Thomas G. Plante, PhD, ABPP
Mary Altaffer/Associated Press
Thomas Plante (@ThomasPlante) Augustin Cardinal Bea, SJ professor of psychology at Santa Clara University, is a faculty scholar with the Markkula Center for Applied Ethics and an adjunct clinical professor of psychiatry at Stanford University School of Medicine.
Recently, a great deal of attention has focused on people “skipping the line” in order to get one of the newly available COVID-19 vaccines before more needy others who are prioritized in the vaccine rollout process (e.g., front-line and patient-facing health care workers, the elderly, those with high-risk, co-morbid health problems). Remarkable stories such as a wealthy young couple flying on their private jet to pose as poor motel workers, young people dressing as elderly grandmothers, fitness instructors claiming to be front line health care workers, and wealthy and well-connected politicians both locally and abroad, have made headline news. Certainly, many people are very anxious to get the vaccine as soon as possible and may do whatever they can do to get it. They may decide that their health and well-being, as well as the health of their loved ones, trump the needs of others using egoism (i.e., what is in my own best interest?) as their guiding ethical principle in their decision-making process.
Some who skip the line may feel guilty about their selfish rule breaking actions and thus are motivated to justify their behavior through a variety of psychological defensive mechanisms such as the liberal use of cognitive dissonance. Cognitive dissonance occurs when someone’s thoughts and behaviors contradict each other and thus result in motivation to change either their thoughts or their behaviors to resolve the dissonance that causes the psychological discomfort. For example, someone might think of themselves as a kind, gracious, selfless, and ethical person interested in participating and supporting the common good and yet they skip the line to get the vaccination nonetheless. They may feel tension between how they view themselves as virtuous and their contradictory and non-virtuous behavior. They may justify their behavior by arguing that they really do meet the criteria as an essential health care worker or an at-risk individual due to their health status, living situation, or work demands. This thinking helps them justify that it is reasonable and appropriate for them to receive vaccination before others who are considered a higher priority. They may also justify their behavior by arguing that the rollout process is unfair, unreasonable, or politically motivated and thus it is okay to ignore the established rollout priority rules.
It is certainly reasonable that the anxious public would want to do whatever they can do to keep themselves, and their loved ones, healthy by getting the potential life-saving vaccination as soon as humanly possible. Human behavior is such that when people are threatened and scared they will likely circle the wagons and do whatever they can do to save themselves, even if it violates ethical standards and norms. Lofty ethical concepts such as working for the common good and the benefit of those in greater need all go out the window quickly in order to save oneself or their loved ones when a significant threat is experienced. At the end of the day, egoism, especially when under stress, usually rules the day. Yet, it is hard to live with one’s self-centered decisions and still claim to be a thoughtful, gracious, and highly ethical person. To live with ourselves we need to do psychological and behavioral gymnastics in order to be at peace with our decisions and behavior. This is why cognitive dissonance is so commonly used in these and other similar circumstances.
We clearly live in unprecedented times during our current COVID-19 global pandemic. We have to expect that people are scared and will act selfishly if allowed. Many will try to skip the vaccination line and find ways to justify their behavior using cognitive dissonance and other defenses to do so. While we can appeal to the “better angels of their nature,” we must be realistic and put policies and procedures in place, using perhaps both carrots and sticks, to ensure that those who are prioritized to get the vaccination do so quickly while others who are lower on the priority list get theirs in appropriate due time. In the meantime, wearing masks, socially distancing, and frequent handwashing will help all of us remain safe and healthy and are actually very easy behaviors to do for the good of both ourselves as well as others.