Voluntariness or validity? A reply to Smith and Mackie

We agree with Smith and Mackie1 that voluntariness is a necessary condition of informed consent in medicine, including instances when people undergo vaccination. However, we disagree with the authors’ claim that the Recipient-Focus-View (RFV) morally validates coercive measures such as vaccine mandates. While we commend their efforts, as we argue herein, if one chooses to hold voluntariness as a necessary condition of the moral permissibility of vaccine mandates, then one must track voluntariness throughout the process of vaccine delivery and uptake, not whether the consent given in the context of a vaccine mandate is valid irrespective of voluntariness.

Very briefly then, we understand the conclusion of their argument as follows: a person receiving a vaccine is a consent-giver (first party), while clinicians who administer the vaccine are consent-receivers (second party). In the context of a vaccine mandate, those establishing the mandate (eg, employers) are the third party who are…

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