[Politics_Observer]

So, here is the question. As ICU beds fill up to 90% capacity in some states, do doctors owe an ethical duty to those who refused COVID vaccination without good medical cause over those who did vaccinate against COVID in COVID related cases that require the use of the ICU?

[wat0n]

Care to elaborate on how that would look like in practice?

If there are few available beds, would the unvaccinated be turned down to keep ICU beds available just in case a vaccinated person who needs one for whatever reason shows up? Or this would only happen if beds were filled?

[Politics_Observer]

@wat0n

Well once the beds are filled up, somebody with a heart attack who needs ICU care could die because somebody else decided not to vaccinate without good medical cause. Who should get that bed in your opinion? Should we just kick the person who did not vaccinate without good medical cause out of the bed so that the one having a heart attack can be saved? Wouldn't the doctor owe more of an ethical duty to that person over the person who refused to vaccinate without good medical cause? This is reality here and real choices that are not easy that a doctor will have to make. Choices that he or she should not been put into a position to have to make in the first place and was preventable. But the fact is, in some states, it seems doctors are beginning to be put in that position. It will also depend on that doctor's ethics too in making his or her decision on who lives and who dies.

[wat0n]

@wat0n

Well once the beds are filled up, somebody with a heart attack who needs ICU care could die because somebody else decided not to vaccinate without good medical cause. Who should get that bed in your opinion? Should we just kick the person who did not vaccinate without good medical cause out of the bed so that the one having a heart attack can be saved? Wouldn't the doctor owe more of an ethical duty to that person over the person who refused to vaccinate without good medical cause? This is reality here and real choices that are not easy that a doctor will have to make. Choices that he or she should not been put into a position to have to make in the first place and was preventable. But the fact is, in some states, it seems doctors are beginning to be put in that position. It will also depend on that doctor's ethics too in making his or her decision on who lives and who dies.

Just trying to understand what do you actually mean by the question.

In that concrete scenario, the vaccinated person would have preference. It's fair, if you did not vaccinate even though you could then you took the risk and you have to deal with the consequences of your decision. I have already advocated for this before.

But I don't think the unvaccinated should be turned down just because the beds are full, to keep some beds ready. Instead, they would only be turned down if it were necessary to save the life of a vaccinated person.

[Politics_Observer]

@wat0n

But I don't think the unvaccinated should be turned down just because the beds are full, to keep some beds ready. Instead, they would only be turned down if it were necessary to save the life of a vaccinated person.

I agree. So, if the beds are full (or close to full where only one bed is available for example) and you have an unvaccinated person needing ICU care and a vaccinated person needing ICU care then the vaccinated person in my view should be given preference over the unvaccinated who chose not to vaccinate without good medical cause. That's my view. I think that would be the right choice to make in such a scenario.

[Rancid]

I voted yes, but my answer is a little more complex then what the question offers.

Doctors, yes, because doctors must always try to care for everyone they possibly can, regardless on if patient did something stupid or not. this is basically an oath they take. it's why you even see doctors from nations that are at war with each other, still treating people from the enemy's army.

However, I thing hospital policy (i.e. non-doctors) should certainly mandate the the vaccinated are a higher priority than the unvaccinated. I guess what I'm saying is I think the policy can be put in place, such that doctors do not have feel like they are breaking their oaths to take care of everyone as best they can.

Doctors should not be creating, suggesting, or mandating policy. However, I think the entities that employ them should. Some shit like that.

[Politics_Observer]

@Rancid

Well these doctors have to choose who lives and who dies once ICUs are at full capacity. Their is no escaping that choice. Who should they choose once ICU beds reach full capacity? Those who chose to refuse to vaccinate without good cause over those who did vaccinate? Or vice versa? Who would you choose to live or die when forced to make such a choice if you were the doctor and forced to make that choice? It's getting to the point where there is no way around it and doctors will be forced to make a choice despite any oath they took as a doctor.

This is something battlefield doctors have to do all the time in war time in the military services. They have to prioritize patients and choose who lives and who dies. In many respects, this is somewhat similar here. Civilian doctors might not realize this until those ICU beds fill up to full capacity because many of them have never been battlefield doctors. But that reality will probably come soon at the rate we are going.

[annatar1914]

Yes, physicians have a duty to all patients, regardless of their own stupidities. If doctors refused care to those who make stupid health decisions, very few people would be treated at all.

[wat0n]

Yes, physicians have a duty to all patients, regardless of their own stupidities. If doctors refused care to those who make stupid health decisions, very few people would be treated at all.

But what would happen in the triage scenario @Politics_Observer is proposing?

[Politics_Observer]

@annatar1914

Unfortunately, these aren't normal times. We are in the middle of a pandemic. ICU beds are filling up to 100% capacity were doctors will have no choice but to choose who lives or dies. This is real life here annatar. At the rate we are going 3 states will reach 100% capacity forcing doctors to choose who lives and who dies. If you were a doctor forced to make that choice (and you HAVE to make that choice given ICU beds are at 100% capacity). Who would you choose to live or die? What is your ethical reasoning behind your choice?

[Rancid]

@Rancid

Well these doctors have to choose who lives and who dies once ICUs are at full capacity. Their is no escaping that choice. Who should they choose once ICU beds reach full capacity? Those who chose to refuse to vaccinate without good cause over those who did vaccinate? Or vice versa? Who would you choose to live or die when forced to make such a choice if you were the doctor and forced to make that choice? It's getting to the point where there is no way around it and doctors will be forced to make a choice despite any oath they took as a doctor.

This is something battlefield doctors have to do all the time in war time in the military services. They have to prioritize patients and choose who lives and who dies. In many respects, this is somewhat similar here. Civilian doctors might not realize this until those ICU beds fill up to full capacity because many of them have never been battlefield doctors. But that reality will probably come soon at the rate we are going.

A doctor will always base their decision on how to ration care based on the current conditions of the patients. That is to say, if an unvaccinated patient appears to be in a worse condition, then they will get more attention/resources. If a vaccinated patient appears to be in worse condition, then they will get more attention/resources. This is how they are supposed to make their choices. They intentionally do not and should not factor the series of events/mistakes/choices the patient made that got them into the hospital. I believe this approach is in line with their oath of care.

We should not expect, nor require doctors to make decision based on how stupid or not stupid their patients are. So yes, they owe an ethical duty to those who refuse to vaccinate.

That said, although I'm saying that doctors should not be tasked with making those kinds of judgements with patients. I think it should be ok for hospitals, healthcare systems, and insurance companies, to make those decisions for the doctors. I guess what I'm saying is, we should position doctors such that they do not have to make decisions on this sort of thing, but the rest of us can do it for them.

EDIT:
If you have two covid patients in equally bad shape, with resources to only treat one. That is a position we should not be putting our doctors in ever. If they are in that position, I would expect them to just do the best they can to save both people with what little they have.

As much as I want the unvaccinated to die. I just don't feel we should be having doctors do that for us.

[Politics_Observer]

@Rancid

I am fully aware of what their oath says, but this isn't the land of unicorns and rainbows where everything is a perfect world. This the real world and I think doctors will be forced to make that choice. Not because they want to be forced into the position to make such a choice but because society, with it's selfishness, has forced doctors into that position to make such a choice. And they might be forced to make that choice in the ICU and people might not always be aware of that. It's not because the doctors are unethical or trying to break their oath or any laws, it's because the choices that society has made has forced them into that position and it's not the doctors fault.

[wat0n]

That said, although I'm saying that doctors should not be tasks with making those kinds of judgements with patients. I think it should be ok for hospitals, healthcare systems, and insurance companies, to make those decisions for the doctors. I guess what I'm saying is, we should position doctors such that they do not have to make decisions on this sort of thing, but the rest of us can do it for them.

I agree, such a decision needs to be the result of a policy at a much higher level than the doctor.

[annatar1914]

In reply to all who replied to my post;

I worked in health care for over 20 years, my entire young adulthood, and I frequently saw triage decisions and also some decisions of questionable morality being exercised by health care professionals. However, that being said I simply cannot see physicians and nurses rationing or refusing care to vaccine refusers. Some in America are vaccine refusers themselves, for one thing.

My own personal position is clear; universal mandatory mass vaccinations. But I also know that that isn't going to happen, at least not at this stage anyway.

[Rancid]

@Rancid

I am fully aware of what their oath says, but this isn't the land of unicorns and rainbows where everything is a perfect world. This the real world and I think doctors will be forced to make that choice. Not because they want to be forced into the position to make such a choice but because society, with it's selfishness, has forced doctors into that position to make such a choice. And they might be forced to make that choice in the ICU and people might not always be aware of that. It's not because the doctors are unethical or trying to break their oath or any laws, it's because the choices that society has made has forced them into that position and it's not the doctors fault.

@Rancid

I am fully aware of what their oath says, but this isn't the land of unicorns and rainbows where everything is a perfect world. This the real world and I think doctors will be forced to make that choice. Not because they want to be forced into the position to make such a choice but because society, with it's selfishness, has forced doctors into that position to make such a choice. And they might be forced to make that choice in the ICU and people might not always be aware of that. It's not because the doctors are unethical or trying to break their oath or any laws, it's because the choices that society has made has forced them into that position and it's not the doctors fault.

Sure, and in that scenario, there is no right/wrong choice for the doctor. It's just an unfortunately situation, and that's about it.

[Politics_Observer]

@annatar1914

I am sure you did see some questionable decisions being made by health care providers in your time in health care. Here is a German doctor who stated that the unvaccinated should be required to give up their ICU bed in the event they are require the use of an ICU for a COVID related illness.

A German geneticist has said those who turn down the new COVID-19 vaccine should carry a note also refusing intensive care treatment. He also said medical decisions should not be left to conspiracy theorists.

eople who refuse the COVID-19 vaccine should not be able to access ventilators and other emergency measures if they become ill, a member of Germany's Ethics Council told the mass circulation Bild newspaper.

"Whoever wants to refuse the vaccination outright, he should, please also always carry a document with the inscription: 'I don't want to be vaccinated!'" Wolfram Henn, a human geneticist, told Bild on Saturday. "I want to leave the protection against the disease to others! I want, if I get sick, to leave my intensive care bed and ventilator to others."

'Leave it to the experts'

While Henn said critical questions in connection with vaccinations are understandable and justified, he recommended relying on the advice of "people who really know their stuff." Researchers worldwide, he said, have "stepped up the pace at a huge expense, but not at the expense of safety."

"Within months, there will also be coronavirus vaccines of the classic type, such as those that have been proven a billion times over for decades against influenza or hepatitis," he added.

Henn also slammed conspiracy theorists and coronavirus deniers, saying decisions should not be left to "lateral thinkers and vaccination opponents," referring to the Querdenker movement, the umbrella group for most of Germany's sometimes violent anti-shutdown demonstrations.

"I urgently recommend that these alarmists go to the nearest hospital and present their conspiracy theories to the doctors and nurses who have just come from the overcrowded intensive care unit completely exhausted," he said.

https://www.dw.com/en/anti-vaxxers-shou ... a-55996805

[Politics_Observer]

@Rancid @annatar1914

Here is another question to vaccinated folks. One of your close family members has an emergency and is rushed to the emergency room. You are informed that they can't give your close family member any medical treatment because they are overwhelmed by people who refused to get the vaccine. Your family member dies but you knew, if they just could have gotten them to the ICU they could have been saved. All because some people didn't get the vaccine. How would you feel? I wonder how good the doctors would feel about that too? Being forced to make those kinds of choices might make some of these doctors leave the profession. And who could blame them?

[annatar1914]

@annatar1914

I am sure you did see some questionable decisions being made by health care providers in your time in health care. Here is a German doctor who stated that the unvaccinated should be required to give up their ICU bed in the event they are require the use of an ICU for a COVID related illness.



https://www.dw.com/en/anti-vaxxers-shou ... a-55996805

@Politics_Observer , he's arguing from emotion, and isn't a health-care provider himself.

It isn't moral to refuse a good vaccine, at all, during a raging pandemic, a plague. But nor is it moral to refuse care to stupid or even malicious and evil people. I've had to care for rapists and murderers and child molesters, fresh from doing their evil deeds sometimes, didn't necessarily like it. But I treated everyone as a human being and swallowed my pride, because it gets real dicey determining who deserves pity and care and who does not.

[Rancid]

@Rancid @annatar1914

Here is another question to vaccinated folks. One of your close family members has an emergency and is rushed to the emergency room. You are informed that they can't give your close family member any medical treatment because they are overwhelmed by people who refused to get the vaccine. Your family member dies but you knew, if they just could have gotten them to the ICU they could have been saved. All because some people didn't get the vaccine. How would you feel? I wonder how good the doctors would feel about that too? Being forced to make those kinds of choices might make some of these doctors leave the profession. And who could blame them?

It would suck. That still doesn't mean I expect doctors to wheel out people. It should not be their call.

I've already stated, that yes, I believe unvacinated people should be wheeled out. Just not by the doctors themselves. We need to make that decision for them.

[Politics_Observer]

@Rancid @annatar1914

I understand where you are both coming from.