Because of the psychological power of rhetoric, words do matter. Words have both a denotation (the meaning) and a connotation (the emotions and associations invoked). Words that have the same denotation can have very different connotations. For example, “police officer” and “pig” (as slang) have the same denotation but different connotations. As would be expected, the ongoing fight over vaccines involves rhetoric. One interesting example of this was presented by Ben Irvine: “People who don’t want the vaccine aren’t “refusing” it. You don’t say a person is “refusing” to take anti-depressants. Or “refusing” to get married. You can decline without refusing. You decide what’s best for you. Refuse is a manipulative term, loaded with unfair moral pressure.”
As Irvine indicates, while “refuse” and “decline” have similar meanings, they differ in rhetorical loading. As Irvine sees it, “refuse” is negatively loaded with “unfair moral pressure.” Presumably “decline” lacks this quality. So, what is the difference between them?
In a moral context, “refuse” implies active rejection, and context determines whether its connotation is negative or positive. While not always the case, “refuse” sometimes implies that there is an expectation to accept rather than reject. As would be expected, if what is being refused is seen as morally wrong, then using “refuse” suggests something positive. For example, “Sergeant Jane Doe refused to obey an illegal order” suggests something positive, that Doe actively rejected the order and that there is an expectation that soldiers will obey. Interestingly, people who believe that requiring vaccinations is morally wrong should embrace the language of refusal as refusing something you think is wrong is the right thing to do. But “refuse” can also be negative.
As Irvine noted, to say those who choose not to get vaccinated are refusing the vaccine asserts they actively reject something rightfully expected of them. To illustrate, to say “Jane Doe refused to stop drinking and smoking while pregnant” suggests Doe should be condemned: there is a moral expectation that Doe should not put her unborn child at risk. “Decline” works differently.
In general, “decline” means to pass on something. It seems more passive, more polite, and less forceful than “refuse.” There is also (usually) no implied expectation of acceptance. In a moral context, there is usually the assumption that there is no (or little) moral weight involved. To illustrate, “when offered dessert by the waiter, Joe declined” indicates that Joe passed on dessert and was under no obligation or expectation to order it. It would be odd to say that Joe refused the dessert, unless he was particularly forceful in his rejection or was for some reason expected to eat it. In contrast, it would make sense to say, “Joe refused to pay for the dessert he did not order or receive and demanded it be removed from his bill.” This is because Joe would be actively rejecting paying and, of course, there is a general expectation that one will pay the bill. Obviously, I am not claiming to be the word police: people can and do use “decline” as they would use “refuse” and vice versa; I am just noting that Irvine has made a reasonable distinction between how we often use these words rhetorically. But is he right?
On the one hand, he seems correct: when people talk about vaccine refusal, they are likely condemning the decision. Their moral expectation is that people should get vaccinated and hence to not accept it would be a refusal (like refusing to stop drinking while pregnant) rather than declining it (like a slice of pie). But his point seems to be that this is wrong: people should not use “refuse” because it is “unfair moral manipulation.” He seems to suggest we should use “decline” instead. If true, then he would be assuming that there is not a legitimate moral expectation for people get vaccinated and thus it is acceptable to decide to remain unvaccinated. For those who disagree with his position, this might seem to be a rhetorical trick.
As discussed above, “decline” implies that the rejection is more passive, less forceful, and of something for which there is no or little expectation of acceptance. To accept that people are declining rather than refusing the vaccine would be to (probably) agree that they are doing nothing wrong or not failing in a moral obligation. That is, they are not refusing to protect others, they are merely declining a shot. This, some might contend, would trivialize their decision: declining to be vaccinated is like declining a slice of pie after dinner and not like refusing to stop drinking while pregnant. This seems a reasonable point: to use “decline” would be to use a term that lacks moral pressure and thus assumes that those who do not get vaccinated are acting morally (or at least not acting wrongly).
While I think people should get vaccinated, discussing the moral issue without begging the question requires using neutral language: language that neither assumes nor refuses condemnation. As such, when discussing the moral issue of whether people should get vaccinated, we should not use “refuse” or “decline” but should use a neutral description such as “decide to not get vaccinated.” Then the ethics of the decision can be debated. It might turn out, as I believe, that there is a moral obligation to get vaccinated. In which case, the use of “refuse” would be warranted. But it might be the case that there is no such obligation, then the use of “decline” would be warranted.