Kuyper and vaccinations: A case study in Kuyper’s approach to an ethical issue

The 2019 translation of the second volume of Abraham Kuyper’s Pro Rege contains chapters on his approach to vaccinations. This article examines his arguments in favour of vaccinations as a case study on Kuyper’s approach to an ethical issue. Kuyper utilizes both sphere sovereignty and common grace as the key philosophical tools as well as using scriptural, rhetorical and pragmatic arguments to make his case.


INTRODUCTION
Why was Kuyper concerned to write on the issue of vaccinations? For one thing it was indicative of his square inch approach -nothing, including vaccination, is exempt from the lordship of Christ. His discussion of it arose from his writings on common grace, and it also serves to illustrate how his view of sphere sovereignty serves to constrain the overreach of the state. In this brief look at Kuyper's approach to vaccinations, I will examine how he approached the subject.

BACKGROUND
Vaccinations ever since Edward Jenner's discovery in 1796 have been controversial. On the one hand, they have been seen as one of the ten great public health achievements (CDC, 1999) and according to the British NHS website: In the past 50 years, it's saved more lives worldwide than any other medical product or procedure (NHS, nd).
On the other hand, opponents, certainly in the UK, 'expressed fundamental hostility to the principle of compulsion and a terror of medical tyranny' (Porter and Porter, 1988: 231). This medical tyranny could be seen in Jenner, his approach would not have passed the medical ethical guidelines of today! Not least the placing in jeopardy the life of a minor, the eight-year-old James Phipps (Riedel, 2005). Prior to Jenner, the Greek Thucydides as long ago as 429 BC, had observed that those who survived smallpox did not get reinfected and the Chinese developed a technique called 'variolation', a proto-vaccination, around 900 BC. It consisted of exposing the healthy to scab tissue from smallpox sufferers. This was done by either inserting the powdered scab in the nose or by placing it under the skin.
Porter and Porter observe: The coming of compulsory health legislation in mid-nineteenth-century England was a political innovation that extended the powers of the state effectively for the first time over areas of traditional civil liberties in the name of public health (Porter & Porter, 1988).

Consequently, numerous anti-vaccination groups began in the UK
MacLeod considers the anti-vaccination movement to be part of a wider public distrust of scientific medicine and "new science" and a cherishing of "natural" methods of treatment and "sanitary" methods of prevention (Porter & Porter, 1988).
The situation in the Netherlands was slightly different. In the 1870s there were some vehement objections against the use of vaccinations. Elsewhere many thought that the imposition of compulsory vaccinations was a denial of civil liberties and many thought it was ineffective as well. However, in The Netherlands the debate also took on religious overtones. Praamsma observes: Many … condemned vaccination against smallpox on the grounds that it represented tampering with the human body and manifested a lack of faith in God's providence.
They also had objections to fire insurance and life insurance: a believer should trust in the Lord and have the future completely in his hands (Praamsma, 1985:142).
These latter objections Kuyper suggests are based on misguided and errant piety. In Common Grace, Volume 2 he endorses the use of vaccinations, although he still maintains that it should not be made compulsory by government (Kuyper, [1903). For the government to do so would be to extend the reach of government beyond that of its calling and vocation.

KUYPER AND COWPOX VACCINATIONS
Kuyper takes two chapters (71 and 72) to discuss 'The vaccination against cowpox' (Kuyper, 2019:606-623). He begins by expressing the idea that 'sitting on one's hands', i.e. doing nothing, is not a Calvinist idea as it is opposed to Scripture and the Confessions. It is obvious that both of these are important to Kuyper.
He then takes time to outline the reservations or objections. The arguments he sees are not so much passivity but not wanting 'to introduce an evil poisonous substance into a healthy body' and that it is a 'defying God's majesty'. Some he notes do object to it on medical grounds as elsewhere, but in The Netherlands it seems to come from 'the side of religious piety'. It is this religious piety that Kuyper examines at first.
Kuyper's discussion of vaccinations begins in the context of discussing the relationship between God and suffering (chapters 69-70). He poses and then goes on to answer the question: If God is the source of suffering how much then should we do to alleviate it?
Misery and suffering that arise from sin are generally seen as coming from God as a punishment. However, this misses the point of the atonement, Kuyper maintains, Christ Original Research www.koersjournal.org.za bore the punishment for us: 'for God's children all suffering has become chastisement rather than punishment' (2019:599).
Much suffering also has its origin in the curse; the curse was the result of God's ordination, yet we can also see the working of Satan in it. Thus some suffering comes on one hand as God's will and yet on the other 'as something against which his compassion does battle' (2019: 560).
Kuyper is clear: The Christian duty not only to combat suffering that has come upon us but also, where possible, to avert through precautionary measures the suffering that could come upon us …we must fight against all suffering, and suffering that can be prevented must be averted by precautionary measures (2019:598-599).
These precautionary measures he sees as being the result of common grace. As Kuyper puts it: His common grace also can use human beings, and this is the aim of every development in the arts and sciences, in agriculture and industry, in design and human relations (2019:580).
God acts directly as in the Israelites' crossing of the Red Sea but he also works indirectly through 'means', as these means are an agent of common grace. These 'means' include: • Earlier, he had argued that Christians are not fatalists, accepting that everything that happens is the will of God, we are to combat sin and suffering, for: … we are required to combat suffering and misery as a common enemy. In this God himself goes before us, and Christ himself understood it in the same way when he was on earth. Passive resignation is therefore no authentic piety, but rather sin, and among the children of God this truth must be proclaimed ever more clearly: suffering and misery are our enemy, against which we must arm ourselves and with which we must do battle (2019:545).
To address these issues of the use of precautionary measures and the need to combat suffering, he begins with the origin of smallpox in the fall. The pox results from the curse of the fall, thus it must be combatted as an enemy of God.
He observes that one group of objectors fight the pox when it breaks out but consider it impermissible to take pre-emptive measures such as vaccination -as that introduces toxins into the body. Kuyper adopts a reductio ad absurdum argument to refute this type of argument. He takes their position to the logical conclusion that if these objectors do not consider it wrong to wrap up against the cold or to take measures to purify the drainage in a house to prevent typhoid, why should they then object to the use of vaccinations? Clearly, it is not logical to do so.
He is also not afraid to utilise rhetorical flourishes: A child who dies of pneumonia because the mother did not protect him against the cold as she should have, or a child who passes away due to typhoid fever because Original Research www.koersjournal.org.za the father did not take adequate precautionary measures by purifying the drainage from his house-in both of these cases the mother and the father respectively are guilty of breaking the sixth commandment (2019:608).
It may be stretching it to mention the sixth commandment (thou shalt not kill) here -but Kuyper is not afraid of hyperbole.
The issue of quarantine is then examined. He draws on Scripture and makes the parallel between quarantine for leprosy and for smallpox: If God clearly reveals in his Word that a person with a contagious illness (in this case, a leper) must be kept apart and quarantined, then this settles and decides the matter, and it is irrevocably certain that those who are truly godly must do the same in the case of other contagious diseases (2019:609).
Once again, this illustrates the high value Kuyper places on Scripture -it settles and decides the matter -in ethical stances.
The second objection he deals with is 'the dripping of a toxic substance in the blood'. From this he isolates two related issues: the distinction between toxic and good substances and whether or not toxic substances have been 'chosen by God as a means for healing' (2019:611).
He remarks that not all poisons are demonic or satanic. He points out that the poison atropine helps against morphine poisoning. Here Kuyper shows his favour towards homoeopathyas he states that in homoeopathy poisons are used extensively for healing! (2019:612).
He then argues from an analogy: we use a dangerous animal to ward off other dangerous animals: Is it permissible for me to use a cat to get rid of mice or a dog to chase a wild boar? (2019:613).
Medical research must also be carried out to reveal how effective vaccination is. If research is favourable then it is: Foolhardy -even immoral -not to apply a means that God has shown us for the protection of the life of our child. We are not advocating coercion on the part of the government (2019:613).
This is an endorsement of the need for scientific and medical research. Kuyper has no antiscientific approach. He then suggests that even if vaccination is valid it should not be forced upon individuals by the government. He goes on: the government has nothing to say about my body and the body of my child. Therefore, we will always protest in the name of our civil liberties against any sort of government coercion (2019:613-614).
This would be extending the reach of government beyond its calling and an overreach of the government's sphere. It has no right to legislate what parents should deem as the best for their child. To do so would violate sphere sovereignty.

CONCLUSION
In this discussion of vaccination, which has served as a case study of how Kuyper deals with an ethical issue, Kuyper utilised Scripture and philosophical and pragmatic arguments to Original Research www.koersjournal.org.za make his point. He roots the discussion in the creation, the fall and in redemption. Smallpox is not part of creation -like disease it is an alien invader. This means that we are called to combat the suffering it causes. By stressing the need to combat suffering Kuyper exposes the false, misguided and fatalistic spirituality that rejected the need for vaccination.
Kuyper draws upon two of his key ideas: common grace and sphere sovereignty. He states: To the extent that many Christians have opposed or avoided for a long time the cowpox vaccination or some other preventive measures because they felt they were not allowed to make use of them for God's sake, they have been under an incorrect understanding of God's providential order and common grace (2019:616).
Vaccination is seen as a means of common grace, but if the government were to enforce and impose compulsory vaccination on all it would transgress sphere sovereignty; the government must, as he writes in Our Program, keep its hands off people's bodies and must respect people's conscientious objections (Kuyper, 2015:248). As regards sphere sovereignty, he limits it to the sphere of the state -the state has 'nothing to do with our bodies'.