Ethical Considerations of the Measles, Mumps and Rubella Vaccine

 

 

The Measles, Mumps, Rubella Vaccine (MMR) is known to cause an increase in the incidence of Autism worldwide.  This hotly debated topic has created a dichotomy between medical, pharmaceutical, religious, education and parents of young children.  All are weighing in on ethical considerations of how the MMR Vaccine is developed; it’s necessity in society and weighing the pros and cons; and how specifically the MMR Vaccine leads to an increase in Autism.  This essay will use Cooper’s ethical decision-making model to develop a case study, logically implement steps of his model to ethical issues of the MMR Vaccine, and propose alternative actions that explain a resolution.  

 According to Theresa A. Deisher, Ph.D. of Sound Choice Pharmaceutical Institute, the MMR Vaccine is heavily contaminated with fetal DNA fragments, cellular debris and in some cases retroviral fragments (Deisher, 2014).  Deisher’s research shows specific change points (or increases of Autistic Disorder) correlating to the birth year of the child as 1980.9, 1988.4 and 1996 in the United States; 1987 for the UK; 1990 for Western Australia; and 1987.5 for Denmark (Deisher, 2014).  Deisher’s conclusion is, “AD changepoints years are coincident with the introduction of vaccines manufactured using human fetal cell lines, containing human fetal and retroviral contaminants, into childhood vaccine regimens….Thus, rising AD prevalence is directly related to vaccines manufactured utilizing human fetal cells” (Deisher, 2014). 

The coincident between the MMR Vaccine and Autistic Disorder has been studied significantly in the last thirty years.  I intend to use Cooper’s Ethical Decision Making Model to ethically determine if parents should allow their children to have the MMR Vaccine based Deisher’s research and the ethical steps to determine one’s decision (Cooper, 2006). 

First, we are invited to determine if a problem exists.  A problem exists on several fronts 1) Big pharmaceutical companies knowingly use fetal stem cells as part of developing the MMR Vaccine 2) educated parents and the media recognize an increase in Autism due to the MMR Vaccine though not all parents know why the increase exists 3) if society fails to vaccinate 95% or greater of it’s population, known as herd immunity, the MMR Vaccine will fail to protect society.  For this essay I will focus on problem two and three that individuals can effectively control through their actions.  It will take significantly more than refusal of individuals to vaccinate for the vaccine to be manufactured differently at the pharmaceutical level. 

Cooper’s model then asks us to gather all of the information available in order to make a decision.  Is the MMR Vaccine really necessary?  A measles infection is normally mild but complications do occur as a result of a measles rash.  A measles infection includes fever, rash, cough and conjunctivitis.  Complications such as pneumonia may occur or more seriously encephalitis (1:1000) or death (1:3000) may occur (Desai, Shane & Lewis, 2012).  A mumps infection is an acute contagious illness characterized by swollen salivary glands and the surrounding area.  Complications include meningoencephalitis, an inflammation of the brain and it’s covering. Most people recover well from any complications (EB, 2014).  Rubella, also known as German measles, only becomes a complication when transmitted to a pregnant mother.  Complications include the loss of the fetus (miscarriage or prematurity) or severe birth defects (EB, 2014). 

Statistically, which is more prevalent in our society: Autism or Measles, Mumps or Rubella infections?  Currently, over 95% of our society gets the MMR Vaccine.  In order for the MMR Vaccine to work effectively, also known as herd immunity, society must be at least 95% vaccinated.  While we have not yet fallen below the 95% mark, every year society does see a decrease in the number of children getting the MMR Vaccine.  Comparatively, 1 in 68 children (14.7 per 1000) is diagnosed with Autism (http://www.cdc.gov/mmwr/preview/mmwrhtml/ss6302a1.htm?s_cid=ss6302a1_w).  In the last twenty years there has been a broadening of the clinical criteria for diagnosing Autism.  Deisher of Sound Choice Pharmaceuticals used a specific type of Autism within the spectrum called “Autistic Disorder” or infantile autism, the most severe form of Autism.  Autistic Disorder is clinically represented by a lifelong disability including deficits in social communication and interaction, repetitive patterns of behavior, interests or activities (http://www.cdc.gov/mmwr/preview/mmwrhtml/ss6302a1.htm?s_cid=ss6302a1_w). Deisher’s study has a relatively consistent clinical presentation of Autistic Disorder over the last fifty years (Deisher, 2014).  Deisher obtained the original printing dates of the DSM editions correlating it to changes in Autistic Disorder diagnosis.

Cooper’s model invites us to identify the conflict and whether it’s ethical, legal, clinical, professional or moral.  The conflict directly relates to being a recipient of a vaccine that is heavily contaminated with fetal DNA fragments, cellular debris and in some cases retroviral fragments (Deisher, 2014).  The decision to vaccinate or not to vaccinate is a moral and ethical conflict. 

Our next step is to look at the complex nature of the decision and describing the critical issues present.  If society fails to vaccinate 95% of its population (herd immunity), there will be an increase in Measles, Mumps or Rubella, the most serious being Rubella, or German Measles.  If society vaccinates 95% to 100% of it’s population with the MMR Vaccine as it’s currently developed with fetal DNA fragments, cellular debris and retroviral fragments, research points to an increase in Autistic Disorder, the most severe form of Autism (Deisher, 2014).

Two major moral principles are considered in this particular ethical issue: autonomy and nonmaleficence.  Parents feel they are entitled to the moral principle of autonomy, or the freedom to choose whether to vaccinate or not vaccinate on their own terms.  Comparatively, the moral principle of nonmaleficence means to avoid doing harm, or applied to this moral scenario, not transmitting measles, mumps or rubella and/or the costs associated to caring for an Autistic child.  Both are valid reasons for or against getting the MMR Vaccine (Cooper, 2006). 

In analyzing alternative courses of action, one is to determine ethical decision-making alternatives.  In 2005, the Vatican weighed in on the MMR Vaccine.  Similar to Deisher’s current research, they too identified vaccines prepared from cells derived from aborted human fetuses (http://cogforlife.org/vaticanresponse.htm).  After outlining the ethical issue in question, the Vatican authored a moral and ethical response to individuals questioning vaccines derived from aborted human fetuses.  The Vatican recalled principles of the classic moral doctrine cooperation in evil.  Formal cooperation exists when a moral individual cooperates with the immorality of another sharing the immoral intention.  Oppositely, when a moral individual participates in the action of another individual without an evil intention, it is therefore material cooperation (http://cogforlife.org/vaticanresponse.htm).  If one is to use this situation of the MMR Vaccine using the Vatican’s moral decision making process, the three categories of immoral individuals are 1) those who prepare the vaccines using human fetal tissue 2) those who participate in mass marketing the vaccines and 3) those who use them for health reasons (http://cogforlife.org/vaticanresponse.htm).  For the purpose of this ethical discussion, parents and doctors are responsible for the third category of responsibility, the remote mediate material cooperation.  According to the Vatican, parents and doctors have a moral duty to seek an alternative vaccine.  In the absence of an alternative vaccine, parents and doctors are to oppose the use of the vaccine through pressure to create morally acceptable alternatives.  The Vatican states that it is right to abstain from vaccines created with fetal stem cells with morally acceptable alternatives provided it is done without harming children or the population as a whole.  The Vatican defends those who choose to vaccinate their children using fetal cell derived vaccines stating they may use them on a temporary basis while actively opposing the use of this method of vaccine development (http://cogforlife.org/vaticanresponse.htm). 

Cooper’s model then invites us to project and enumerate possible consequences of various decisions.  If society fails to vaccinate using the currently available MMR Vaccine, we may see a rise in Measles, Mumps or Rubella, with Rubella being the most severe and directly associated to fetal derived cells.  An increase in Rubella, or German Measles, will increase the risk of severe disabilities or miscarriage of a pregnant woman.  Comparatively, the MMR Vaccine is both clinically documented as using fetal stem cells through Sound Choice Pharmaceuticals and religiously through the Vatican, shown to increase the incidence of Autistic Disorder. 

In exploring an ethical decision making process, we are to return and look at the moral principles of autonomy and nonmaleficence.  The moral principle of autonomy is centrally based on reasons of self-centeredness: me, my and mine.  Examples include: I will not get the MMR Vaccine for my children because I do not believe in it.  The moral principle of nonmaleficence therefore states: you and yours, or, I will get the MMR Vaccine as I do not want to do harm to others.  It is difficult to determine whether someone may use nonmaleficence to refuse the MMR Vaccine or Autonomy to get the vaccine. 

At this stage of Cooper’s Ethical Decision Making Model we are invited to establish a formal process that is conscious and systematic.  We now recognize that clinical research points specifically to vaccines prepared from aborted human fetuses.  Additionally, the Vatican (a religious leader of 1.2 billion Catholics) also has dually researched moral issues relating to vaccines prepared from aborted human fetuses.  It unarguable that vaccines are created from aborted human fetuses.  Now that we recognize that fact, we need to make a conscientious and systematic moral and ethical decision making recommendation. 

The conscientious and systematic moral and ethical steps I recommend taking are to move forward and give a child the MMR Vaccine.  The Vatican calls this material cooperation.  If one takes this a step further, a parent is remotely cooperating in the moral sin of the vaccine manufacturer, however they are using nonmaleficence in their decision to avoid harm to others.  Secondly, a parent is to educate themselves on the moral and ethical issues of aborted human fetuses in the development of a vaccine and effectively denounce this action as an immoral act, putting educated pressure on the developers of vaccines to change their manufacturing process.  When parents use the moral argument of autonomy it does nothing to rectify the moral situation.  It serves them well individually but the autonomous individual fails to consider their moral responsibility of nonmaleficence.  Using that same construct, an individual using the moral issue of nonmaleficence does not fail to consider the moral responsibility of autonomy but they are implicitly responsible for the promotion of the fetal cell derived vaccine. 

Therefore, the best course of action is to give a child the vaccine through informed consent, educate oneself on the specific moral and ethical issues of vaccinating using aborted fetal cells and seek to change how the MMR Vaccine is manufactured.  Until changes do occur at a multinational level, one must recognize their implicit consent in the sin recognizing and asking forgiveness for that act of ethical duty. 

 

References:

 

Cooper, Terry. The Responsible Administrator: An Approach to Ethics for the

Administrative Role. San Francisco: Jossey-Bass, 2006. Print.

 

 

Desai, S., A. Shane, and R. Lewis. "Measles." Canadian Medical Association

Journal184.16 (2012): 1811. Web. 25 Oct. 2014. <http://www.cmaj.ca/content/184/16/1811>.

 

Mumps. (n.d.). In Encyclopedia Britannica online.  Retrieved from:

file:///Users/ladykatecascamo/Google%20Drive/Essay%20%234%20-%20MMR%20Vaccine/mumps%20(pathology)%20--%20Encyclopedia%20Britannica.html

 

 

Rubella. (n.d.).  In Encyclopedia Britannica online.  Retrieved from:

file:///Users/ladykatecascamo/Google%20Drive/Essay%20%234%20-%20MMR%20Vaccine/rubella%20(disease)%20--%20Encyclopedia%20Britannica.html