Medical ethicists criticize doctors who refuse to treat the unvaccinated

Linda Marraccini, a family physician in South Miami, Fla., Is tired of patients refusing to be vaccinated and endangering themselves and everyone they come in contact with – so she gave them an ultimatum: Get vaccinated or find another primary care physician. Marraccini sent a letter to her patients last month informing them that once the Food and Drug Administration had fully approved the Pfizer vaccine, she would no longer see those who were not fully vaccinated.

“This is a public health emergency – public health takes precedence over the rights of any given person in this situation,” Marraccini wrote in the letter, according to NBC Miami. “There seems to be a lack of selflessness and concern for the burden on the health and well-being of our society from our meetings.”

Marraccini is not alone. Over the past month, as the Delta variant of COVID-19 has been torn across the country, a doctor in Alabama also said he will not treat unvaccinated adults.

This decision has caused setbacks in the medical profession, with many critics saying that doctors should not choose who they treat.

“We have to find ways to take care of people, even if we do not agree with their actions,” says Dr. Jonathan Moreno, Professor of Medical Ethics at the University of Pennsylvania, to Yahoo News.

A woman in Indianapolis in April at a protest against COVID-19 vaccination outside Governor Eric Holcomb’s mansion. (Photo by Jeremy Hogan / SOPA Images / LightRocket via Getty Images)

But that responsibility must be balanced with the need to protect their most vulnerable patients. Marraccini believes that by demanding that all her patients be vaccinated, she reduces the chance that her immunocompromised patients are threatened by those who have not received the vaccine. For long-term patients in Marraccini who have not found a new provider as a result of her decision, she told Newsweek that she will continue to provide telesealth consultations until they do.

64 percent of the total U.S. population has had at least one dose of the COVID-19 vaccine, according to data from the Center for Disease Control and Prevention, and more than 182 million Americans are fully vaccinated. Yet many people, especially in rural and minority areas, are still skeptical of the vaccines despite their effectiveness.

In total, more than 680,000 Americans have died from COVID-19 since the pandemic began, and 1,500 Americans continue to die every day, according to the CDC. The increasing number of deaths has left many doctors frustrated and others exhausted by those who remain unvaccinated.

Anti-vaccination protesters are gathering in Los Angeles near City Hall in August, in contrast to the city council's vote to introduce a decree requiring proof of vaccination to enter many public indoor spaces.

Anti-vaccination protesters are gathering in Los Angeles near City Hall in August, in contrast to the city council’s vote to introduce a decree requiring proof of vaccination to enter many public indoor spaces. (David McNew / AFP via Getty Images)

Another physician at the Diagnostic and Medical Clinic Infirmary Health in Mobile, Ala., Dr. Jason Valentine, posted a Facebook message expressing a similar sentiment last month: refusing to see people die of a “preventable disease.”

“We do not yet have good treatments for serious illness, but we have great prevention with vaccines,” he wrote in a letter posted online, according to the Washington Post. ‘Unfortunately, many have refused to take the vaccine and some end up seriously ill or dead. I can and will not force anyone to take the vaccine, but I also cannot continue to watch my patients suffer and die of a disease that can be avoided. ”

The doctors who refuse to treat the unvaccinated are in states with bad COVID-19 outbreaks. Alabama has seen a significant drop in the number of hospital admissions due to COVID-19 across the state in recent weeks, but according to state health officer Dr. Scott Harris’s can be attributed in part to a “really high rate” of daily deaths. With a state population just under 5 million, Alabama has an average of 135 COVID deaths a day, a dramatic increase of 324 percent over the last 14 days. Florida currently infects more than 9,000 daily new infections, and nearly 52,000 Florida people have died from the virus.

“We still have more patients requiring critical care than critical beds,” Harris told the Montgomery Advertiser. “It’s better than it has been, but it still means we do not have any ICU beds available in Alabama. It is a problem for people with non-COVID diseases. ”

Marraccini and Valentine did not respond to Yahoo News’ request for comment.

A Johnson & Johnson COVID-19 vaccine is being prepared for a clinical trial in Aurora, Colo., In 2020.

A Johnson & Johnson COVID-19 vaccine is being prepared for a clinical trial in Aurora, Colo., In 2020. (Photo by Michael Ciaglo / Getty Images)

They are not alone in wondering whether people who choose to overwhelm healthcare providers and set up dangerously crowded hospitals by refusing vaccination should be prioritized in the healthcare system. A leaked note from the co-chair of the North Texas Mass Critical Care Guideline Task Force, a voluntary group that periodically updates medical guidelines for hospitals in the region, also indicated that the task force considered whether vaccination status should be taken into account when deciding who receives a ICU bed when the numbers get low. That decision has since been overturned.

While it is legal for physicians to stop seeing a patient for any reason who does not violate anti-discrimination laws based on race, gender, and gender, medical ethical standards may go beyond the letter of the law.

According to Moreno, the law is not an effective barometer of right and wrong in the medical field because it does not have perfect guidance in every situation. He noted that in the late 1980s, during the HIV AIDS epidemic, some doctors refused to care for patients who were more likely to be gay, black, or belong to another marginalized group.

“This is very dangerous,” Moreno said. “When the medical profession begins to decide, pick and choose who can be cared for and who not for some reason, we are in a really bad position.”

“The basis of medicine requires doctors to take care of patients,” he added. “If they stopped doing that, then we really have no business.”

A dose of the Pfizer-BioNTech vaccine is being prepared for a massive COVID-19 vaccination event in Denver in January.

A dose of the Pfizer-BioNTech vaccine is being prepared for a massive COVID-19 vaccination event in Denver in January. (Michael Ciaglo / Getty Images)

Yahoo News Medical Contributor Dr. Kavita Patel, a primary care physician in Washington, DC who also serves as a health policy colleague at the Brookings Institution, says that although she disagrees with not treating the unvaccinated, she understands the feeling.

“I do not blame health professionals who feel this way because I think they practice self-preservation,” Patel told Yahoo News. “They get hammered … and they are frustrated and tired. There are three vaccines and we have people deliberately not taking them. ”

But Patel stresses the importance of being able to share his personal feelings for the benefit of others.

“When you say no to someone, it creates an incredibly morally slippery slope,” she said. “I do not think that doctors should write it. … Medicine is both art and science, but it is also incredibly clear to be objective. ”

It is already common practice for some doctors to refuse to treat children who do not have childhood vaccines. A 2020 University of Colorado study found that more than 50 percent of pediatric offices have policies that reject families that do not vaccinate their children.

Moreno believes this is justified, but argues that it is different from refusing to treat those who have not been vaccinated from COVID-19.

“I suspect these pediatricians consider themselves protectors of children and do not want to see their patients get sick from an easily preventable and serious illness,” he said. And of course, if you do not receive the usual childhood vaccinations, children may be isolated from school and other activities. I also think pediatricians are concerned that immunosuppressed children can get diseases like measles in their offices from other children who were not vaccinated. ”

Protesters against masks, vaccines and vaccine passes gather outside the Centers for Disease Control (CDC) headquarters in Atlanta in March.

Protesters against masks, vaccines and vaccine passes gather outside the Centers for Disease Control headquarters in Atlanta in March. (Elijah Nouvelage / Getty Images)

However, with the exception of protecting children from the dangerous decisions of their parents, these reasons are no different from those given by doctors who do not want to treat people who reject the COVID-19 vaccine: they do not want their patients to die of a disease that can be prevented and they want to protect the immunosuppressed. Increasingly, work, school, travel and other social activities also require vaccination against COVID-19.

A recent study by CNBC / Change Research found that of the 29 percent of Americans who are unvaccinated, 83 percent never plan to get the COVID-19 vaccine, largely based on distrust of the government and fears of the vaccine’s side effects, which have been hugely overrated or even invented in online misinformation campaigns and some right-wing media, such as Fox News.

Hesitant vaccines have also come into the medical field. More than 100 employees at Houston Methodist Hospital, including many nurses, were fired in June for refusing to comply with the company’s vaccine mandate.

For Dr. Alyssa Burgart, bioethicist and pediatric anesthesiologist at Stanford University, when it comes to healthcare professionals deciding whether to get vaccinated, not everything that feels right is actually good.

“I think the important thing to recognize is that sometimes something feels right but is actually morally misleading,” she said.

Cover thumbnail photo illustration: Yahoo News; Photos: Angela Weiss / AFP via Getty Images, Stephen Zenner / SOPA Images / LightRocket via Getty Images

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