MDNews - Mid Hudson

++++++++++++++ + +ETHICS  +++ ++++++++++++++ +++ Taking a Shot in the Arm WHEN AN EPIDEMIC STRIKES AND AN EFFECTIVE VACCINATION BECOMES AVAILABLE, DOCTORS OFTEN URGE PATIENTS TO PROTECT THEMSELVES BY GETTING THE VACCINATION; HOWEVER, NOT ALL DOCTORS PRACTICE WHAT THEY PREACH. W THE PUBLIC’S OPINION A RECENT SURVEY on mdnews.com asked the question, “Do you think physician offices and hospitals should have a mandatory flu shot policy for nonallergic health care workers and other employees?” + Thirty-three percent voted “Yes. Influenza-infected employees could spread germs to patients who a l re ady suf fe r f rom compromised health.” + Eighteen percent voted “No. Hospital employees should have a choice about getting vaccinated like everyone else does.” + Five percent voted “Maybe, but only if they deal directly with patients.” + Three percent voted “Yes for high-traffic facilities, but no when it comes to smaller facilities seeing fewer patients.” ITH MANY PHYSICIANS unwilling to roll up their sleeves to get vaccinated, questions arise as to whether it is ethical for a doctor to care for vulnerable patients if he or she is not vaccinated. The American Medical Association (AMA) Council on Ethical and Judicial Affairs recently opined on the issue, expressing that with such close contact with patients, it is a physician’s ethical duty to do everything possible to avoid the spread of communicable diseases — including vaccination. The main reason physicians cite for refusing vaccinations is concern they may have a higher risk of spreading the sickness to family members or a specific patient group, according to the AMA Council on Ethical and Judicial Affairs. Professions of independence and religious opposition are other reasons given by physicians who refuse vaccines. These views may be influenced by confidence in alternative ways to prevent the spread of infectious disease, aggressiveness of the disease, how the physician views his obligation as a provider of care and the effective- ness of a vaccine. Addressing the Problem A survey analysis published in Mortality and Morbidity Weekly Report shows that less than 50% of health care workers nationwide get f lu 18 | Mid Hudson MD NEWS  MDNEWS.COM vaccinat ions. With one in f ive Americans contracting the flu every year and such low percentages of health care workers vaccinated, some health care institutions are including flu vacci- nations in fitness-for-duty requisites in an effort to ensure infectious diseases are not spread. Other hospitals require all workers who are not vaccinated to wear masks during flu season. While some people support hospitals that require employees to get vac- cinations, others claim the practice impinges on personal rights. When the state of New York tried to require all health care workers to get the flu vaccination in 2009, it was met with protests and union lawsuits. Taking into account issues that arise from requiring physicians to get vac- cinations, the AMA Council on Ethical and Judicial Affairs counsels that physicians have an ethical obligation to prevent the spread of communi- cable diseases and should agree to immunization unless there is a valid religious, health or philosophic reason. When physicians refuse a vaccination that is safe, effective and the best way to prevent the spread of disease to coworkers and patients, they are not only putting themselves at risk, but the patient population they serve. The AMA Council on Ethical and Judicial Affairs also recommends that such a clause be added to the AMA Code of Medical Ethics. ■

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