April 26, 2013, by Neil Sinclair

Measles, Mill, Madoff

What can the state legitimately compel its citizens to do? This is not a question about the means of compulsion (e.g. criminal vs. civil law; incentives vs. penalties) but the question of whether such compulsion is ever justified.

There are good reasons to think not.  One is that it is usually the individual who is in the best position to judge what is in their own best interest. Given this, even well-meaning state interventions may not improve citizens’ lives. A more powerful argument is that even if the state were reasonably sure that compulsion would be in the interests of the compelled, there is something valuable lost in the mere act of compulsion. Being forced to act in a certain way is not the same as responding rationally to the facts of the case. To compel, therefore, is to bypass distinctively human rational faculties, thereby neglecting one of the most important and distinctive human values.

But there are limits. It is of course appropriate for the state to compel someone to stop acting where that action is creating significant harm to others. It is in one way good that a fraudster like Bernie Madoff used his rational capacities to defraud investors of their life-savings. But it is legitimate for the state to compel him to stop given the harm he did. Such a line of thought is summed up in Mill’s famous Harm Principle: “…the only purpose for which power can rightly by exercised over any member of a civilized community, against his will, is to prevent harm to others.”

Mill is clear that this applies to inaction as much as action. Sometimes, as in Madoff’s case, actions result in harm to others. But sometimes not doing something can have the same result. Mill talks of “certain acts of individual beneficence, such as saving a fellow creature’s life.” (Some jurisdictions have laws that compel bystanders to come to the aid of those in peril, as famously featured in the final episode of Seinfeld).

Now consider the issue of compulsory vaccination and the recent Measles outbreak. Recently, a US expert called for the UK to follow the US in making vaccination mandatory. One justification for this might be that mandatory vaccinations are in the best interests of those being vaccinated. As the expert put it: “…we just don’t think it’s your inalienable right to catch…a potentially fatal infection.” This is the type of paternalistic justification that Mill would reject: “His own good, either physical or mental, is not sufficient warrant.” But another type of justification would find Mill’s support. The quote from the US expert, in full, reads: “In this country we just don’t think it’s your inalienable right to catch and transmit a potentially fatal infection.” Catching Measles is harmful to oneself, but transmitting it is harmful to others. This week BBC Four’s Today programme ran an item about a child undergoing chemotherapy, a treatment that makes the patient extremely vulnerable to infection. Given the Measles outbreak, the parents had taken the precaution of removing their child from school. This is harm in itself, but nothing compared to the harm of contracting measles.

From this perspective mandatory vaccinations may not be prying paternalism, but a legitimate attempt to prevent harm to others. The question that remains is whether the costs of imposing mandatory vaccinations would outweigh the benefits of the harms prevented. As Mill puts it: “As soon as…a person’s conduct affects prejudicially the interests of others, society has jurisdiction over it, and the question of whether the general welfare will…be promoted by interfering with it, becomes open to discussion.” Now might be a good time to start that discussion.

(References to Mill are from his essay On Liberty.)

Neil Sinclair (neil.sinclair@nottingham.ac.uk)


Posted in Political Philosophy