Welcome back to second year of medical school, Ethics 101, where medical students spend hours discussing "do no harm" and other ethical dilemmas that don't follow the typical algorithms we are often trained to learn and apply.
Recently a German physician from Germany's Ethics Council suggested that those who refuse the COVID-19 vaccine shouldn't have access to ventilators or other resources such as ICU admission. I put out a poll asking whether people agree or disagree with this proposal; 76% agreed.
If are reading this to see if I agree or disagree, unfortunately I don't have an answer. But I do have something to say; the discussion is more important than having an answer.
First of all, to be fair, what the headlines don't mention is he went on to say: "It is perfectly clear that in the end no one will forego treatment in an emergency. The point is that people who are very critical very quickly and say what they are against should say what they are for instead. And if they turn against something, then they should really think through the consequences of their actions to the end."
What was interesting is that the poll had an open ended option to message/comment. No one used those options. This made me realize how much the virus and vaccine have not only been politicized, but in today's world most people seem to just know the answer to even some of the most difficult ethical questions (such as this), without asking questions or for more details. No one listed the pros and cons or any reason why they stand by their decision.
Was this a trick poll? Maybe, depends how you look at it. Social ethical experiment? More likely. To be honest, this was a loaded statement.
At the end of the day, no physician will deny any patient care regardless of their age, gender, sex, religion, race, political beliefs or even vaccination stance! However, when an infectious disease process that has caused one of the biggest pandemics in the century we must realize that we can't approach it as individuals. Our herd immunity is what protects us from the deadliest viruses out there. Individualism might be part of the American dream, but when it comes to our evolutionary survival Homo sapiens have relied on each other for thousands of years. In other words we must think about our herd and take actions that are selfless...such as physicians caring for sick patients who don't believe in vaccinations or those who are likely going to be fine if they become ill with COVID still get vaccinated to protect the elderly and the immunocompromised.
Feel free to discuss!
*I won't go into detail in this post why you should get vaccinated or the science behind herd immunity and how it's achieved. But I do believe in order to achieve herd immunity without overwhelming hospitals, having millions of unnecessary deaths and putting physicians in a position that they must decide who lives and who dies, we must continue to socially distinct, wash hands, wear masks and get vaccinated. These are not anecdotal methods but tried and proven evidence based practices.
* I will stay to those who think anti-vaxxers shouldn't be allowed to receive ventilators because it's unfair...you're right. They have an unfair advantage that they can cause harm to others with their beliefs and actions yet they will still receive 100% equal care as you and possibly take away a bed or ventilator from another patient who did try their best to follow guidelines. This is the same as the freedom impaired (prisoners) I often take care of at the hospital. As a physician I don't ask what crimes they've committed in order to decide what type of care I will provide. I provide the same care to all 100% of the time. Are anti-vaxxers as bad as the freedom impaired? Well if we've learned our lesson we'd know that's a whole other discussion.
*The most important take away from all this, is to realize we must continue with educating the public! I'm a firm believer the fundamentals start in grade school. Yes we have a lot of work to do...