If Ezekiel Emanuel thinks it is wise policy, the country’s preeminent bioethicist generally wants to mandate it. For example, he repeatedly called for mandatory national shutdowns. He has urged that all children be forced to have a flu shot every year. He also advocated that different levels of government impose vaccine mandates. He also believes that doctors should be required to perform abortions when asked, or find an abortionist for the patient if they have a conscientious objection. “Mandate” should be Emanuel’s middle name.
Now, he is back with a seemingly more reasonable demand, but which really isn’t. He has co-authored a piece advocating that every health-care worker — from doctors to pharmacists to nurses to custodians — be vaccinated as a condition of continued employment. From “Vaxed or Axed,” published in STAT:
One industry that has been strangely silent about mandates is health care, including hospitals, home health agencies, long-term care facilities, and others. Why aren’t all 17 million health care workers at hospitals, nursing homes, skilled nursing facilities, home health care agencies, and outpatient care sites such as federally qualified health clinics, pharmacies, physician offices, physical therapy offices, and the like required to get vaccinated against Covid-19?
Maybe because a lot of those workers would quit rather than be forced to put an experimental, RNA-impacting chemical in their bodies?
Emanuel and company complain about the low rate of vaccinations among health-care workers:
A survey of nine hospital networks found rates of fully vaccinated workers were as low as 53%. Even worse, as we rely more and more on out-of-hospital care, it turns out only 26% of home-health workers had been vaccinated as of March. A survey released in April found that fully 30% of health care workers are “vaccine hesitant” with 18% of frontline workers outright opposed to vaccination.
That raises an interesting red flag. Why are those so intimately impacted by COVID — and who are clearly not cowardly, having worked valiantly in the trenches saving lives before the vaccines came out — reluctant to receive the jab? It seems to me that addressing their concerns — rather than coercing them with the threat of job loss — is the better approach.
But, but, the Hippocratic Oath!
Mandating vaccination isn’t just the right thing to do, it’s also the ethical thing to do. All health care workers pledge that their highest duty is to promote the best interests of their patients. In the words of the Hippocratic oath, physicians pledge that, “Into whatever homes I go, I will enter them for the benefit of the sick …” (There were no hospitals at the time of Hippocrates, only home care.)
Funny, the oath also forbids abortion, and Emanuel doesn’t blink in his pro-choice views.
I can think of several reasons to oppose such mandates: First, the vaccines have received only an “emergency use” authorization. That means they are not fully approved. It also means — according to the law that allows EU approvals — that people can refuse such substances. Specifically, the statute states (my emphasis):
Appropriate conditions designed to ensure that individuals to whom the product is administered are informed—
(I) that the Secretary has authorized the emergency use of the product; (II) of the significant known and potential benefits and risks of such use, and of the extent to which such benefits and risks are unknown; and (III) of the option to accept or refuse administration of the product, of the consequences, if any, of refusing administration of the product, and of the alternatives to the product that are available and of their benefits and risks.
Oops. If we have the legal right “to accept or refuse administration” of the COVID vaccine, it means that workers cannot be forced to be inoculated. And that should apply to the private sector as well as the public. After all, it is like trying to force someone to take a drug for an “off label” use. That is just not reasonable.
Even when the vaccines receive full approval, which I expect they will, it would still be unwise for health-care employers to compel their employees to be vaccinated. Many already have natural immunity, having previously recovered from COVID. Moreover, there are real questions being asked whether somebody who already has antibodies in their blood should also be vaccinated.
Perhaps Emanuel hasn’t noticed, but people don’t trust “the experts” much anymore. Mandates of the kind Emanuel proposes would only make things worse. Besides, we should resort to coercion only for compelling reasons. The current state of the COVID pandemic doesn’t warrant such draconian measures.
We should also be wary about having the private sector enforce policies desired by the federal government, but which it won’t engage for political or constitutional reasons. Checks and balances matter. Having the private sector do the mandating — when the feds and state governments can’t or won’t — would not be good policy from either direction.
Finally, there is a reasonable middle-ground way of achieving Emanuel’s goal of improving patient safety without forcing people to choose between putting unwanted chemicals in their bodies and keeping their jobs. And we know it works — because we did it before the vaccines came online, and to great success. Just require health-care workers who don’t want the shots to be tested for COVID twice a week. That will protect patients significantly and by far less intrusive means. Moreover, many patients will have been inoculated — as I have been — meaning they are already significantly protected anyway.
Once again Emanuel wants to force us to do what he thinks is right. And, as before, his advice should be ignored.