When it comes to vaccinations, more is more

The FDA and CDC should worry less about sins of commission and more about sins of omission

Published : 04 Mar 2021 09:17 PM

Sins of commission and sins of omission are often treated differently, but it’s not clear they should be. Most of us, for example, would never dream of killing another person. At the same time, about 160,000 people around the world die every day, often of preventable causes. Letting people die — a sin of omission — seems tolerable in a way that killing a person — a sin of commission — does not.

Philosophers such as Peter Singer have argued that people ought to take their obligations to the global poor far more seriously. Yet most people simply go about their lives, and even if they make major donations to charity, it’s not half their incomes. For better or worse, common-sense morality leads most people to devote only a limited amount of attention to problems outside their own social circle.

But what about governments? It is an increasingly important question whether regulators and public officials should treat sins of commission and sins of omission in such an asymmetrical manner. As I understand the Food and Drug Administration and the Centers for Disease Control, they worry much more about sins of commission than about sins of omission.

The FDA, for instance, still has not approved the AstraZeneca vaccine, or outlined a clear path to approval, although it is approved in many other developed nations, including Canada, and the recent evidence on safety and efficacy is strongly positive, even for a single dose. The result of the FDA’s sluggishness, quite simply, is thousands of additional American deaths, for no good reason. Yet Americans are not taking to the streets to demand the AstraZeneca vaccine.

Governments should follow a broader, more inclusive 

moral code than should citizens. This will push them 

closer to utilitarianism, and an equal concern for all

How US public officials and regulators talk about vaccination also reflects an asymmetric treatment of errors of commission and omission. The general message is that even after Americans are vaccinated, they will still have to wear masks, refrain from visiting their loved ones, and so on. And to be sure, even twice-vaccinated people face some risk of contracting Covid or transmitting it. Public health officials are afraid if they tell people to relax, some Americans will take more risk, and more deaths will result.

That is a legitimate concern — but there are risks in both directions. If getting vaccinated is not seen as a significant life improvement, people will be less likely to get vaccinated. So the better message, from both an individual and public-health standpoint, is that getting vaccinated will lead to fun consequences.

To be clear, public health officials are encouraging additional vaccinations. But they don’t seem to realize how much their own ostensibly “careful” rhetoric makes vaccination sound unappealing. “Not talking up the vaccines” is a sin of omission, not a sin of commission, and so it is tolerated and is not a major issue for public debate.

Should public officials be allowed, indeed encouraged, to treat sins of commission and omission so differently, as private citizens (myself included) typically do?

I live near Arlington National Cemetery, where approximately 400,000 veterans (and family members) are buried. I suspect they would not care so much whether their deaths were the result of errors of commission or omission. Did a commanding general order a hill to be charged that should have been left alone? Or did he make the mistake of not charging a hill that could have been taken?

Most citizens care about the total number of military casualties from a battle and are only modestly concerned about the details of the mistakes that caused them. That seems like the right and rational attitude. Perhaps it is also the correct attitude for the war against the coronavirus — that is, an overriding concern with casualties and outcomes, regardless of the kind of error that led to them. 

The philosopher Robert E. Goodin has argued that individuals cannot help but give priority to their own selfish interests. But governments have overarching responsibilities to all citizens — and when it comes to life-and-death decisions, the outcome rather than the process should be paramount. Governments thus should follow a broader, more inclusive moral code than should citizens. This will push them closer to utilitarianism, and an equal concern for all.

In fact, the very act of failing to discard the traditional distinction between errors of commission and omission is itself an error of omission, and a very serious one.

Tyler Cowen is a Bloomberg opinion columnist. 

Source: Bloomberg