Should we tell stories of vaccine sceptics who have died of COVID?

As vaccine uptake starts to wane, stories have began to emerge of people who refused the jab ending up in intensive care, ruing not having had the vaccine, and subsequently dying. These cautionary tales are certainly attention-grabbing, but is it right to publish or broadcast them?

If human morality depended only on totting up costs and benefits, our moral lives would be simple matters of accounting. On the plus side, if the vaccine saves lives, any cautionary tale to persuade the unpersuaded has to be good – doesn’t it? On the minus side, perhaps cautionary tales don’t always work. And what about the effects on bereaved families if a loved one is heartlessly portrayed as a victim of their own folly?

According to a philosophical view called consequentialism – which proposes that what is morally right is whatever makes the world best in the future – we should “do the sums” as best we can and check that the benefits outweigh the costs. But consequences, whether good or bad, are only part of our complex moral psychology, as shown by a long history of experiments, especially the famous trolley problems. A runaway trolley is hurtling down a railway line towards a crowd of people who will face certain death. There is a switch that will flip the trolley into a siding, saving the crowd but hitting and killing a single person. Should you flip the switch and divert the trolley?

A cost-benefit story is clear: flip the switch! But in experiments, many people refuse to flip the switch. Doing nothing means the whole crowd will die. But perhaps doing nothing isn’t killing, just allowing a tragic sequence of events to unfold.

Flipping the switch becomes very much less popular in a clever variant where the runaway trolley can only be stopped by pushing an innocent and heavy bystander, who happens to be standing on a footbridge, into the path of the oncoming trolley (imagine you are too light to stop the trolley by diving over the parapet yourself). Few people want to push an innocent person to their death, even if it saves many. And surely even those who judge this is morally right feel conflicted and uncertain.

So our moral queasiness about reporting the deaths of vaccine sceptics won’t go away just by showing that the ends justify the means. But what exactly is the missing moral ingredient that makes us so uncomfortable?

Moral psychology researchers often assume our morality is governed by two forces. One is a slow, rational process that tots up costs and benefits. The other is a fast emotional process that cares mainly about obeying moral rules (“killing is wrong!”). This way of putting things gives the impression that it is the rational system that we should be listening to.

The emotional system, with its blind desire to follow the rules, is pulling us away from the “right” action. From this standpoint, moral discomfort should be recognised, but put aside. If publicising the deaths of vaccine sceptics helps save others, we should do it, whether we feel queasy or not.

Contract-based approach

But there is a third philosophical tradition in ethics that psychologists have only recently started to consider. This puts matters in a very different light and helps us understand moral dilemmas in a new, but insightful, way.

According to contract-based approaches to ethics, people care not only about consequences and rules, but agreement. Roughly, something is morally OK if people agree to it – or would agree to it, if we had time to ask them.

This viewpoint helps explains why we are morally conflicted by flipping the switch: the hapless person on the siding would surely not agree to be killed. By contrast, we don’t need to get anyone’s agreement for doing nothing. Doing nothing is just the default option.

And consider the person on the footbridge. They surely, in our imagination, will protest even more vigorously against the terrifying prospect of being pushed to their death. And hence this feels even less morally acceptable.

From a contract-based view of moral psychology, the crucial question is: would the tragic victims of COVID have agreed to their case being reported? What about their families? And would they have approved the tone and storyline?

In some reported cases, people close to death, or their families, have asked for their stories to be broadcast to warn others. These cases feel morally fine, as the contract-based view would suggest. In other cases, though, such permission has neither been sought nor granted. Here, our queasiness is greatest, especially where people are portrayed, however subtly, as foolishly endangering their own lives. No one would agree to the printing of a story spun like that.

And there is yet another element. Our moral psychology cares, too, about whether people – and especially ourselves – are virtuous. Yet schadenfreude – the delight in the misfortune of others – is surely a vice: better to be kind and compassionate. So publicising, and being riveted by, the tragic deaths of vaccine sceptics invites us to indulge this vice, and we feel morally uncomfortable in doing so.

Our mixed feelings about reporting the deaths of vaccine sceptics reflect the complexity of our moral selves – consequences, rules, agreements and virtues can pull us in different directions. There is no one source of moral intuition but many, each with deep psychological roots.

So when is reporting justified, and when is it not? Moral psychology can only help us understand why people have different opinions and why many of us feel conflicted. Resolving these conflicts isn’t a job for psychology. It is a task for democratic societies and each individual conscience.

Nick Chater receives funding from the ESRC. He is member of the UK's Committee on Climate Change and co-founder of Decision Technology, a research consultancy.