A mandate that specifically requires frontline health care workers to be vaccinated against Covid is most just and ethical thing to do for patients, says nurse Theresa Brown, and could be implemented through the Centers for Medicare and Medicaid Services.
In my view, personal choice must surrender to professional responsibility if someone’s choice endangers patients. That is why I support a national mandate requiring the Covid vaccine for all health care workers who work with patients, including nurses, doctors, dietary workers, home health aides and others. On Monday, amid a disturbing rise in Covid-19 cases in the US, more than 50 health care groups — including the American Medical Association, the American Academy of Pediatrics, the American Academy of Nursing and the American Nurses Association — issued a joint statement calling for all health care and long-term care employers to mandate their employees be vaccinated against Covid 19. A mandate that specifically requires front-line health care workers to be vaccinated against Covid is the right thing to do for patients. In a recent viral Facebook post, Alabama physician Brytney Cobia described treating unvaccinated patients who ask for the Covid vaccine as they are dying. Her only choice is to tell them it’s too late, but she described in moving terms how she encourages their families to get vaccinated as a way of honoring their dying loved one. It should be common sense that institutions caring for patients cannot have employees who, because they are unvaccinated, might find themselves in the same situation as Dr. Cobia’s patients: infected with Covid, contagious and deathly ill. The four primary principles invoked by medical ethicists are beneficence (doing good), non-maleficence (not doing harm), justice and autonomy. It is easy to see that requiring the Covid vaccine for front-line workers meets the standards of beneficence and maleficence, but health care staff who refuse the vaccine often invoke their own autonomy as patients and insist they have the right not to be vaccinated. They do have that right, but ethical due diligence requires weighing the most just course of action, which means that all patients must be treated equally and fairly. Looked at in terms of justice, it is clear that front-line staff who remain unvaccinated against Covid offer unequal care that is also unfair because it threatens patients. Working as a nurse with bone-marrow transplant patients showed me how vulnerable hospitalized patients who are immune-suppressed are to disease. Dying patients with fungal infections had ugly black splotches marking their arms and legs.
