Interesting opinion: Doctors should be allowed to give priority to vaccinated patients when resources are scarce

Riva

Lister
Washington post article
I’m going to come right out and say it: In situations where hospitals are overwhelmed and resources such as intensive care beds or ventilators are scarce, vaccinated patients should be given priority over those who have refused vaccination without a legitimate medical or religious reason.

This conflicts radically with accepted medical ethics, I recognize. And under ordinary circumstances, I agree with those rules. The lung cancer patient who’s been smoking two packs a day for decades is entitled to the same treatment as the one who never took a puff. The drunk driver who kills a family gets a team doing its utmost to save him — although, not perhaps, a liver transplant if he needs one. Doctors are healers, not judges.
This conflicts radically with accepted medical ethics, I recognize. And under ordinary circumstances, I agree with those rules. The lung cancer patient who’s been smoking two packs a day for decades is entitled to the same treatment as the one who never took a puff. The drunk driver who kills a family gets a team doing its utmost to save him — although, not perhaps, a liver transplant if he needs one. Doctors are healers, not judges.

But the coronavirus pandemic, the development of a highly effective vaccine, and the emergence of a core of vaccine resisters along with an infectious new variant have combined to change the ethical calculus. Those who insist on refusing the vaccine for no reason are not in the same moral position of the smoker with lung cancer or the drunk driver. In situations where resources are scarce and hard choices must be made, they are not entitled to the same no-questions-asked, no-holds-barred medical care as others who behaved more responsibly.


There are a number of reasons. It’s hard to quit smoking, stop drinking, lose weight or even take up exercise. So even those whose health problems can reasonably be blamed on their own lapses deserve the best care possible. After all, for the most part, they are their own victims.
Vaccine resisters are different. Their refusal to take the shot doesn’t just affect their own health — it poses a known risk to the health of others, especially now, with the spread of the delta variant. To decline to be vaccinated is to fail to live up to your duty to your community. And it should mean that you forfeit — if necessary — your claim to equal medical treatment.
Emphasis on “if necessary,” because that is the other part of the equation. Scarcity has consequences for the distribution of medical resources; the limited supply of donor organs is one reason why it is acceptable to take a patient’s history of alcoholism, and likelihood of continued drinking, into account in distributing livers.


If hospital and health-care resources were not severely strained, if there were not areaswhere vaccination rates are dangerously low and the delta variant is spreading fast, there would be no problem. The vaccine refuser, although morally blameworthy, would still deserve the best care possible.
But that is not the case in too many parts of this country. Say one person arrives at an emergency room suffering a massive heart attack. The other, defiantly unvaccinated, has come down with covid-19 and is struggling to breathe. ICU beds are scarce at this hospital; so are ventilators — the foreseeable result of the decision by this covid patient, and scores of others like him, not to live up to theirresponsibility to be vaccinated. It is not only ethical to discriminate against him, it would be morally wrong not to give priority care to the heart attack victim.
One argument against this position is that it puts health-care providers on a slippery slope toward becoming free-ranging moral arbiters. Nope, I don’t think the slope is unduly slippery. This is a unique setting that combines the availability of lifesaving treatment, the imperative of individual responsibility and the attendant, pandemic-created shortage of resources. Carving out a justifiable exception from ethical rules doesn’t mean risking that they will be routinely ignored.

Another argument is more practical. Hospitals and physicians aren’t going to explicitly implement the kind of policy I’m advocating for fear of lawsuits. When a group of Texas health-care providers began exploring a scaled-back version of the idea,proposing that “vaccine status therefore may be considered when making triage decisions as part of the physician’s assessment of each individual’s likelihood of survival,” the project was quickly abandoned as a “homework assignment.”
No one is going to yank a ventilator from an unvaccinated patient to treat a vaccinated one in desperate need of treatment, and that’s not what I’m endorsing. In the real world, these decisions are going to be made in split-second assessments upon arrival. My argument is that doctors aren’t acting unethically by putting a finger on the scale in favor of the vaccinated — they’re behaving rationally and justly.

Emergency physician Dan Hanfling has written extensively about how to triage care, and he agrees. “If you believe there’s a certain degree of accountability that we as citizens have to take for each other to protect our community, then that group of individuals who have willingly chosen not to vaccinate, for illegitimate reasons, it would be fair to place them at the back of the line. Not kick them out of line, just move them back,” he told me. “At the end of the day, if you have willingly chosen not to do something that benefits the public good in the setting of a national crisis, then there are certain consequences.”

This is an uncomfortable conversation. The irresponsibly unvaccinated have made it a necessary one.


Personal view on this:
If the vaccinated can end up requiring critical hospital resources coz of the flu, there is no difference between them and the unvaccinated patients needing the same critical resources coz of the flu.

And doctors cannot be judges.
 

Burner

Elder Lister
Personal view on this:
If the vaccinated can end up requiring critical hospital resources coz of the flu, there is no difference between them and the unvaccinated patients needing the same critical resources coz of the flu.

And doctors cannot be judges.
I would agree if the flu were causing a strain on hospital resources. As it is, that is not the case.
Covid on the other hand does, and there is a definite difference between the number of people vaccinated vs unvaccinated requiring critical care.

Is your only point then that doctors are not healers?
 

Riva

Lister
I would agree if the flu were causing a strain on hospital resources. As it is, that is not the case.
Covid on the other hand does, and there is a definite difference between the number of people vaccinated vs unvaccinated requiring critical care.

Is your only point then that doctors are not healers?
Actually I mean Covid when I say the flu.
Its true that we have varying numbers of people requiring critical care between the vaccinated vs unvaccinated.
The question is, if you have two people needing critical care one vaccinated and one unvaccinated (meaning both have ended up at the same outcomes of severe illness), should you (or would there be justification to) prioritize the vaccinated?

Doctors are healers not judges, that was my other point.
 

Burner

Elder Lister
Actually I mean Covid when I say the flu.
Its true that we have varying numbers of people requiring critical care between the vaccinated vs unvaccinated.
The question is, if you have two people needing critical care one vaccinated and one unvaccinated (meaning both have ended up at the same outcomes of severe illness), should you (or would there be justification to) prioritize the vaccinated?

Doctors are healers not judges, that was my other point.
Good question. I dont have an answer for that. i dont believe there would or could be a justification to prioritize one over the other.
 

kijanamrefu

Elder Lister
This sounds like it was written by a vaccinated person. The whole scenario is based on the premise that the unvaccinated person has refused to be vaccinated, which isn't the case, making the whole argument flimsy.
 

Burner

Elder Lister
This sounds like it was written by a vaccinated person. The whole scenario is based on the premise that the unvaccinated person has refused to be vaccinated, which isn't the case, making the whole argument flimsy.
The premise is solid. There are people who have vehemently refused to be vaccinnated. Hell, there are people in this very forum who have said they will not get the jab. How is that not the case?

There are strains on health systems because people with covid are increasingly being admitted to HDU and ICU beds which means there are fewer beds for people with other severe conditions that need those beds.
 

kijanamrefu

Elder Lister
The premise is solid. There are people who have vehemently refused to be vaccinnated.
Bro, how do you determine, in an emergency situation as described above, who refused the jab (irresponsibly unvaccinated) vs those who didn't have access to the jab?
 

Burner

Elder Lister
Bro, how do you determine, in an emergency situation as described above, who refused the jab (irresponsibly unvaccinated) vs those who didn't have access to the jab?
Well at the emergency point you cant. But two things to remember here;
1. The writer has stated that there are people who have consciously refused the vaccine and that group is what he refers to when he says unvaccinated.
2. This is being written from the point of view of a person in a country where there is a massive rollout of the vaccine (with options of pfizer, AZ or J&J). Accessibility to the vaccine isnt considered because as far as they are concerned, that isnt a problem.
 

kijanamrefu

Elder Lister
Well at the emergency point you cant. But two things to remember here;
1. The writer has stated that there are people who have consciously refused the vaccine and that group is what he refers to when he says unvaccinated.
2. This is being written from the point of view of a person in a country where there is a massive rollout of the vaccine (with options of pfizer, AZ or J&J). Accessibility to the vaccine isnt considered because as far as they are concerned, that isnt a problem.
I understand.
Maybe I'm not asking the question clearly enough.

How do we identify the person who refused the jab?
To add another, if indeed they did refuse the jab, do we leave it at that and punish them for it? Is it worth looking into why they refused?

I personally don't think the skeptics are baseless in their train of thought, because it's not the first time that crazy shit has been found in vaccines.

All in all, it's a bit hasty to basically condemn a group of people for not believing what we happen to believe in.
 

bigDog

Elder Lister
But this ain't the first or last scenario where doctors have to make a choice between who to let die or who to try save, and tho policy needs to be made by legislators, it never covers every scenario
I would go with the vaccinated any time.
I understand.
Maybe I'm not asking the question clearly enough.

How do we identify the person who refused the jab?
To add another, if indeed they did refuse the jab, do we leave it at that and punish them for it? Is it worth looking into why they refused?

I personally don't think the skeptics are baseless in their train of thought, because it's not the first time that crazy shit has been found in vaccines.

All in all, it's a bit hasty to basically condemn a group of people for not believing what we happen to believe in.
What crazy stuff has been found in vaccines? Can you provide evidence? May be a link from a credible source?

Do you have any facts that lends credibility to anti-vaccine mob claims? Aren't they baseless? Why shouldn't we dismiss the anti-vax mob claims and tell them them off?

Indeed, why not tell them to go shove that uneducated opinion to-you-where? Kiulizo TU.
 

AU5

Administrator
Staff member
This sounds like it was written by a vaccinated person. The whole scenario is based on the premise that the unvaccinated person has refused to be vaccinated, which isn't the case, making the whole argument flimsy.

In US vaccines are literally everywhere and not like Kenya where some people even pay to get vaccinated
 

Riva

Lister
What crazy stuff has been found in vaccines? Can you provide evidence? May be a link from a credible source?

Do you have any facts that lends credibility to anti-vaccine mob claims? Aren't they baseless? Why shouldn't we dismiss the anti-vax mob claims and tell them them off?

Indeed, why not tell them to go shove that uneducated opinion to-you-where?.
First labeling people ‘anti-vaccine mob’ is a bit shallow, there are people who are not opposed to vaccines but are hesitant to take this particular vaccine.
Why are some people hesistant?
1. The shots have not undergone long term testing
2. There lacks clarity on the nature and extent of adverse effects expected
3. There is lack of reliability as people who’ve taken the shot are still at risk of disease and in some instances severe disease. check out these stats from West Virginia between 3:35 and 4:45 ()
4. There is inconsistency in the recommendations. I for one I’ve heard doctors recommending the shots for pregnant women but none of the clinical trial reports for all vaccines indicate any form of testing even up to phase 3 testing for pregnant women (I.e none of the clinical trials included a pregnancy person in the studies).

Lastly, from your questions, you seem to be very emotional about this issue. It’s not an emotional issue. It’s a research based, fact based issue. You need to be objective when looking into these issues whether you’re vaccinated or not. It will help you assess any information you come across objectively and with skepticism, regardless of your vax status.

My personal policy is to doubt everything I’m told especially when too many people agree on it.
 
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Riva

Lister
In US vaccines are literally everywhere and not like Kenya where some people even pay to get vaccinated
This is true. Anyways, what’s your view on the opinion set forth by the Washington Post article?
 

bigDog

Elder Lister
First labeling people ‘anti-vaccine mob’ is a bit shallow, there are people who are not opposed to vaccines but are hesitant to take this particular vaccine.
Why are some people hesistant?
1. The shots have not undergone long term testing
2. There lacks clarity on the nature and extent of adverse effects expected
3. There is lack of reliability as people who’ve taken the shot are still at risk of disease and in some instances severe disease. check out these stats from West Virginia between 3:35 and 4:45 ()
4. There is inconsistency in the recommendations. I for one I’ve heard doctors recommending the shots for pregnant women but none of the clinical trial reports for all vaccines indicate any form of testing even up to phase 3 testing for pregnant women (I.e none of the clinical trials included a pregnancy person in the studies).

Lastly, from your questions, you seem to be very emotional about this issue. It’s not an emotional issue. It’s a research based, fact based issue. You need to be objective when looking into these issues whether you’re vaccinated or not. It will help you assess any information you come across objectively and with skepticism, regardless of your vax status.

My personal policy is to doubt everything I’m told especially when too many people agree on it.
Hesitancy my foot! It's another politically correct anti-vax argument. Lets look at your argument:.

1. How long should a medical trial for a vaccine last? Is the period more important than the process. Can the anti-vax mob tell us how every drug regulatory agency ignored due process. As they are claiming.

2. Not understood by who? For which vaccine? Where did you get this information?

3. Some vaccinated people get the disease. TRUE. But the disease is not as severe as those unvaccinated. A condom is not 100% effective against STI. But we still insist to 'nyama Kwa nyama' brigade wavae because it protects. Ama niaje mtu yangu? I hope we agree on this one. Ndythy kwa ndythy apana.

4. Aren't those papers saying what has been said all along. The vax protects people against SEVERE disease.

The OP argument was that people who refuse to take the vaccines should not have the same priority in ICU admissions. I have shown you that they have excuses and not reasons for their anti-vax stand.

Medical facilities are a scarce resource that cannot cater for mass casualty emergencies. You triage and triage some more to prioritize those who get intervention. The anti-vax mob is stressing the ability of these facilities to cope. When one of them gets sick, they rush into immergency care and ask us to pray for them and help save their lives. These very idiots cannot suffer the pain of a little jab and an inconvenience of very mild discomfort. They get infected and spread the disease further and cause variants to appear.

You are excusing their behaviour. Stop hanging out with anti-vax mob Senyata. You see what they have done?
 

Burner

Elder Lister
I understand.
Maybe I'm not asking the question clearly enough.

How do we identify the person who refused the jab?
To add another, if indeed they did refuse the jab, do we leave it at that and punish them for it? Is it worth looking into why they refused?.
Identifying someone who refused the jab is not at all difficult. They will happily tell you why they refused the jab even when they are actually coming to the hospital for treatment for a "funny cough".
Go through this sub-reddit https://www.reddit.com/r/HermanCainAward/
Majority of the posts read out the same. Usually trash talking the need for masks...downplay the vaccine...saying they have been admitted....thoughts and prayers...gone.
Why they refused is irrelevant. Every point they will question can be answered, the problem is the people to whom they ask the questions. Usually its on facebook or forums like these where people may not have the expertise to precisely answer the questions. This reinforces the doubt that there is something wrong or off.
Even @Riva 's questions in his post up there have answers. Find a biochemist or a professor of biology/medicine/pharmacology and have the conversation.
To add another, if indeed they did refuse the jab, do we leave it at that and punish them for it?
From the Opinion piece, it would seem that the writer is advocating for them to be given only the basic care and send them on their way and not use up valuable hospital resources towards their care. Every ICU/HDU bed taken up by a covid patient who refused the jab is a bed denied to some other patient with some other unrelated ailment.
Actively choosing not to protect oneself from a disease should exempt you from the best care should you contract it. Why should you choose to be reckless and disregard despite all medical advice and then demand to be treated to the best of the abilities of those same health practicioners?

I personally don't think the skeptics are baseless in their train of thought, because it's not the first time that crazy shit has been found in vaccines.
Im not sure what you mean by this. From what i know, when people talk about "crazy shit" in vaccines, they point out one constituent part of the vaccine and when they find out it is used to make something like say plastics they freak out and go on about how its poison. Apple seeds have cyanide in them. Does that mean all apples should be taken off the shelves immediately? No. Coz the dosage is so incredibly small that the effects are negligible.
 

ShakaZulu

Lister
I thought those vaccinated would be at home and sparing hospital facilities to nonvaccinated . But no.... they are getting sick as well, why then should one be discriminated if he choose to get immunity the natural way.
 
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