**4. The concept of prevention**

For this to be possible, governments and health authorities must change the concept of prevention that they normally use. In regulatory ethics, which would support, for example, mandatory vaccination against Covid-19, the concept of prevention is identified with *risk reduction*. In this sense, a health system will achieve better prevention when the risk of contracting the disease is lower. In the case of vaccination against Covid-19, this will occur when the greatest possible number of individuals is vaccinated. This is an argument that, from a normative ethical point of view, would justify vaccinating as many people as possible against Covid-19 on a compulsory basis.

However, from the point of view of a normative ethics, all preventive medicinal measures, including vaccination against Covid-19, run the risk of becoming a set of *obligations* and *prohibitions* for citizens. These obligations and prohibitions can increase frictions between political decisions and the individual autonomy, and can increase personal frustrations, because these preventive measures are perceived only as an instrument for the good of society. Even worse, they can also potentially lead to a lack of motivation in regard to everything else related to one's own health.

We propose a different concept of preventive medicine. For us, prevention consists in *the acquisition by the individual of ethical behaviors* - this is the novelty with respect to the thought of Hans Jonas - that allow the development of the person towards a "first-person ethics" in the attainment, in general, of his or her own good, and in the particular case, of that which, as Descartes had already observed, is the "greatest" of one's goods: health.

If citizens move from this perspective of personal responsibility in the pursuit of the collective health, compulsory vaccination against Covid-19 would be unnecessary: if the efficacy and the medical and social value of the new Covid-19 vaccines are guaranteed, and citizens are properly informed, vaccination would be, so to speak, a "moral responsibility," a moral duty [16], and vaccination would be one more among the actions that direct the individual towards the achievement of both individual and community health. We believe that, through a first-person ethics, it is possible to create an alternative based on personal responsibility, one that, together with a series of legal actions of a political nature that we will enunciate

#### *Covid-19 Vaccines and Institutional Trust DOI: http://dx.doi.org/10.5772/intechopen.99124*

below, allows effective protection of the entire community and, at the same time, guarantees the expression of personal autonomy. For example, in order to institute confinement, a regime of sanctions was established by the government (normative ethics), but what has allowed confinement to have a high success rate has been the concept of prevention based on personal responsibility, exercised by the citizens according their own determination to cooperate, in a responsible manner, with the prevention measures (first-person ethics).
