Although it seemed a relatively innocuous line item in last year's federal budget, the Conservative government's HPV (human papillomavirus) vaccination program has generated more controversy than might have been expected. The latest instalment in the debate unfolded as various Catholic school boards in Ontario considered whether to allow the vaccine to be administered within their elementary schools. The Ontario Conference of Catholic Bishops weighed in with an open letter, suggesting that introduction of the vaccine is inconsistent with a Roman Catholic understanding of human life and sexuality.
Defenders of the vaccination program remind us that Gardasil (Merck's HPV vaccine) immunizes girls and young women against the two strains of HPV that cause 70 per cent of cervical cancer cases. And for many this is enough to settle the debate — if it reduces the risk of cancer, what other response could we offer than a resounding “Yes?” Indeed, in view of the purported health benefits of the vaccine, the unwillingness of the Ontario Conference of Catholic bishops to endorse the vaccine appears to some as nothing less than medieval. On this issue, however, our sympathies should lie with the bishops.
My own criticism of this national program takes as a point of departure the realization that there is a fundamental difference between HPV and other childhood diseases against which most of us have been inoculated; the difference is in the method of transmission. With the measles, chicken pox, polio, or the mumps, transmission is through everyday human intercourse. These diseases are passed from one person to the next through sneezing, coughing, or skin-to-skin contact. Although they have varying degrees of contagiousness, in a world without vaccinations it would be relatively difficult to protect oneself or one's children from these diseases.
Gardasil differs from other childhood vaccinations by virtue of the fact that the disease it protects against is transmitted primarily through a particular form of human intercourse — namely, genital contact — rather than through everyday human interaction. This means that Gardasil protects against HPV while allowing unprotected sexual contact, which is to say that a national vaccination program is intended to allow a very specific form of behaviour while mitigating the harm that might otherwise result from it.
The logic behind this vaccination program is the same logic that governs many social policy decisions in Canada today: harm prevention. Various philosophers and ethicists have remarked that “harm prevention” is almost the only ethical principle available to societies that lack a shared sense of what is good and true and beautiful. Canada is one such society. Ours is increasingly a society in which judgments about the good, the true, and the beautiful are cast into the private sphere — we have no shared, public vision of the good.
Accordingly, the HPV vaccination program simply ignores the question of what is good and right for our children and youth with respect to sexual intimacy. It aims only to prevent harm. But this creates a dilemma for those who identify themselves as Christians and who are therefore inheritors of a particular vision of human life and sexuality.
Confronted with the question of whether we will buy into the HPV vaccination program, we are forced to ask whether we will repudiate the virtue of practical wisdom, and the good toward which it leads, and buy into the anemic logic of harm prevention. Some in the Church will suggest that the two can be held together in this situation, but I am far from convinced. These represent two competing and incommensurable ways of looking at and living in the world. To choose one is decisively to undermine the other. Will we lead our daughters in a rich vision of the good that is handed down to us in scripture and tradition, or will we live in a Gardasil world of harm prevention?
This, of course, is not only a dilemma for Christians. It is a dilemma for every parent who would train their children in practical wisdom and lead them into a form of life (including a sexual life) that is true to their humanity.
