Welcome to the new ethical dilemma in the health care industry. Should doctors be denying care to the unvaccinated? Should the unvaccinated be put in the back of the queue for ICU beds at hospitals. Should care be rationed? If you don't think care is being rationed in our overwhelmed hospitals then let's start with an article blow to wake you up to the new reality. Which diseases or conditions should get rationed care first? What are the standards for ranking those to get care in hospitals? Should patients deemed less likely to survive not get a bed in the intensive care unit? Should nurses be asked to treat many more patients than is normally considered safe? Should patients be discharged from the hospital before they would normally go home? Should some patients who would usually be admitted for hospital care be denied? Should unvaccinated Covid patients get care before a cancer patient? A COVID Surge Is Overwhelming U.S. Hospitals, Raising Fears Of Rationed Care https://www.npr.org/sections/health...helming-hospitals-raising-fears-rationed-care
A Florida doctor said she's refusing to treat unvaccinated patients in person but denied violating the Hippocratic Oath, says report https://www.businessinsider.com/flo...at-unvaccinated-patients-in-her-office-2021-9 A Florida doctor said she's refusing to treat unvaccinated patients in person,Newsweek reported. Dr. Linda Marraccini denied violating the Hippocratic Oath and said she is "following the science." Marraccini will still treat unvaccinated patients through virtual meetings instead. (More at above url)
Alabama doctor pledges to stop treating unvaccinated patients Dr. Jason Valentine said in a letter to patients that he could not watch more of them "die from an eminently preventable disease." https://www.nbcnews.com/news/us-new...-stop-treating-unvaccinated-patients-n1277316
Will Unvaccinated People Face Barriers to Medical Care? https://www.healthline.com/health-news/will-unvaccinated-people-face-barriers-to-medical-care An increasing number of unvaccinated people are being hospitalized or dying from COVID-19 in the United States. This has sparked discussions about whether doctors have the right to refuse care for patients who choose to remain unvaccinated. Although some healthcare professionals can choose which patients they will see, denying treatment to certain groups is seen as unethical. Doctors also have a duty not to discriminate based on race, gender, or religious beliefs, among others. Now that vaccines are widely available and accessible in the United States, many healthcare professionals are experiencing compassion fatigue when patients who knowingly choose to remain unvaccinated wind up hospitalized with life threatening COVID-19 complications that could have been prevented with vaccination. One doctor in Alabama said he will no longer treat unvaccinated patients. “We do not yet have any great treatments for severe disease, but we do have great prevention with vaccines. Unfortunately, many have declined to take the vaccine, and some end up severely ill or dead. I cannot and will not force anyone to take the vaccine, but I also cannot continue to watch my patients suffer and die from an eminently preventable disease,” the doctor wrote in a letter sent to patients. Although many healthcare professionals across the country are experiencing compassion fatigue, part of the job is meeting patients where they’re at. Independent physicians can technically choose who they do or don’t treat, but all in healthcare have an ethical and moral obligation to treat patients regardless of their beliefs and behaviors. Consequently, most health experts don’t expect unvaccinated patients to face barriers to accessing medical care. Can doctors refuse to treat patients? Most healthcare professionals agree that it’s unethical to deny patients care, regardless of their beliefs or behaviors. “Physicians and providers do not randomly decide that they are not going to not treat people who smoke or eat in ways that are unhealthy,” said Craig Laser, PhD, RN, a clinical associate professor at Arizona State University and associate director of the Health Innovation Program. Some people do not have access to food within a balanced diet. But many with access know these behaviors are unhealthy and do them anyway — and physicians still treat people for the health issues linked to these behaviors. Dr. Jeffrey Norris, the chief medical officer at Father Joe’s Villages, a large homeless service agency in San Diego, California, said doctors are obliged to meet patients where they are at. Healthcare professionals do not turn away people with diabetes because they don’t take insulin or decline care because someone has used heroin. “We do listen to them and try to understand where they are coming from, and what their perspective is. Vaccination is no different,” Norris said. Norris does not expect unvaccinated people to have trouble accessing care. “I do not think we will see a large number of healthcare providers decline to provide care to unvaccinated people. I think most healthcare providers will choose to meet patients where they are, even if that means being unvaccinated,” said Norris. Private providers can decide who they see Technically, individual providers such as physicians, dentists, and dermatologists can decide which patients they see, according to Laser. Healthcare professionals cannot discriminate based on a person’s race, gender, sexual orientation, gender identity, or religious beliefs. Denying care to unvaccinated people could come with repercussions from payers they are contracted with, licensing boards, and their public reputation, Laser added. Healthcare professionals working on behalf of an organization or healthcare system likely wouldn’t be able to exclude patients. Anyone who goes to the emergency room, regardless of whether they’ve been vaccinated or not, must be examined under the Emergency Medical Treatment and Labor Act (EMTALA), which requires anyone coming to the ER to be treated regardless of their insurances status or ability to pay. Laser believes healthcare professionals have an ethical and moral obligation to treat all patients, regardless of their vaccination status. “While a [physician] can decide who they do or don’t want to provide care for in a variety of situations, I personally believe there is a fine line on this issue,” Laser said. Denying care misses opportunities to vaccinate By refusing to treat unvaccinated patients, healthcare professionals would miss many opportunities to listen to unvaccinated patients’ concerns, educate them, and encourage them to get vaccinated. Faith Fletcher, PhD, an assistant professor at the Center for Medical Ethics and Health Policy at Baylor College of Medicine, said this is especially important as so many people are victims of misinformation about COVID-19 and vaccines. Healthcare professionals are vital and reliable sources of facts and information, said Fletcher. By refusing to treat unvaccinated patients, providers are potentially missing a critical window of opportunity to address vaccine concerns and misinformation through tailored messaging, and to influence behavior change among the unvaccinated. — Faith Fletcher, PhD Mistrust in the healthcare system only reduces confidence in the vaccines, she added. “Healthcare providers have an ethical and professional obligation to demonstrate trustworthiness through their actions, and to build trusting relationships with all patients and communities,” Fletcher said. The bottom line Many healthcare providers are experiencing compassion fatigue for unvaccinated patients who get severely ill with COVID-19. So much so that one doctor in Alabama said he will no longer see unvaccinated patients. Although private physicians can choose which patients they see, health experts do not expect many to deny care to unvaccinated patients. Doctors have a moral and ethical obligation to treat all patients, regardless of their beliefs or behaviors.
Opinion; Do the unvaccinated deserve scarce ICU beds? https://www.washingtonpost.com/opinions/2021/09/01/do-unvaccinated-deserve-scarce-icu-beds/ Compassion fatigue is a rising condition, as public sympathy for unvaccinated covid-19 patients sinks beneath the weight of news reports. Need brain surgery? Better not live in Gulfport, Miss., where brain and heart surgeries are being postponed at one hospital for lack of intensive care unit beds. Need an ambulance? Wait times are spiking as multiple hospitals go on “critical care bypass” and first responders have to drive farther to find space. No surprise, then, to see the backlash, including the Alabama doctor who announced that he would not treat patients who refused to get vaccinated, after Gov. Kay Ivey (R) said “it’s time to start blaming the unvaccinated folks” for the jump in cases. Social media hosts the bloodless celebration of celebrities who wind up in the ICU or the morgue, such as Tennessee radio host Phil Valentine, who once made a song mocking vaccines, and whose death from covid inspired responses along the lines of “#COVIDiots thanks for playing the natural selection game.” The less and less “silent majority” from business leaders to health-care workers to much of Blue America, leans toward making the unvaccinated pay for holding everyone else hostage. But even as the culture wars rage over masks and mandates, access to health care adds a new dimension. ICU beds are a finite resource; so is time, and this is a zero-sum game. Hallways, conference rooms and cafeterias are being turned into covid wards, but what happens when the ambulance pulls up with a stroke victim, the clock is ticking and there’s no space left? “We’re going to have to choose who gets care and who doesn’t get care,” says New Mexico Health and Human Services Secretary David Scrase of the state’s looming crisis, “and we don’t want to get to that point.” “Triage” comes from the French word to choose or select. Hospitals have scoring systems for prioritizing patients based on multiple factors, such as the seriousness of their condition and chance of recovery. The question now is whether someone who refuses to get a lifesaving vaccine approved by the Food and Drug Administration has the same claim to scarce health-care resources as those who were vaccinated. One group of Texas doctors explored the idea in a private memo obtained by the Dallas Morning News: They noted that because a patient’s prognosis is part of the equation and vaccination reduces the chances of severe infection and death, “vaccine status therefore may be considered when making triage decisions as part of the physician’s assessment of each individual’s likelihood of survival.” There was plenty of pushback when that memo leaked, including among doctors, and the Texas team characterized it merely as a thought experiment. As an oncologist friend explained to me, he does not shame lung cancer patients if they smoked for 30 years; nor does the emergency-room doc turn away from the drunk driver with lacerations or the gang member with the gunshot wound. We only ever have incomplete facts, and if caregivers shift from weighing who needs care most to who deserves it, the slope gets very slippery. And yet. Something still feels different about the debate over treating the unvaccinated. Health-care workers recount the trauma of too many shifts, too many deaths, too many avoidable tragedies. It’s soul-crushing to watch people die because they made bad choices. Partly it’s the maddening hypocrisy — the patients who proudly dismiss science right up until the moment their lives depend on it. Partly it’s the sanctimony, the assertion of personal freedom over any sense of public good. The tension strikes close to home: I had cancer surgery at the end of May, and had I been living in one of many states with exploding caseloads, my procedure might have been postponed. Doctors are being forced to delay all kinds of treatments that feel anything but “elective” in the face of overcrowding. Studies have shown that even a 30-to-40-day delay in colon cancer surgeries or chemotherapy, for example, was linked with worse survival odds. When does a quietly metastasizing tumor or occluded artery become sufficiently life threatening to qualify you for a gurney? Opinion by Nitesh N. Paryani: Unvaccinated covid patients are straining hospitals like mine, where I had to turn a cancer patient away Imagine if some private hospital corporation, or even a state legislature, ruled that when you arrive at the emergency room, you need either proof of vaccination or proof that you were medically unable to be vaccinated, to have an absolute right to care; otherwise, care is conditioned on whether there is room. Would that count as legitimate protection of the public good? Or one more step in the penetration of politics into demilitarized zones? Vax Americana wants to hold the unvaccinated accountable for the public toll of their private choices. But, once through the hospital doors, that’s a dangerous piece of road. We depend on health-care providers to save us from the cumulative costs of our luck, imperfections and weaknesses. And we are, none of us, perfect. Trust between doctors and patients depends on the exercise of medical, not moral, judgment, and we all benefit from their dispassion. So, yes, cheer the colleges, restaurants and corporations that are mandating vaccines. Keep working hard to persuade your unvaccinated cousin to step up. But praise the caregiver who might one day save that cousin’s life if he doesn’t.
If Covid vaccine refusers are turned away at hospitals and doctor offices, is that ethical? Taking vaccination status into account when deciding whether to treat a patient can be acceptable — sometimes. https://www.nbcnews.com/think/opini...ned-away-hospitals-doctor-offices-ncna1277475
So as overloaded hospitals are forced to ration care.... who gets the beds? Oregon COVID Patient Dies After Hospital Runs Out of ICU Beds https://www.newsweek.com/covid-patient-dies-oregon-hopsital-waiting-icu-bed-1621326
That's a good debate to have. Where does personal responsibility end? What if there's a trend of people jumping in front of trains for fun and getting injured. Should we just treat them as is even if it means running out of hospital beds?