“It’s a Terrible Idea to Deny Medical Care to Unvaccinated People”
For The Atlantic, Ed Yong writes about an idea that has gained a certain amount of traction in recent weeks as hospital systems have been overwhelmed by the Omicron surge: medical care for unvaccinated people should be limited. Yong says that’s a very bad idea:
I ran this argument past several ethicists, clinicians, and public-health practitioners. Many of them sympathized with the exasperation and fear behind the sentiment. But all of them said that it was an awful idea — unethical, impractical, and founded on a shallow understanding of why some people remain unvaccinated.
“It’s an understandable response out of frustration and anger, and it is completely contrary to the tenets of medical ethics, which have stood pretty firm since the Second World War,” Matt Wynia, a doctor and ethicist at the University of Colorado, told me. “We don’t use the medical-care system as a way of meting out justice. We don’t use it to punish people for their social choices.” The matter “is pretty cut-and-dry,” Sara Murray, a hospitalist at UC San Francisco, added. “We have an ethical obligation to provide care for people regardless of the choices they made, and that stands true for our unvaccinated patients.”
Unvaccinated people are unvaccinated for a wide variety of reasons, many of them structural constraints beyond their control. Yong connects the care of the unvaccinated to the difficulty in receiving quality care already faced by women, Black people, and disabled people:
As health-care workers become more exhausted, demoralized, and furious, they might also unconsciously put less effort into treating unvaccinated patients. After all, implicit biases mean that many groups of people already receive poorer care despite the ethical principles that medicine is meant to uphold. Complex illnesses that disproportionately affect women, such as myalgic encephalomyelitis, dysautonomia, and now long COVID, are often dismissed because of stereotypes of women as hysterical and overly emotional. Black people are undertreated for pain because of persistent racist beliefs that they are less sensitive to it or have thicker skin. Disabled people often receive worse care because of ingrained beliefs that their lives are less meaningful. These biases exist-but they should be resisted. “Stigma and discrimination as a prism for allocating health-care services is already embedded in our society,” Goldberg told me. “The last thing we should do is to celebrate it.”
That is a compelling argument and provides a necessary dose of empathy for those of us who might feel betrayed by people who are unvaccinated at this point in the pandemic. Blaming individuals for these collective responsibilities and failures is of a kind with asserting that mask-wearing and vaccination are solely personal choices rather than necessary collective actions to be undertaken by communities to keep people safer. This is the same sort of individualist thinking that has people focused on their personal “carbon footprint” instead of what massive corporations, high-emissions industries, and governments should be doing to address the climate crisis.
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