Everyday Ethics

Should We Vaccinate Health Care Workers For Swine Flu Whether They Like It Or Not?

Saturday October 10, 2009

Health care workers are on the front lines of the battle against H1N1 this year. So why not look at the question of whether it ought to be mandatory for them to receive swine flu vaccinations using a military metaphor?

army-doctor.jpg

There's been a lot of argument about whether hospital workers should be forced to get vaccinated before they continue to work with the public this flu season - and some states, like New York, already have made it mandatory. A lot of folks say it's a violation of people's rights to nail them down and shove a needle in their arm (or a nozzle up their nose) if they don't want it. Some doctors, nurses, orderlies, etc harbor the same prejudices against vaccines as the paranoid elements in the general public, and they don't want it.

So... perhaps they shouldn't be forced to get it? It would seem to be a pretty clear violation of one's individual civil rights, wouldn't it?

But others argue it's a matter of simple mathematics, not ethics or legalities, and these folks should just shut up and take their medicine. The medical establishment seems to agree - sick health care workers make for sicker patients, and we need these vital foot soldiers healthy to take care of the rest of us. Not only that, we need them not to carry and spread flu virus to immunosuppressed patients like the elderly in hospice care, cancer patients receiving chemotherapy, etc. 

Voluntary programs have been shown not to work. To get the necessary 90% compliance to make vaccination worthwhile, nothing less than a mandatory vaccination campaign will really make a dent.

On to our metaphor. If this was the Army, they'd take it and salute afterward. In the armed services, you don't have to like your orders, but you have to obey them. It's part of your sacred trust. You are protectors and defenders of your country, and you've sworn an oath to that effect.

Don't doctors and nurses have a similar obligation to uphold the best practices of the medical establishment, as laid down by, for instance, the C.D.C.?

Ah ha! you say. Here's the flaw in your syllogism. Unlike soldiers, if health care workers don't like it, they can quit without being considered AWOL. It's no fun to be out of a job, but at least it's not Leavenworth. It's not the same for health care workers as for soldiers - sure, they protect us, but they haven't sworn their lives to Uncle Sam. And since they haven't made any such vow, didn't sign on the dotted line, don't they have the right not to be out of a job because of a personal health choice about what to put - or not put - in their own bodies? That's what the labor unions are arguing, and it seems a fair point.

But wait, I retort, don't doctors take the Hippocratic Oath to "first, do no harm"? If science says conclusively (and it does appear to) that getting the flu vaccine will lessen the risks for the general public, you'd be breaking that oath if you refuse it. New York State agreed, and to hell with the health care unions. People in NY are pretty pissed, and now other states are taking up the question.

May I suggest that, just like pharmacists who don't like giving out the 'morning after pill', you either suck it up and follow the rules or get out of the business. If I had my way, you'd be court-martialed for doing anything less.


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Comments
Trish
October 10, 2009 9:20 PM

Excuse me, I'm only slightly overweight and have NEVER smoked. I have never taken the Flu vaccine nor do I plan to. Please remember, last year they weren't closing hospitals d/t the H1N1, we know how to prevent spread of illness. Guess Big Pharm has agreed to give NY a cut of their 10 BILLION (not million, but BILLION) in profits from this mandate. As an RN, I plan on practicing in a very close neighboring state, or a nursing home or maybe as you said, leaving nursing all together. It will be NY's loss. I'm a great RN. Wonder who will be left to take are of the patients? At least my immune system will be left somewhat intact. Maybe I can enjoy retirement without some sort of MS from the vaccines.

Rob Kozik
October 11, 2009 8:13 AM

Let's be real, if it were the general public being force to get the shot, it would be a public relations nightmare. Instead of a sea of healthcare workers complaining that their rights are being violated it would be a sea of lawyers instead.

The general public should be the ones getting the vaccine. Period. 90% of the general public would be lucky if they washed their hands once a day let alone figure out what soap and water is used for. Patients should be protected from themselves and the general public because they are the ones spreading the flu. Not the healthcare workers.

churchmouse
October 12, 2009 3:01 PM

No one should be forced to take a vaccine.

KES
October 13, 2009 2:20 PM

You need to be very careful about why you want to restrict the liberty of a person or group.

Influenza immunizations (H1N1 or the usual variety) are not guaranteed protection, and there are definite risks.

If you want herd immunity, you should immunize the herd, not the herders. Try mandating that, and see how it works out for you.

Kira
October 15, 2009 1:24 AM

When I worked in human services I had specific regulations and policies I had to follow to protect the health and safety of my clients, myself and my co-workers. This is no different. If the employees don't want to comply they're free to find other employment.

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This blog is all about ethics. It's also about us--ordinary people facing ordinary situations. It's about asking ourselves the hard questions: What responsibility do we bear in our interactions (and yes, confrontations) with the people we meet? How do we best respond to those around us in a way that leaves us feeling good about ourselves and confident our behavior has done no harm? Have we helped or hurt our fellows in these moments? It's our belief that by asking some big questions (and some little ones too) we can grow as humans. We're glad you're along for the ride!

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