A Muslim doctors’ leader has provoked an outcry by urging British Muslims not to vaccinate their children against diseases such as measles, mumps and rubella because it is “un-Islamic”. Dr Abdul Majid Katme, head of the Islamic Medical Association, is telling Muslims that almost all vaccines contain products derived from animal and human tissue, which make them “haram”, or unlawful for Muslims to take.
This is not the view of most Muslim doctors in the UK. Dr Shuja Shafi, a spokesman for the health and medical committee of the Muslim Council of Britain, said: “In terms of ingredients in vaccines, there are so many things that are probably haram, but in the absence of an alternative we are allowed to take it for the sake of our health.”
However, it does raise the question of whether religious freedom should be limited, and if so how.
Francis Fukuyama has written about this topic in the current issue of Prospect in a piece adapted from an article in Journal of Democracy 2006; 17:2. I have abridged and quoted what I take to be his views.
Fukuyama argues that Hobbes and Locke insist that human beings possess natural rights as individuals — rights that can only be secured through a social contract that prevents one individual's pursuit of self-interest from harming others. It can easily be argued that Muslims insisting on avoiding vaccination harms others in the community. Because some in the community cannot be vaccinated because of another illness, and because in some the vaccination does not ‘take’, we rely on the phenomenon of ‘herd immunity’ for their protection. This means that should an infectious disease enter a community it does not become an epidemic because most of the exposed individuals are immune. Thus there is a social duty to be vaccinated.
We do allow some religious freedom in medical matters. Jehovah’s Witnesses are allowed to refuse blood transfusion on religious grounds. However, we draw the line at their imposing such beliefs on their children. The Courts would intervene if they tried because a child would be too young to take that decision fro himself. Using typically muddled thinking the British National Health Service provides erythropoietin to JWs who refuse blood transfusion even though it would be an acceptable medical treatment yet refuses it to patients with MDS for whom erythropoietin would be a more preferable treatment than blood transfusion, because it is more expensive. With the JW precedent the courts would probably agree to impose vaccination on children against the wishes of their parents, though in the present climate of don’t antagonize Muslims, the state would try and avoid confrontation.
The distinction between religious freedom and social responsibility is one that impacts on several issues currently in the public eye. Faith schools and gay adoption are currently prominent.
Fukuyama traces the problem to the Reformation. Martin Luther argued that salvation could be achieved only through an inner state of faith, and attacked the Catholic emphasis on works, that is, exterior conformity to a set of social rules. The Reformation thus identified true religiosity as an individual's subjective state, dissociating inner identity from outer practice. Rousseau, in the Second Discourse and the Promenades, argued that there was a big disjuncture between our outer selves, which were the accretion of social customs and habits, and our true inner natures. Happiness lay in the recovery of inner authenticity.
The American and French Revolutions swept away the old order of society and in their various accommodations with this, all Western democracies have followed suit. One's social status (or class in England) is now achieved rather than ascribed; it is the product of one's talents, work and effort rather than an accident of birth. One's life story is the search for fulfillment of an inner plan, rather than conformity to the expectations of one's parents, kin, village or priest.
Fukuyama identifies a gap in the political theory underlying liberal democracy. That gap is liberalism's silence about the place and significance of groups. He also identifies the Canadian Law 101 of 1977 as the first exploitation of that gap to the detriment of the whole community. He says that it violates the liberal principle of equal individual rights: French speakers enjoy linguistic rights not shared by English speakers. Quebec was recognized as a "distinct society" in 1995 and as a “nation” in 2006.
Increasingly it appears that universal recognition based on a shared individual humanity is not enough, particularly on the part of groups that have been discriminated against in the past. Hence modern identity politics revolves around demands for recognition of group identities, that is, public affirmations of the equal dignity of formerly marginalized groups, from the Québécois to African-Americans to women to indigenous peoples to homosexuals.
Multiculturalism, not just as tolerance of cultural diversity but as the demand for legal recognition of the rights of racial, religious or cultural groups, has now become established in virtually all modern liberal democracies. US politics over the past generation has been consumed with controversies over affirmative action for African-Americans, bilingualism and gay marriage, driven by formerly marginalized groups that demand recognition not just of their rights as individuals but of their rights as members of groups. A conflict has arisen between individual rights against group rights.
The question of identity does not come up at all in traditional Muslim societies, as it did not in traditional Christian societies. In a traditional Muslim society, an individual's identity is given by that person's parents and social environment; everything, from one's tribe and kin to the local imam to the political structure of the state, anchors one's identity in a particular branch of Islamic faith. It is not a matter of choice. Identity becomes problematic precisely when Muslims leave traditional Muslim societies by, for example, emigrating to Western Europe. One's identity as a Muslim is no longer supported by the outside society; indeed, there is strong pressure to conform to the west's prevailing cultural norms. The question of authenticity arises in a way that it never did in the traditional society, since there is now a gap between one's inner identity as a Muslim and one's behavior vis-à-vis the surrounding society. This explains the constant questioning of imams on Islamic websites about what is haram (prohibited) or halal (permitted). In Muslim communities these questions never arise.
In Canada, the US and Europe, cultural diversity was seen as a kind of ornament to liberal pluralism that would provide ethnic food, colorful dress and traces of distinctive historical traditions to societies often seen as numbingly conformist and homogeneous. Cultural diversity was something to be practiced largely in the private sphere, where it would not lead to any serious violations of individual rights or otherwise challenge the essentially liberal social order. Where it did intrude into the public sphere, as in the case of language policy in Quebec, the deviation from liberal principle was seen by the dominant community more as an irritant than as a fundamental threat to liberal democracy itself.
But out of a misplaced sense of respect for cultural differences—and in some cases out of imperial guilt—Europe, especially, ceded too much authority to cultural communities to define rules of behavior for their own members. Liberalism cannot ultimately be based on group rights, because not all groups uphold liberal values. The civilization of the European Enlightenment, of which contemporary liberal democracy is the heir, cannot be culturally neutral, since liberal societies have their own values regarding the equal worth and dignity of individuals. Cultures that do not accept these premises do not deserve equal protection in a liberal democracy. Members of immigrant communities and their offspring deserve to be treated equally as individuals, not as members of cultural communities. There is no reason for a Muslim girl to be treated differently under the law from a Christian or Jewish one, whatever the feelings of her relatives.
Some contemporary Muslim communities are making demands for group rights that simply cannot be squared with liberal principles of individual equality. These demands include special exemptions from the family law that applies to everyone else in the society, the right to exclude non-Muslims from certain types of public events, or the right to challenge free speech in the name of religious offence (as with the Danish cartoons incident). In some more extreme cases, Muslim communities have even expressed ambitions to challenge the secular character of the political order as a whole. These types of group rights clearly intrude on the rights of other individuals in the society and push cultural autonomy well beyond the private sphere.
The right to be excluded from vaccination clearly falls within this category. Britain should not be ashamed to deny it.