Ethical framework has been developed to guide companies on vaccine policy

Only 49% of South Africans say they will get vaccinated within a year, the Edelman Trust Barometer reports. Fearing exposure to the coronavirus, other employees do not want to be in the same workplace environment. Customers have similar fears.

How can and should companies respond? Make the vaccine mandatory and fire unvaccinated staff, overriding individual rights? Ignore the concerns of other staff and customers, possibly endangering their health, and risk alienating them?

These are questions that powerfully express a classic moral dilemma: what do you do when individual freedom collides with the public good? Discovery’s recent decision to order all employees to be vaccinated was a decisive and bold response. Should other SA companies follow Discovery’s lead?

As with all moral dilemmas, a simple or single answer is elusive. Yet a morally rigorous examination of various courses of action is possible and necessary. Corporates need to justify their decisions and actions in the public domain, citing reasons that have normative force. This is where conversations between corporate leaders, ethicists and health professionals become invaluable.

The Centre for Business Ethics of the Gordon Institute of Business Science (Gibs) convened and facilitated discussions between SA corporate managers and public health and business ethics scholars from Harvard, Vienna and Warwick universities. The result is an ethical framework that encourages an organisation’s decisionmakers to explore and debate five key questions to achieve  the most appropriate  response. This response may end up being similar to or different from Discovery’s.

The questions are the following:

• Is our decision legal: does it respond to local laws and societal demands?
• Does it adhere to the company’s policies and values?
• Can it pass the “newspaper test”: if revealed in the public domain would it tarnish the organisation's reputation and stakeholder trust?
• Are we following the “golden rule”: do unto others what you would have done to yourself, putting ourselves in the shoes of affected parties. 
• Would we sleep soundly at night after making the decision?

The tension between individual freedom and the public good is expressed in law. SA’s constitution enshrines the rights to bodily integrity and the freedom of religion, belief and opinion. Compulsory vaccination would clearly encroach on these individual rights. Companies also need to consider the Employment Equity Act, which protects employees against unfair discrimination, including on the grounds of belief.

Companies are equally obliged under the Occupational Health & Safety Act to take reasonable and practical steps to ensure a safe working environment underscored by the foundational medical principle of “first do no harm”. 

Halton Cheadle and Glenda Gray, prominent experts in law and public health, respectively, have defended mandatory vaccination on constitutional grounds. Their argument is based on employers’ health and safety obligations, with the premise that no constitutional right is absolute. The constitutional debate will inevitably continue and intensify.

Core values

In the absence of a clear legal answer, can company values help establish a moral imperative? Discovery’s decision was explained by CEO Adrian Gore in terms of the organisation’s core purpose and values: “to make people healthier and to enhance and protect their lives” and “acting as a force for social good”. Companies could also strengthen the capacity for some of their unvaccinated employees to work remotely, but this is not always possible in the case of front-line staff.

How could a company’s response pass the newspaper test? Some employees are  “vaccine hesitant” for what they believe are genuine health concerns. As such, companies have a responsibility and opportunity to engage respectfully with employees and address the reasons for vaccine hesitancy with educational programmes — and to do so publicly.

But what if some remain opposed to vaccines despite authoritative information? Putting oneself in others’ shoes is crucial to act fairly towards all the stakeholders of the company, as well as other fellow citizens. High vaccination rates may lead to herd immunity — is it fair that all should benefit through the actions of some? Can one really defend “opting out”? Surely every citizen has duties towards the vulnerable who, for reasons of medical contraindications, cannot be vaccinated? Are we not all responsible for protecting life, safeguarding our health system and supporting struggling businesses?

The final question should be whether the response chosen allows one to sleep soundly, that one can in good conscience say there are good ethical reasons for the decisions and actions taken. Ethical frameworks do not aim to generate straightforward or pristine solutions. Their purpose is rather to generate a process of broad stakeholder engagement and rigorous decision-making, enabling organisations to develop their own morally nuanced approaches to the conflict between individual freedom and the public good.

• The authors are with the Gibs Centre for Business Ethics.