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In a section of The Vaccine Book titled “Is it your social responsibility to vaccinate your kids?” Dr. Bob asks, “Can we fault parents for putting their own child’s health ahead of that of the kids around him?” This is meant to be a rhetorical question, but Dr. Bob’s implied answer is not mine. In another section of the book, Dr. Bob writes of his advice to parents who fear the MMR vaccine, “I also warn them not to share their fears with their neighbors, because if too many people avoid the MMR, we’ll likely see the disease increase significantly.” I do not need to consult an ethicist to determine that there is something wrong there, but my sister clarifies my discomfort. “The problem is in making a special exemption just for yourself,” she says. This reminds her of a way of thinking proposed by the philosopher John Rawls: Imagine that you do not know what position you are going to hold in society—rich, poor, educated, insured, no access to health care, infant, adult, HIV positive, healthy immune system, etc.—but that you are aware of the full range of possibilities. What you would want in that situation is a policy that is going to be equally just no matter what position you end up in. “Consider relationships of dependence,” my sister suggests. “You don’t own your body—that’s not what we are, our bodies aren’t independent. The health of our bodies always depends on choices other people are making.” She falters for a moment here, and is at a loss for words, which is rare for her. “I don’t even know how to talk about this,” she says. “The point is there’s an illusion of independence.
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