Ethical considerations in the formation of smallpox vaccine policy.

Abstract

FOR MONTHS NOW, the nation has been embroiled in controversy about smallpox vaccine. That there is considerable disagreement about whom to vaccinate and when is hardly surprising. The alternatives confronting policy makers involve trade-offs of both incommensurable values and uncertain societal risks. The purpose of this article is to propose a set of ethical considerations that ought to be considered in our deliberations about the most appropriate public policy for smallpox vaccination in the United States. The considerations outlined below are meant to facilitate the accounting of these trade-offs and highlight the importance of public dialogue and sound judgment in the development of morally defensible public policy options. Once each of the considerations has been explicated, we briefly discuss two examples of the types of competing values we may encounter in the development and implementation of smallpox vaccination policy.