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Everyday Ethics

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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