The Duty of Care and the Right to Be Cared For: is There a Duty to Treat the Unvaccinated?

Overview

Journal Med Health Care Philos

Specialty Medical Ethics

Date 2024 Jan 5

PMID 38180693

Authors

Zohar Lederman

Shalom Corcos

Affiliations

Soon will be listed here.

Abstract

Vaccine hesitancy or refusal has been one of the major obstacles to herd immunity against Covid-19 in high-income countries and one of the causes for the emergence of variants. The refusal of people who are eligible for vaccination to receive vaccination creates an ethical dilemma between the duty of healthcare professionals (HCPs) to care for patients and their right to be taken care of. This paper argues for an extended social contract between patients and society wherein vaccination against Covid-19 is conceived as essential for the protection of the right of healthcare providers to be taken care of. Thus, a duty of care is only valid when those who can receive vaccination actually receive it. Whenever that is not the case, the continuing functioning of HCPs can only be perceived as supererogatory and not obligatory.

References

Bakewell F, Pauls M, Migneault D . Ethical considerations of the duty to care and physician safety in the COVID-19 pandemic. CJEM. 2020; 22(4):407-410. PMC: 7211799. DOI: 10.1017/cem.2020.376. View

Schmidt H . Personal responsibility for health: conceptual clarity, and fairness in policy and practice. J Med Ethics. 2019; 45(10):648-649. DOI: 10.1136/medethics-2019-105686. View

Childress J, Faden R, Gaare R, Gostin L, Kahn J, Bonnie R . Public health ethics: mapping the terrain. J Law Med Ethics. 2002; 30(2):170-8. DOI: 10.1111/j.1748-720x.2002.tb00384.x. View

Braeye T, Catteau L, Brondeel R, van Loenhout J, Proesmans K, Cornelissen L . Vaccine effectiveness against transmission of alpha, delta and omicron SARS-COV-2-infection, Belgian contact tracing, 2021-2022. Vaccine. 2023; 41(20):3292-3300. PMC: 10073587. DOI: 10.1016/j.vaccine.2023.03.069. View

Emanuel E . Do physicians have an obligation to treat patients with AIDS?. N Engl J Med. 1988; 318(25):1686-90. DOI: 10.1056/NEJM198806233182511. View

Malm H, May T, Francis L, Omer S, Salmon D, Hood R . Ethics, pandemics, and the duty to treat. Am J Bioeth. 2008; 8(8):4-19. DOI: 10.1080/15265160802317974. View

Brown R, Maslen H, Savulescu J . Against Moral Responsibilisation of Health: Prudential Responsibility and Health Promotion. Public Health Ethics. 2019; 12(2):114-129. PMC: 6655424. DOI: 10.1093/phe/phz006. View

Lopez Bernal J, Andrews N, Gower C, Gallagher E, Simmons R, Thelwall S . Effectiveness of Covid-19 Vaccines against the B.1.617.2 (Delta) Variant. N Engl J Med. 2021; 385(7):585-594. PMC: 8314739. DOI: 10.1056/NEJMoa2108891. View

Lyngse F, Mortensen L, Denwood M, Christiansen L, Moller C, Skov R . Household transmission of the SARS-CoV-2 Omicron variant in Denmark. Nat Commun. 2022; 13(1):5573. PMC: 9508106. DOI: 10.1038/s41467-022-33328-3. View

10.

Gholami M, Fawad I, Shadan S, Rowaiee R, Ghanem H, Khamis A . COVID-19 and healthcare workers: A systematic review and meta-analysis. Int J Infect Dis. 2021; 104:335-346. PMC: 7798435. DOI: 10.1016/j.ijid.2021.01.013. View

11.

Johnson S, Butcher F . Doctors during the COVID-19 pandemic: what are their duties and what is owed to them?. J Med Ethics. 2020; 47(1):12-15. PMC: 7565272. DOI: 10.1136/medethics-2020-106266. View

12.

Lederman Z, Lederman S . The land of no milk and no honey: force feeding in Israel. Monash Bioeth Rev. 2017; 34(3-4):158-188. DOI: 10.1007/s40592-017-0071-9. View

13.

Jing S, Milne R, Wang H, Xue L . Vaccine hesitancy promotes emergence of new SARS-CoV-2 variants. J Theor Biol. 2023; 570:111522. PMC: 10193816. DOI: 10.1016/j.jtbi.2023.111522. View

14.

McMenamin M, Nealon J, Lin Y, Wong J, Cheung J, Lau E . Vaccine effectiveness of one, two, and three doses of BNT162b2 and CoronaVac against COVID-19 in Hong Kong: a population-based observational study. Lancet Infect Dis. 2022; 22(10):1435-1443. PMC: 9286709. DOI: 10.1016/S1473-3099(22)00345-0. View

15.

Lederman Z . Comment on: What to do during inflight medical emergencies? Practice pointers from a medical ethicist and an aviation medicine specialist. Singapore Med J. 2017; 58(5):282. PMC: 5435850. DOI: 10.11622/smedj.2017041. View

16.

Ruderman C, Tracy C, Bensimon C, Bernstein M, Hawryluck L, Shaul R . On pandemics and the duty to care: whose duty? who cares?. BMC Med Ethics. 2006; 7:E5. PMC: 1459179. DOI: 10.1186/1472-6939-7-5. View

17.

Reid L . Diminishing returns? Risk and the duty to care in the SARS epidemic. Bioethics. 2005; 19(4):348-61. DOI: 10.1111/j.1467-8519.2005.00448.x. View

18.

Harris R, Hall J, Zaidi A, Andrews N, Dunbar J, Dabrera G . Effect of Vaccination on Household Transmission of SARS-CoV-2 in England. N Engl J Med. 2021; 385(8):759-760. PMC: 8262621. DOI: 10.1056/NEJMc2107717. View

19.

Sheahan L, Lamont S . Understanding Ethical and Legal Obligations in a Pandemic: A Taxonomy of "Duty" for Health Practitioners. J Bioeth Inq. 2020; 17(4):697-701. PMC: 7445726. DOI: 10.1007/s11673-020-10003-0. View

20.

Chin E, Leidner D, Lamson L, Lucas K, Studdert D, Goldhaber-Fiebert J . Protection against Omicron from Vaccination and Previous Infection in a Prison System. N Engl J Med. 2022; 387(19):1770-1782. PMC: 9634863. DOI: 10.1056/NEJMoa2207082. View