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Response
Phantom premise and a shape-shifting ism: reply to Hassoun
  1. Kyle Ferguson,
  2. Arthur Caplan
  1. Division of Medical Ethics, New York University Grossman School of Medicine, New York, New York, USA
  1. Correspondence to Dr Kyle Ferguson, Division of Medical Ethics, New York University Grossman School of Medicine, New York, New York, USA; kyle.ferguson{at}nyulangone.org

https://doi.org/10.1136/medethics-2021-107404

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    In ‘Against vaccine nationalism’, Nicole Hassoun misrepresents our argument, distorts our position and ignores crucial distinctions we present in our article, ‘Love thy neighbor? Allocating vaccines in a world of competing obligations’. She has created a strawman that does not resemble our position. In this reply, we address two features of ‘Against vaccine nationalism’. First, we address a phantom premise. Hassoun misattributes to us a thesis, according to which citizen-directed duties are stronger than noncitizen-directed duties. This thesis is a figment of her imagination, not a fragment of our argument. Second, we address a shape-shifting ism. Ambiguity attaches to ‘vaccine nationalism,’ ambiguity that Hassoun exploits despite our distinguishing various meanings of the phrase. As a result, the type of vaccine nationalism she argues against is not the type we defend.

    A phantom premise

    Hassoun objects to the following argument, which is her reconstruction of ours:

    P1. When we belong to a nation-state, we belong to a community that creates

    (moral) reasons to act in the interest of our citizens.

    P2. Our obligations to members of the global community (or those outside of our nation[-]state) are weaker than those [to] our cocitizens because of the associative ties with them.

    C.[‘]Within a nation-state, there are moral reasons to procure and allocate vaccines in a self-interested manner’. (Hassoun,1 p1)

    Hassoun does not contest P1.1 Instead, she objects to P2, which is the focal point of her response. She writes, ‘The problem with Ferguson and Caplan’s argument is that they just baldly assert P2’ (Hassoun,1 p1). She then asks, ‘Why are our obligations to members of the global community (or those outside of our nation[-]state) weaker than those to our cocitizens because of the associative ties?’ (Hassoun,1 p1).

    There are obvious problems with Hassoun’s formulation of P2. Notice that P2 contains an inference …

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    Footnotes

    • Contributors KF contributed to the conception and design of the work, reviewing and interpreting the literature, drafting the article and revising the article. AC contributed to the conception and design of the work, critical revision of the article and gave final approval of the version to be published.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; internally peer reviewed.

    • ↵While we will not quibble at length with Hassoun’s formulation of P1, it runs together two sources of obligation: (1) associative ties that bind community members to one another and (2) role-based obligations of leaders. As we write in our article, ‘Our claim is that community membership and intra-communal roles create special obligations. These, in turn, can justify partial allocations of vaccines or at least elevate those considerations to the status of moral reasons’ (Ferguson and Caplan,2 p3). This is significant since the latter type of obligation belongs only to particular role-occupying agents.

    • ↵In the context of granting that citizens also belong to a global community, we write, ‘it does not follow that cosmopolitan obligations automatically outweigh obligations one bears by virtue of one’s membership to other, smaller-scope communities’ (Ferguson and Caplan,2 pp2–3). But that does not mean the latter outweighs the former. We also note that community membership and intra-communal roles mean that ‘some will have the primary obligation, though not their only obligation, to privilege their own’ (Ferguson and Caplan,2 p3, italics added). But just because leaders have these obligations immediately, in their capacity as leaders, and consider them first in a sequence of deliberation, it does not mean those obligations are absolute or that they necessarily overpower all other obligations regardless of circumstances.

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