Monday, December 14, 2020

A Brief Critique of "Vaccines and the Christian Worldview: Principles for Christian Thinking in the Context of COVID" by Dr Albert Mohler

Dr Mohler's recent contribution to the bioethical discussion on vaccines and vaccination is a welcomed opinion piece, his political affiliation notwithstanding.

At the outset, I would like to state that I appreciate his effort in elaborating his “seven points for considerations” clearly and unequivocally. However, there are some brief comments that must be made. I am hereby writing this from the perspective of a Christian medical professional who administers vaccines as part of my practice – so let no one accuse me of being anti-vaccination.

Dr Mohler’s first point is relatively uncontroversial amongst evangelicals. I do agree that generally speaking, “Christians do not believe in medical non-interventionism.” And neither do I, or else I wouldn’t be a medical doctor.

In point 2, Dr Mohler addresses the concerns of the usage of foetal cell-lines derived from aborted foetuses in the manufacture of Covid-19 vaccines. He writes, “In most of the major COVID-19 vaccines, there was a use of foetal cell lines, which are known as HEK-293. The original cells for that line were taken from tissues derived from an abortion in the Netherlands in the 1960s.” Other cell-lines derived from aborted foetuses used in Covid-19 vaccines are PER.C6 and E.C7.

Dr Mohler argues that “the vaccine’s structure relied upon the cell line of HEK-293, which originated with an aborted foetus. This is a tragedy of history. A horrifying wrong was done—but that does not mean that good cannot come from that harm, even as it is a good tainted by the realities of a sinful world. This idea is expressed, for Christians, as the doctrine of double effect. Some actions have more than one effect. For Christians, the primary intention must aim at virtue and good. The intention behind an act must never seek harm or evil or any moral reality and outcome against God’s will. We must never be complicit in intending sin, and certainly, this applies to every dimension of abortion. But the Christian also acknowledges a potential double effect, for every moral act can lead to consequences not intended, but unavoidable. If the abortion of even a single human baby was required for this vaccine, or if abortion-derived materials were included in the vaccine, Christians would be rightly outraged. This is not the case. The vaccine can be taken by pro-life Christians with legitimacy.”

Although I would reserve judgment now concerning his conclusion that it might not be immoral for Christians to take a vaccine made from foetal cell-lines derived from abortion, his use of the doctrine of double effect is erroneous.

With respect to the intrinsically evil act of abortion by the principal agent (i.e. the abortionist), the moral object of that act has determined the morality of the principal agent’s act. The act of abortion is always morally wrong, an intrinsic evil because the moral object is evil.

However, patients receiving vaccines are not principal agents performing a questionable moral act with potentially good and evil effects, and hence, the doctrine of double effect does not apply in this regard. Dr Mohler should have discussed the principle of cooperation (with evil) instead. In other words, is the patient who receives a Covid-19 vaccine guilty of cooperation with an evil act (abortion)?

Very succinctly, the act of receiving a vaccine based upon cell lines derived from aborted foetuses is considered to be a remote, mediate material cooperation based upon the three fonts of morality of intention, moral object and circumstances.

The problem of scandal is the main ethical consideration – based upon the third font – that I am cautious about. If the act of receiving the vaccine gives other believers or non-believers the impression that termination of pregnancy is acceptable, it would be unacceptable morally speaking (no pun intended).

I do give credits to Dr Mohler for explaining the remoteness of the cooperative act of receiving a vaccine from the intrinsically evil act of the principal agent (i.e. abortion by the abortionist). I believe the explanation and information furnished by Dr Mohler should suffice to avoid stumbling other Christians concerning the issue of abortion, but the point remains – it has nothing to do with the doctrine of double effect.

Furthermore, even though "the vaccine’s structure relied upon the cell line of HEK-293, which originated with an aborted fetus," and even though "that does not mean that good cannot come from that harm, even as it is a good tainted by the realities of a sinful world," we may never commit evil so that good may come, which is a condition required for the principle of double effect to be valid.

In his third point, he claims that “the medical community demonstrates enormous confidence in the vaccine.” This is patently inaccurate. Although the general narrative allowed by Big Tech is that Covid-19 vaccination is safe and effective, there had been issues raised which – from a medical perspective – are valid concerns. These had been vigorously censored on various social media platforms.

For example, on December 1, 2020, Dr. Michael Yeadon (former Vice President Respiratory & Chief Scientific Advisor, Pfizer) and Dr. Wolfgang Wodarg (lung specialist and former head of the public health department) filed an application with the EMA, the European Medicine Agency responsible for EU-wide drug approval, for the immediate suspension of all SARS CoV 2 vaccine studies, in particular, the BioNtech/Pfizer study on BNT162b (EudraCT number 2020-002641-42).

Dr. Wodarg and Dr. Yeadon demand that the studies – for the protection of the life and health of the volunteers – should not be continued until a study design is available that is suitable to address the significant safety concerns expressed by an increasing number of renowned scientists against the vaccine and the study design.

Also, a video that is banned on Facebook and YouTube compiles the concerns of several medical professionals on the Covid-19 vaccine's safety, some of which I do not agree with. America's Frontline Doctors have likewise presented their significant concerns regarding this experimental vaccine.

It is also generally acknowledge by vaccine experts that for a safe, effective vaccine to be produced, the time from start to finish with all the necessary clinical trials is about 20 years. Do also note that Medscape (the website in the related link) is a Continuing Medical Education (CME) provider for doctors and health professionals. The person interviewed is a vaccine specialist.

It is absolutely legitimate for medical professionals to be cautious with any hastily produced vaccine as the most basic ethical principle in medicine is primum non nocere (i.e. first, do no harm). The patient’s interests come first for a conscientious doctor.

Mohler’s fourth point deals with governmental coercion in regard to vaccination. I generally agree with Dr Mohler on his analysis, and I would like to add that from a local perspective, similar concerns might also arise in Singapore. As Dr Mohler had written, “Christians will have to judge these policies as they come.” At present, Covid-19 vaccination is not mandatory in Singapore, and I hope it wouldn’t be. I also pray that there will be no unreasonable restriction of liberty even for the unvaccinated individual.

Dr Mohler’s fifth point is regrettably flawed. Let me explain why. He writes, “vaccines deals with the common good—the issue of love of neighbour. Some people might approach the issue of vaccination through self-defined terms. Such a person might say, “If a vaccine is available, then people can take it who want it. I’m not taking it. I pose no threat to anyone. I’ll deal with the consequences of my own actions.” Here is the problem with this kind of moral equation: There are third parties—people who cannot take the vaccine or do not yet have access to it that could still be infected by those who refuse to take the vaccine.”

Firstly, the science is incorrect. There is a reasonable risk of asymptomatic transmission of Covid-19 even in vaccinated individuals. Hence, governments (including ours in Singapore) recommend the wearing of masks even after vaccination.

Mohler’s argument here is therefore a moot point. Vaccination cannot prevent asymptomatic transmission. It’s that simple. So even if you are vaccinated, you are still able to transmit the virus to your loved ones.

Secondly, there are Christians who would be cautious with taking the vaccine because of inconclusive data concerning vaccine safety. The safety information at present is admittedly very limited, and it wouldn’t be fair to accuse fellow brethren of refusing to love their neighbours by their failure to receive the vaccine.

The factual error committed by Dr Mohler imposes an unnecessary burden upon the conscience of Christians. These brethren who refuse the vaccine are not disobeying the 2nd greatest commandment, and therefore, guilty of sin. They have the responsibility to protect themselves from harm, and it is reasonable from both a medical and ethical perspective to wait until further data emerge.

Mohler’s sixth point is likewise flawed because of his third and fifth points. He writes, “Reasonable Christians and Christian parents will differ over whether or not to take the vaccine. But, speaking personally, I will take this vaccine as soon as it is available to me. I will take it not only for what I hope will be the good of my own health, but for others as well. I will seek to encourage others to take the vaccine. Encouragement, however, is very different from coercion.”

As explained above, the vaccine protects the individual who receives the vaccine from Covid-19. This does not directly protect non-vaccinated individuals. Asymptomatic transmission is a real possibility.

On the other hand, it was mentioned by certain experts that “six in 10 people in Singapore would need to get vaccinated against COVID-19 for the country to achieve herd immunity.” Herd immunity, however, does protect the population at large against Covid-19 indirectly. Vaccine herd-effects indirectly protect even unvaccinated individuals by reducing the population prevalence of vaccine-targeted pathogens. This herd-effect occurs at the level of the vaccine-targeted pathogen and indirectly impact the population at large, including unvaccinated bystanders.

But the achievement of herd immunity needs to be balanced against the limited safety data we have at the moment and waiting for such data to emerge is not an unreasonable or unethical option. This is all part of weighing the consequences of our action based upon the third font of morality. Indeed, we have to refrain from imposing such vaccination requirements upon the consciences of believers, at least in this stage of vaccine development.

Nevertheless, I do heartily agree with Dr Mohler that “we ought to be wary of any government or other intrusion into the family structure—in this case, we should stand against government policies that give vaccines to children and adolescents over and against (or without the knowledge of) the convictions of their parents.”

I also stand with Dr Mohler on his final point that, presupposing that the vaccine is not morally dubious, “those who are at greater risk or serving on the frontlines of this pandemic ought to be the first in line to receive the vaccine.”

There is a temptation for spiritual leaders to take sides during the current Covid-19 pandemic on issues that they might not be an expert in. I would advise all of us to be guarded in dispensing our so-called medical advice and to be aware of our limitations, especially when it comes to complex ethical issues which intersect with immunology, virology, bioethics and theology.