On August 20 last year (2020), the leaders of the three main Christian Churches in Australia, Anglican, Catholic and Greek Orthodox Archbishops, wrote a letter to the prime minster expressing ‘ethical’ concerns about the COVID-19 vaccine being developed by Oxford University and AstraZeneca. This vaccine is one of the more promising, and the government was pleased to announce that it had secured an agreement to buy the vaccine from AstraZeneca, who would produce it if the trials were successful. Moreover, Australia has the capability to manufacture the vaccine, whereas this is not the case for the most promising alternatives, from Pfizer and from Moderna. It is also the case that the AstraZeneca vaccine does not require refrigeration at very low temperatures, unlike the other two.
At the time of writing, January 2021, all three vaccines have been approved in the USA, the UK and other countries experiencing very high rates of infection. Australia is not yet so stressed, but nevertheless clearly needs a vaccine, and the AstraZeneca vaccine (hereafter A) is by the far the most easily accessible candidate. Last month Pope Francis said that the use of the vaccine was ‘morally acceptable’, given the present dire circumstances. This might give some comfort to devout Catholics worried by the Archbishops’ letter, but that still leaves members of the other two churches who are wont to take the pronouncements of their archbishops seriously. The purpose of this note is to explain the issues raised, and come to some decision about whether there is any sense in which using the vaccine is morally wrong. The basis of the Pope’s judgment is a document carefully written by (I assume) well-informed Catholic theologians and as such stands in stark contrast to the Archbishops’ letter. (The Archbishops raise ethical concerns while the Pope talks about moral acceptability: for present purposes I will conflate ethics with morality and express the issues in terms of the latter).
The Archbishops’ Letter
The concern of the Archbishops is that A is ‘morally compromised’ in view of the way in which it has been developed. It is not, as the Archbishops are at pains to point out, because they are opposed to vaccination: indeed, they ‘are praying’ that a suitable vaccine will be made that will end the pandemic. The Archbishops are not anti-vaxxers, and they do not maintain that all vaccines are morally compromised. The problem with the A is that it was developed using cloned stem cells from an electively aborted foetus. While opposition to elective abortion is the official position of the Catholic Church, the other two churches, especially the Anglican, have been more tolerant and pragmatic. However, the Anglican Church in Australia is very conservative and it is no surprise that their Archbishop has signed the letter (it was probably his idea).
The cells, or cell line, which were used in the development of A have been in existence for some considerable time, with the abortion in question taking place over forty years ago, the details of which are not known. So the objection is not that an abortion was performed in order to produce the vaccine or even that cells were taken from a foetus recently aborted. The cells are freely available and have been widely used for many years, and have become something of a standard research tool. It is worth quoting in full the paragraph that states the Archbishops’ objection
Some will have no [moral] problem with using tissue from electively aborted foetuses for
medical purposes. Others may regard the use of a cell-line derived from an abortion
performed back in the 1970s as now sufficiently removed from the abortion itself to be
excusable. But others again will draw a straight line from the ending of a human life in
abortion through the cultivation of the cell-line to the use for manufacturing this vaccine;
even if the cells have been propagated for years in a laboratory far removed from the
abortion, that line of connection remains. They will be concerned not to benefit in any way
from the death of the little girl whose cells were taken and cultivated nor to be trivialising
that death, and not to be encouraging the foetal tissue industry.
That the foetus is a ‘little girl’ is a gross misrepresentation which might lead us to suppose that the Archbishops feel they need to resort to tricks in the absence of good argument. However, the main issue here, yet again, is just when do moral principles come into play: at what stage of development does a member of our species become ‘protected’ by morality? The second issue raised is the claim that ‘others will draw a straight line from the ending of human life in abortion through to the cultivation of the cell line to the use for manufacturing this vaccine…’. The raises the following question: suppose a wrongful act was committed at some time in the past, is it morally permissible to use information, material, etc., that became available as a result for good ends? It turns out that the Pope has something to say about this. To see what is at stake here overall, it is worth stepping back for a moment to consider what is involved in making moral judgements, such as those put forward by the archbishops.
All human actions and decisions can be placed in one of three categories: those that are morally wrong, those that are morally permissible and those that are morally unobjectionable. Not everyone will always agree on which actions are placed in which categories - if they did, there would never be any moral disagreement. That is not to say that no one can ever agree on any such judgment, for there are, clearly, lots of things we do that are in no way morally controversial, so there will at least be lots of agreement about those matters. It is in regard to some judgements about moral wrongness and moral permissibility that we might expect controversy, with the issue under discussion here being a case in point. The archbishops think that the way in which A was developed is morally wrong and they also think that accepting it, allowing it to be injected into one’s body, is morally wrong.
No action is morally wrong unless it affects some moral subject, someone who is ‘protected’ by morality. Disagreements can, and have, occurred because people disagree about who, or what, deserves such protection. In fact this is the nub of the problem here: the archbishops believe a long-dead foetus (which I will call F) in some way deserves moral consideration, whereas many others do not. How do we decide who is right in this instance, and how, in general, do we decide who deserves moral consideration? There is again much everyone agrees on. Everyone accepts that all moral agents, all mature fully rational members of our species, all persons, deserve moral consideration. More controversial, though less so than it once was, is the idea that all sentient animals also deserve moral consideration. More controversial, and more so than it used to be, is the claim that all members of our species deserve moral consideration, even those that are unborn. If the archbishops are suggesting, as it appears they are, that a long dead aborted foetus deserves moral consideration, then this seems a very controversial claim indeed.
Once we have decided that a moral subject has been affected by an action, the next step in making a moral judgment involves applying a moral principle. Here there can be differences of opinion, but again there is agreement about certain paradigm instances. Thus, if a moral subject is harmed, then this is a prima facie moral wrong. That is to say, if all we know about an act is that it harms a moral subject, then such judgement is warranted. However, if it turns out, on further investigation, that the harm caused was justified, then the judgement of wrongdoing can be withdrawn and the act classed as morally permissible. For example, suppose all we know in the first instance is that one person causes another pain. This is the wrong thing to do. Then we learn that the process was done with the consent of the subject, who was volunteering to help develop a treatment for a serious disease and moreover the subject was fully-informed and consented to every step in the process. Clearly there was in actual fact no moral wrongdoing in this instance. But deciding if a harmful act is justified may not always be so easy. Furthermore, there are other moral principles besides the no (unjustified) harm principle. Perhaps if harming is morally wrong, then actions that prevent (unjustified) harm are morally right or even morally required? Introducing moral principles along these lines complicates the relatively simply view of morality I have sketched, and we do not in fact need to do so to address the archbishops’ concerns.
Only sentient creatures can know or be aware that they are being harmed. It does not follow that sentient creatures, persons for example, always realise that they are being harmed at the time, or even ever realise that this has happened. Suppose a spiteful employer refuses to promote an employee, claiming that his references, to which only she has access, were unsatisfactory. The employee, whose career is blighted, never as a matter of fact finds out what took place. But it is not impossible that he could find out. His employer could carelessly discard the (in actual fact) very favourable references and he sees them – we can construct any number of other scenarios. But F could not be aware that its cells were used to develop a vaccine, and for two overwhelmingly convincing reasons: first of all, F has been dead for nearly fifty years, and secondly, foetuses are not aware anything because their brains have not developed enough. So if we were to judge the use of cells harvested from F to develop a vaccine on the basis of the outline of morality given thus far, it seems that there could be no moral wrongdoing. This is because F does not qualify for moral consideration as it is not a sentient creature because it lacks self-awareness. But Catholic ‘ethicists’ do not let matters rest here, for they argue that all members of our species deserve moral consideration, even foetuses. There has been considerable discussion about on this topic. I agree with those philosophers who maintain that membership of a species is not in itself enough for moral consideration, and that some further grounds are required. The position sketched above in terms of harm and awareness of harm derive, ultimately, from the nineteenth century English philosopher Jeremy Bentham. I won’t say more about this, but simply note that there is thus a venerable philosophical tradition which underpins the account I have given.
Past Action and Moral Judgment.
The Archbishops believe that the relative remoteness of the abortion which yielded the stem cells used to develop A is not irrelevant when it comes to making an evaluation about the development of the vaccine. They worry that some might think that this work is now ‘excusable’, but others, themselves included of course, ‘draw a straight line’ from the abortion to the scientific research that led to A. I assume that what they mean is that the passage of time has done nothing to mitigate or reduce the moral wrongdoing in question. They would presumably reject a proposal to the effect that while it would be impermissible to benefit immediately from a morally wrong action, if we wait long enough then (perhaps) it would become permissible. I’m inclined to agree with them here, but it is worth looking at the proposal a bit more closely.
If moral values can change, then actions that were once thought to be morally wrong may become re-evaluated. It is, in fact, easier to find examples of actions that were once thought morally acceptable that we now take to be wrong, than the other way around, although there are many examples of social values and mores that are no longer accepted. Rather than make up an example involving moral values changing, I will simply reject this way of defending the proposal. I will assume that the moral values which inform moral judgments surrounding abortion have not changed in the past fifty years. Another possibility is that circumstances can change in such a way that the benefits derived from the action are now so large that they outweigh or somehow compensate for the moral wrongdoing. This not a (moral) principle that we have canvassed thus far, but it does inform the Pope’s judgment that A is morally acceptable. The basis of this judgment, no doubt worked out by a team of Catholic theoreticians, is interesting, and I shall quote the relevant passages from the document put out by the Congregation for the Doctrine of the Faith where such theoreticians reside (and which used to be the Holy Office for the Inquisition).
The judgment by the Pope refers to the need to make a vaccine available to those who live in countries that do not have the resources to avail themselves of alternatives. Thus:
In this sense, when [morally] irreproachable Covid-19 vaccines are not available (e.g. in countries where vaccines without [moral] problems are not made available to physicians and patients, or where their distribution is more difficult due to special storage and transport conditions, or when various types of vaccines are distributed in the same country but health authorities do not allow citizens to choose the vaccine with which to be inoculated) it is morally acceptable to receive Covid-19 vaccines that have used cell lines from aborted fetuses in their research and production process.
Vaccines confer benefit by reducing harms, by preventing recipients from getting a disease. One might suppose, therefore, that in some circumstances it is morally permissible (acceptable) to do something wrong, provided that further harms are thereby prevented. This might lead us to invoke the following criterion (CJ) for assessing whether a prima facie morally wrong action is after all permissible: A harmful act can be justified, and hence be permissible, if a commensurate (presumably greater) amount of harm is prevented than is caused by the act. I do not think we should accept CJ because it would allow innocent people to be deliberately harmed in order to prevent greater harms. Rationales along the lines of CJ have been the justification for many barbarous actions, including the atomic bombing of Hiroshima and Nagasaki. I believe CJ should be rejected and it seems that the Catholic theoreticians agree.
In assessing the limits of morally acceptance for wrongful actions that can result in benefits, they say, and I quote at length again:
The fundamental reason for considering the use of these vaccines morally licit is that the kind of cooperation in evil (passive material cooperation) in the procured abortion from which these cell lines originate is, on the part of those making use of the resulting vaccines, remote. The moral duty to avoid such passive material cooperation is not obligatory if there is a grave danger, such as the otherwise uncontainable spread of a serious pathological agent--in this case, the pandemic spread of the SARS-CoV-2 virus that causes Covid-19. It must therefore be considered that, in such a case, all vaccinations recognized as clinically safe and effective can be used in good conscience with the certain knowledge that the use of such vaccines does not constitute formal cooperation with the abortion from which the cells used in production of the vaccines derive. It should be emphasized, however, that the morally licit use of these types of vaccines, in the particular conditions that make it so, does not in itself constitute a legitimation, even indirect, of the practice of abortion, and necessarily assumes the opposition to this practice by those who make use of these vaccines.
Notice, first of all, how the last sentence refutes the claim made in the corresponding sentence of the passage from the Archbishops’ letter quoted above. The reason why it is acceptable to use cells for the foetus is expressed in the first sentence, which I think could have been expressed a bit more clearly. I would say that those who used the cells have no relation whatsoever to the abortion: the connection was not merely remote, it was non-existent. The Catholic theoreticians, however, see any kind of relationship to the abortion, including using cloned cells, as ‘cooperation in evil’, of the genus ‘passive material cooperation’. But there is no ‘formal cooperation with the abortion’, which would presuppose that those using the cells would have endorsed the act and hence would have had to have been around at the time. That would have been wrong. I am inclined to agree, and do so because I reject CJ.
I believe that A, the vaccine produced by AstraZeneca on the basis of the research conducted used clone stem cells from an unknown aborted foetus some fifty years ago, is entirely unencumbered by any moral wrongdoing – I place the activities in question in the category of morally unobjectionable. And that is because I do not believe that foetuses deserve moral consideration, for the reasons I have given. But if one did believe that they deserved such consideration, then the discussion by the Catholic theoreticians from the Congregation for the Doctrine of the Faith, and endorsed by the Pope, should relieve any anxiety about taking the vaccine. That careful and humane discussion stands in stark contrast to the crude attempt by the Australian Archbishops to sow doubts amongst the innocent people they are supposed to guide. Their letter, with its emotive appeal about a ‘little girl’, and its specious argument, is a disgrace.
At the time of writing, the complete text of the Archbishops letter can be found here: https://twitter.com/cokeefe9/status/1297777711004360706?s=20
The discussion by the ‘Catholic theoreticians’ can be found here: https://www.vatican.va/roman_curia/congregations/cfaith/documents/rc_con_cfaith_doc_20201221_nota-vaccini-anticovid_en.html