Vaccines and cell-lines descended from tissue derived from abortion

A number of Catholic authorities have made a moral distinction between the Pfizer and Moderna vaccines, on the one hand, and the AstraZeneca and Johnson & Johnson vaccines, on the other, with respect to the involvement of cells that descend (after many generations) from an aborted fetus (e.g., see here and here). The difference appears to be that in the Pfizer and Moderna cases, the cells were only used in a confirmatory test of efficacy, while in the other two vaccines, they were used throughout the development and production. Consequently, the Catholic authorities said that the AstraZeneca (AZ) and Johnson & Johnson (JJ) vaccines may be used if no alternatives are available, but the Pfizer and Moderna are preferable if available.

A colleague at another institution asked me if I thought that the moral distinction here is sustainable. I do think it is, and my judgment concurs very closely with the recent statements from Catholic authorities: all four vaccines may (indeed, should) be used, but the Pfizer and Moderna ones are to be chosen when available.

In a 2004 paper, I argued that (a) while it is not categorically forbidden to engage in research using cell-lines that ultimately descend from tissue from an aborted fetus, (b) this may only be done for “sufficiently beneficial purposes”. Such research—and likewise the use of the fruits of the research—is thus a situation that involves the weighing of different factors rather than categorical prohibitions. It seems clearly right that in the case of the vaccines (AZ and JJ) where the illicitly derived cell-lines are used more heavily, we have more of the morally problematic feature, and hence we need greater benefits to outweigh them. Those benefits are available in the case of the current pandemic when alternatives that involve less of the problematic features are not available: thus the AZ and JJ vaccines may be used when the alternatives are not available. But when the alternatives—which also appear to be significantly more effective as vaccines!—then they should be used.

In a 2006 paper, I argued that the Principle of Double Effect allows one to use, and even manufacture, vaccines that make use of the morally tainted cell-lines. The use of the cell-lines in itself is not innately morally evil (after all, it need not be wrong to transplant an organ from a murder victim). What is problematic is what I call “downstream cooperation” with the plans of those involved in the evil of abortion: they likely acted in part (probably in very small part) in order to procure tissue for public health benefits, and now by using the vaccine, we are furthering their plans. But one need not intend to be furthering these plans. Thus, that “downstream cooperation” is something one should weigh using the complex proportionality calculus of Double Effect. In the paper I concluded that the use of the vaccines is permissible, and in the present emergency the point is even clearer. However, it seems to me that the more heavily the cell-lines are used, the more there is of the unintended but still problematic cooperation with the plans of those involved in the evil of abortion, and so one should opt for those vaccines where the cooperation is lesser when possible.

I note that even apart from the moral considerations involving cell-lines descended from aborted fetuses, in a time of significant and unfortunate public vaccine scepticism, it was rather irresponsible from the public health standpoint for the vaccine manufacturers to have made use of such cell-lines if there was any way of avoiding this (and I do not know if there was given the time available).

HHS contraception mandate

I am one of the signatories of an amicus brief by Catholic theologians and ethicists in the Gilardi case against the HHS contraception mandate. The DC Circuit Court recently ruled against the HHS in this case. The main line of thought in our brief was that a Catholic employer's providing coverage for contraception makes the employer cooperate in the employee's use of contraception. Now, Catholic moral thought not only takes (marital) contraception to be wrong, but also takes cooperation in someone else's sin to be morally problematic. Whether the cooperation is not just problematic but wrong depends on questions about the degree and kind of cooperation involved.

Reflecting on these issues makes me think there is a second really crucial thing going on, besides making employers complicit in employees' sin (and we touch on this in the brief, though I think it can be developed). One of the reasons for the HHS mandate is precisely to encourage women to use contraception (this is certainly not denied). But this means that the employer is made complicit in what the employer conscientiously takes to be the government's morally wrongful promotion of wrongdoing. And this cooperation is even closer, and thus far even more morally problematic, than cooperation with the employee's use of contraception. For the employer here acts as the government's instrument in its policy of promotion of contraception. Note that promotion does not require success: in this case, governmental promotion of contraception occurs whether or not any employees actually use the contraception.

A tension about cooperation with evil

It seems pretty clear that we have strong, though perhaps at times defeasible, reason to avoid cooperating in evil activities. Here is something, however, that has struck me, after thinking about material in Wojtyla's The Acting Person (he is explicit about the tension) and correspondence with Mark Murphy. There is a tension between this presumption against cooperating in evil activities and the apparent fact that there is a non-instrumental value in all genuine interpersonal cooperation. There are ways to reduce or remove the tension, but it strikes me as quite an interesting tension. Does the fact that an instance of cooperation is in a bad activity somehow subvert the goods of cooperation?