly necessary to choose one ethical value over another, the ethical decision-maker will do the thing that he or she sincerely believes to be best for society in the long run.

Despite wearing a mask and distancing when going outside, a risk remains that he or she could contract the virus threatening the “well-being of all likely to be affected by their decision.” This alone, answers the question. But let’s look at the rest of the steps in this scenario.

What ethical value(s) are involved? Responsibility to the community where she or he lives, and, in the case of the sympathetic administrator, compassion for others whose age and health puts them at greater risk. 

This brings us to the third step: a choice between responsibility to their community and compassion for others who are more vulnerable. While the administrator sincerely believes that postponing the vaccination for the sake of others, her or his delay still leaves open the possibility of contracting the disease resulting in consequences to the community. In this scenario, however, the administrator’s dilemma really stops after answering the first question – it’s best for society in the long run to get vaccinated. 

The second story focuses exclusively on responsibility.

In an opinion piece from a local newspaper, Norm King asks,Should those who refuse to get vaccinated be punished?”

“Apparently, a large percentage of Americans,” King writes, “say they will refuse to be vaccinated. These people personally benefit from medical advances made possible by ever-improving medical science yet, they refuse to take advantage of one of the most important breakthroughs in the history of medicine. Their reasons range from stupidity and unfounded fear to ideological and political issues.

“No matter their reasoning… refusing to be vaccinate is not just a matter of personal risk it is an act of selfishness and disregard for the lives of others. That is, anyone who refuses to take the vaccine will cause others to die or suffer from permanent damage.

“…we hold those who commit personal injury and economic injury crimes accountable. There is no reason not to apply the same criminal standards to those who, by their own inaction, participate in the murder of others.

“…this is a moral issue: how does one live with oneself knowing that by not getting vaccinated they are contributing to someone else’s death?”

Dear Norm,

You make several points in favor of not only getting vaccinated against a deadly, contagious virus but all vaccinations that help prevent disease. While not all illnesses are contagious, we all have a responsibility to be an example to others especially family.

However, Norm, rather than appealing to one’s sense of shared responsibility and citizenship, you’re relying on the guilt rational. “Maybe I can get them to accept vaccination if I guilt them enough.” You also say that stupidity by some plays a part. A family counselor would likely challenge any method that places someone on the defensive.

Further, your suggestion that vaccinations should be required would be virtually impossible to enforce.

You cannot punish people who refuse vaccination any more than you can punish people who smoke around others despite evidence that second-hand smoke can have serious or fatal consequences. While you can always walk away from a smoker, the alternative in confronting a potential anti-vaxxer would be to question everyone you come in contact with, setting yourself up to be ostracized by many for imposing your morality on others.

The only reasonable approach would be in appealing to the well-being of their children, grandchildren, friends, as well as their responsibility to the community. Politely point out that getting vaccinated helps mitigate the spread and allow all of us to return to a more normal life more quickly.

Boiled down to one general observation: “You can lead a horse to water, but you can’t make him drink.”

My advice: Get vaccinated as soon as possible and stop moralizing. It annoys the horse.


  1. As a psychotherapist, yes, “A family counselor would likely challenge any method that places someone on the defensive.” Allowing him/her to talk out their reasoning (and get some facts) helps “them” come to their decision. Yes, Mr. Ethics Professor, “An ethical decision-maker makes decisions characterized by their core, ethical values of Respect, Trustworthiness, Responsibility, Fairness, Citizenship and Caring.” Lets be safe and help protect those around us.

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