Select header/footer to go to
Table of Contents
Think
Assess
Patient: Autonomy
Practitioner: Beneficence & Nonmaleficence
Public Policy: Justice
Conclude
1x Speed
2x Speed
24. Immunization - Vaccine Hesitancy
Select Button
As medical practitioners say … at the beginning of a malady, it is easy to cure but difficult to detect, but over time, not having been either detected or treated in the beginning, it becomes easy to detect but difficult to cure.
~ Niccolo Machiavelli
Vaccination Betrayal
The Case of the Unvaccinated Nurse
Detective John was called to the hospital to investigate a mysterious outbreak of a highly contagious disease. Upon arriving at the hospital, he discovered that several patients and healthcare workers had become infected. As he began to investigate, he noticed that a nurse who had been in contact with infected patients had not been vaccinated.
The nurse, Sarah, was a staunch believer in personal liberty and autonomy and did not believe in mandatory vaccinations. However, Detective John soon realized that her belief in personal liberty had led to a violation of the patient-practitioner social contract and the principles of bioethics.
Sarah’s refusal to be vaccinated had increased the risk of harm to her patients and colleagues, violating the principle of nonmaleficence. Her belief in personal liberty had also violated the principle of justice by unfairly burdening her patients with the risk of harm.
Detective John found evidence that Sarah had been warned about the risks of not being vaccinated and had even been offered counseling on the importance of vaccines, but she had refused. As a result, she was not only putting her patients at risk, but also her colleagues and the community at large.
In the end, Detective John discovered that Sarah’s actions had led to the outbreak of the disease in the hospital, and she was charged with professional misconduct. The case served as a reminder to healthcare workers that they have a professional and social obligation to stay up-to-date on all vaccinations, and not doing so can have serious consequences for their patients, colleagues, and the community. Patient-centered healthcare is the ultimate goal, and the principles of bioethics must always be upheld to ensure the best interests of patients are being met.
Abstract
There is a professional and social obligations of medical practitioners and medical-care workers towards their patients that they take reasonable measures to reduce and prevent the spread of infectious diseases, including being vaccinated. The American Medical Association (AMA) states that in the context of a highly transmissible disease, practitioners should accept immunization if there is a safe and effective vaccine available. The justification for this is based on the principles of patient autonomy, professional beneficence and nonmaleficence, and social justice and how they apply in the patient-practitioner relationship. It is concluded that vaccine hesitancy based on individual liberty of the practitioner, is a violation of the patient-practitioner social contract and therefore a violation of all four principles of bioethics. Practitioners have a professional obligation to stay up-to-date on vaccinations and not doing so is professional misconduct. Patient-centered healthcare is the ultimate goal.
**
Think
[24:1] Medical practitioners and medical-care workers have a social contract and a professional obligation to maximize their patients’ best interests and not just reduce harm but to reduce even the risk of harm. It is expected that practitioners and medical-care workers as stewards of public health take reasonable measures for reducing and preventing any spread of infectious diseases in the health care setting. Such activities include but are not limited to washing hands, wearing personal protective equipment (PPE), appropriate isolation precautions, and being vaccinated.
[24:2] The American Medical Association (AMA), 8.7 Routine Universal Immunization of Practitioners, states:
In the context of a highly transmissible disease that poses a significant medical risk for vulnerable patients or colleagues or threatens the availability of the health care workforce, particularly a disease that has the potential to become epidemic or pandemic, and for which there is an available, safe, and effective vaccine, practitioners should: a) Accept immunization.
Assess
Patient: 1) Autonomy
[24:3] Autonomy generally focuses on the patient’s choice of informed consent. Part of this “informing” necessarily includes disclosing risks of harm the practitioner or medical-care provider presents to the patient due to not being vaccinated. 45 Code of Federal Regulations 46 (Common Rule 45CFR46) is a federal law that forbids research on human subjects that increases even the risks of harm based on the bioethical principle of nonmaleficence (do no harm) as expressed in the Belmont Report. If medical care reflects human research standards, then unvaccinated practitioners and medical-care workers should not contact patients if doing so increases the risk of harm to the patient, and the patient should be made aware of such risks. Medical professional vaccine hesitancy is a failure of the professional to recognize the patient’s rights to be informed about their exposure, increased risks of harm, and the patient’s right not to be exposed to unvaccinated medical professionals.
Practitioner: 2) Beneficence & 3) Nonmaleficence
[24:4] Based on the principle of beneficence (do good), practitioners and medical-care workers must pursue the patient’s best interests. This patient-practitioner relationship is a patient-centered professional relationship. Beneficence (do good) requires washing hands, taking respiratory precautions, and getting vaccinated.
[24:5] Nonmaleficence (do no harm) requires actions such as not exposing patients and their colleagues to increased risk of harm due to a failure to get vaccinated. These professional obligations hold more weight than the practitioner’s personal beliefs and convictions of individual liberty. If getting immunized is not acceptable to a practitioner or medical-care provider, and if not getting vaccinated increases the risk of harm to the patient, then the practitioner or medical-care worker should not have patient contact until they are vaccinated.
[24:6] Vaccine hesitancy, in combination with patient contact, is a self-centered approach to health care rather than an altruistic patient-centered approach to health care. Vaccine hesitancy, at the expense of patient safety is a form of professional misconduct.
Public Policy: 4) Justice
[24:7] The principle of justice is the fair distribution of benefits and burdens. The patient-practitioner relationship is a social contract that requires that the practitioner’s role be a healer, not a harmer. Practitioners and medical-care providers who do not get vaccinated at the patient’s peril is a violation of the social principle of justice. Socially requiring, through the legislative process, that practicing practitioners and medical-care workers are vaccinated to prevent social harm is consistent with the role and function of the government towards public safety and the principle of justice. Making vaccinations mandatory is also well within the authority of healthcare institutions. Patients are already in a vulnerable state, and exposing patients to an avoidable pathogen because of vaccine hesitancy of a practitioner or medical-care worker would be an unfair and unjust distribution of benefits and burdens and a violation of the patient’s constitutional right to liberty. Practitioners and medical-care workers also have liberties, but they do not have the liberty to willfully violate their patient’s liberty by a medical team who could do more harm than good by one or more of them not getting vaccinated. Vaccine hesitancy by medical-care professionals is a violation of the patient-practitioner social contract, and therefore a violation of justice.
[24:8] Vaccine hesitancy based on individual liberty violates all four principles of autonomy (informed consent), beneficence (do good), nonmaleficence (do no harm), and justice (be fair).
Conclude
[24:9] Medical practitioners have a professional and social obligation to stay up-to-date on all vaccinations, and not doing so is professional misconduct. It is never acceptable for a practitioner or medical-care worker to increase the risk of harm to patients, other healthcare providers and staff because of personal liberty and beliefs inconsistent with evidence-based medicine. Patient-center healthcare is paramount.
[24:10] In summary, medical practitioners and healthcare workers must uphold their professional and social obligation to stay up-to-date on all vaccinations, as not doing so is considered professional misconduct. Vaccine hesitancy based on personal beliefs is not acceptable when it increases the risk of harm to patients and other healthcare providers. Ultimately, the focus should be on providing patient-centered healthcare, ensuring that the patient’s best interests are always at the forefront of medical decision-making.
**
24. Review Questions
1. Practitioners and medical-care workers have a social contract and a professional obligation to maximize their patients’ best interests and not just reduce harm but to reduce even the risk of harm.
2. Practitioners and medical-care have a professional, legal, and moral responsibility to prevent the spread of infectious diseases by:
3. Patients have the right to be informed about infectious disease exposure risks and not to be exposed to unvaccinated medical professionals.
4. The practitioner’s personal beliefs and convictions of individual liberty carry more moral weight than the professional obligation to get vaccinated.
5. Vaccine hesitancy, in combination with patient contact, is a self-centered approach to health care rather than an altruistic patient-centered approach to health care.
6. Patients are vulnerable, and to expose them to an avoidable pathogen because of vaccine hesitancy of a practitioner or medical-care worker would be an unfair and unjust distribution of benefits and burdens and a violation of the patient’s constitutional right to liberty.
7. Vaccine hesitancy based on individual liberty violates all four principles of autonomy (informed consent), beneficence (do good), nonmaleficence (do no harm), and justice (be fair).
**
CORRECT! 🙂
[24:1] Practitioners and medical-care workers have a social contract and a professional obligation to maximize their patients’ best interests and not just reduce harm but to reduce even the risk of harm. It is expected that practitioners and medical-care workers as stewards of public health take reasonable measures for reducing and preventing any spread of infectious diseases in the health care setting. Such activities include but are not limited to washing hands, wearing personal protective equipment (PPE), appropriate isolation precautions, and being vaccinated.
Wrong 😕
[24:1] Practitioners and medical-care workers have a social contract and a professional obligation to maximize their patients’ best interests and not just reduce harm but to reduce even the risk of harm. It is expected that practitioners and medical-care workers as stewards of public health take reasonable measures for reducing and preventing any spread of infectious diseases in the health care setting. Such activities include but are not limited to washing hands, wearing personal protective equipment (PPE), appropriate isolation precautions, and being vaccinated.
CORRECT! 🙂
[24:1] Practitioners and medical-care workers have a social contract and a professional obligation to maximize their patients’ best interests and not just reduce harm but to reduce even the risk of harm. It is expected that practitioners and medical-care workers as stewards of public health take reasonable measures for reducing and preventing any spread of infectious diseases in the health care setting. Such activities include but are not limited to washing hands, wearing personal protective equipment (PPE), appropriate isolation precautions, and being vaccinated.
Wrong 😕
[24:1] Practitioners and medical-care workers have a social contract and a professional obligation to maximize their patients’ best interests and not just reduce harm but to reduce even the risk of harm. It is expected that practitioners and medical-care workers as stewards of public health take reasonable measures for reducing and preventing any spread of infectious diseases in the health care setting. Such activities include but are not limited to washing hands, wearing personal protective equipment (PPE), appropriate isolation precautions, and being vaccinated.
CORRECT! 🙂
[24:3] Autonomy generally focuses on the patient’s choice of informed consent. Part of this “informing” necessarily includes disclosing risks of harm the practitioner or medical-care provider presents to the patient due to not being vaccinated. 45 Code of Federal Regulations 46 (Common Rule 45CFR46) is a federal law that forbids research on human subjects that increases even the risks of harm based on the bioethical principle of nonmaleficence (do no harm) as expressed in the Belmont Report. If medical care reflects human research standards, then unvaccinated practitioners and medical-care workers should not contact patients if doing so increases the risk of harm to the patient, and the patient should be made aware of such risks. Medical professional vaccine hesitancy is a failure of the professional to recognize the patient’s rights to be informed about their exposure, increased risks of harm, and the patient’s right not to be exposed to unvaccinated medical professionals.
Wrong 😕
[24:3] Autonomy generally focuses on the patient’s choice of informed consent. Part of this “informing” necessarily includes disclosing risks of harm the practitioner or medical-care provider presents to the patient due to not being vaccinated. 45 Code of Federal Regulations 46 (Common Rule 45CFR46) is a federal law that forbids research on human subjects that increases even the risks of harm based on the bioethical principle of nonmaleficence (do no harm) as expressed in the Belmont Report. If medical care reflects human research standards, then unvaccinated practitioners and medical-care workers should not contact patients if doing so increases the risk of harm to the patient, and the patient should be made aware of such risks. Medical professional vaccine hesitancy is a failure of the professional to recognize the patient’s rights to be informed about their exposure, increased risks of harm, and the patient’s right not to be exposed to unvaccinated medical professionals.
CORRECT! 🙂
[24:5] Nonmaleficence (do no harm) requires actions such as not exposing patients and their colleagues to increased risk of harm due to a failure to get vaccinated. These professional obligations hold more weight than the practitioner’s personal beliefs and convictions of individual liberty. If getting immunized is not accepted to a practitioner or medical-care provider, and if not getting vaccinated increases the risk of harm to the patient, then the practitioner or medical-care worker should not have any patient contact until they are vaccinated.
Wrong 😕
[24:5] Nonmaleficence (do no harm) requires actions such as not exposing patients and their colleagues to increased risk of harm due to a failure to get vaccinated. These professional obligations hold more weight than the practitioner’s personal beliefs and convictions of individual liberty. If getting immunized is not accepted to a practitioner or medical-care provider, and if not getting vaccinated increases the risk of harm to the patient, then the practitioner or medical-care worker should not have any patient contact until they are vaccinated.
CORRECT! 🙂
[24:6] Vaccine hesitancy, in combination with patient contact, is a self-centered approach to health care rather than an altruistic patient-centered approach to health care. Vaccine hesitancy, at the expense of patient safety, is a form of professional misconduct.
Wrong 😕
[24:6] Vaccine hesitancy, in combination with patient contact, is a self-centered approach to health care rather than an altruistic patient-centered approach to health care. Vaccine hesitancy, at the expense of patient safety, is a form of professional misconduct.
Wrong 😕
[24:7] The principle of justice is the fair distribution of benefits and burdens. The patient-practitioner relationship is a social contract that requires that the practitioner’s role be a healer, not a harmer. Practitioners and medical-care providers who do not get vaccinated at the patient’s peril is a violation of the social principle of justice. Socially requiring, through the legislative process, that practicing practitioners and medical-care workers are vaccinated to prevent social harm is consistent with the role and function of the government towards public safety and the principle of justice. Making vaccinations mandatory is also well within the authority of healthcare institutions. Patients are already in a vulnerable state, and exposing patients to an avoidable pathogen because of vaccine hesitancy of a practitioner or medical-care worker would be an unfair and unjust distribution of benefits and burdens and a violation of the patient’s constitutional right to liberty. Practitioners and medical-care workers also have liberties, but they do not have the liberty to willfully violate their patient’s liberty by a medical team who could do more harm than good by one or more of them not getting vaccinated. Vaccine hesitancy by medical-care professionals is a violation of the patient-practitioner social contract, and therefore a violation of justice.
CORRECT! 🙂
[24:7] The principle of justice is the fair distribution of benefits and burdens. The patient-practitioner relationship is a social contract that requires that the practitioner’s role be a healer, not a harmer. Practitioners and medical-care providers who do not get vaccinated at the patient’s peril is a violation of the social principle of justice. Socially requiring, through the legislative process, that practicing practitioners and medical-care workers are vaccinated to prevent social harm is consistent with the role and function of the government towards public safety and the principle of justice. Making vaccinations mandatory is also well within the authority of healthcare institutions. Patients are already in a vulnerable state, and exposing patients to an avoidable pathogen because of vaccine hesitancy of a practitioner or medical-care worker would be an unfair and unjust distribution of benefits and burdens and a violation of the patient’s constitutional right to liberty. Practitioners and medical-care workers also have liberties, but they do not have the liberty to willfully violate their patient’s liberty by a medical team who could do more harm than good by one or more of them not getting vaccinated. Vaccine hesitancy by medical-care professionals is a violation of the patient-practitioner social contract, and therefore a violation of justice.
CORRECT! 🙂
[24:8] Vaccine hesitancy based on personal liberty violates all four principles of autonomy (informed consent), beneficence (do good), nonmaleficence (do no harm), and justice (be fair). Altruistic patient-centered health care is central in the patient-practitioner social contract relationship.
Wrong 😕
[24:8] Vaccine hesitancy based on personal liberty violates all four principles of autonomy (informed consent), beneficence (do good), nonmaleficence (do no harm), and justice (be fair). Altruistic patient-centered health care is central in the patient-practitioner social contract relationship.
24. Clinical Vignettes
1. Sandra Roberson is a 32-year-old pharmacist who works at a local hospital. She is presenting with mild flu-like symptoms and is concerned that she may have contracted the flu. Her differential diagnosis includes influenza, a common cold, or COVID-19. As part of the hospital's policy, Sandra Roberson is required to be up-to-date on her immunizations, including the flu vaccine. An ethical question arises: Should Sandra Roberson continue to work until her diagnosis is confirmed, and should she inform her patients and colleagues that she may be infectious?
2. Dr. Fabian Johnson is a 45-year-old practitioner who works at a busy hospital. He has been hesitant to get vaccinated against COVID-19, which is a violation of the hospital's policy on mandatory vaccination for healthcare workers. Despite multiple efforts from hospital administration to encourage Dr. Johnson to get vaccinated, he still refuses to do so. Clinical symptoms: none. Differential diagnosis: none. What steps should the hospital take to ensure that Dr. Johnson is taking reasonable measures to reduce and prevent the spread of infectious diseases in the healthcare setting?
3. Dr. Bertha Davis is a 50-year-old oncologist who works at a hospital specializing in cancer treatment. Despite being informed about the risk of hepatitis B transmission and the availability of a safe and effective vaccine, Dr. Davis has not been vaccinated against hepatitis B. She has expressed concerns about the safety of the vaccine and has chosen not to get vaccinated. Clinical symptoms: none. Differential diagnosis: none. What are the implications of Dr. Davis's vaccine hesitancy for her patients and colleagues, and what steps should be taken to ensure that she is not exposing them to increased risk of harm?
4. Dr. Hayden Allen is a 60-year-old practitioner who works in a rural hospital. He has been working for the hospital for the past 25 years and is highly respected by his colleagues and patients. However, Dr. Allen is hesitant to get vaccinated against preventable diseases, including influenza, measles, and hepatitis B. Clinical symptoms: none. Differential diagnosis: none. What are the implications of Dr. Allen's vaccine hesitancy for his patients and the principle of justice, and what can be done to ensure that he fulfills his professional and ethical obligations?
5. Ms. Chloe Williams is a 35-year-old woman who is concerned about the safety of vaccines for her young daughter. She has read about possible links between vaccines and autism, and is hesitant to vaccinate her daughter as a result. Her practitioner has recommended that her daughter receive all the recommended vaccines to protect her from serious diseases. Which of the following statements most accurately reflects parental authority of a minor child?
CORRECT! 🙂
Explanation: Sandra Roberson's ethical obligation is to ensure that she is not exposing her patients to any infectious disease that she may have contracted [24:5]. She should stay home until her diagnosis is confirmed and inform her colleagues and patients that she may be infectious. This is in line with the principles of nonmaleficence and beneficence [24:4][24:5]. The principle of nonmaleficence requires that Sandra Roberson does not cause harm to her patients, and the principle of beneficence requires that she acts in the best interest of her patients [24:4][24:5]. By staying home and informing her colleagues and patients of her symptoms, she is taking appropriate measures to prevent the spread of infectious disease, and this is consistent with the AMA's guidelines for routine universal immunization of practitioners [24:2]. The other options are not appropriate as they violate the principles of nonmaleficence and beneficence by exposing patients to the risk of harm [24:5]. It is not appropriate as Sandra Roberson to be working in close proximity with patients or colleagues if she may be infectious, as this violates the principle of nonmaleficence [24:5].
Wrong 😕
Explanation: Sandra Roberson's ethical obligation is to ensure that she is not exposing her patients to any infectious disease that she may have contracted [24:5]. She should stay home until her diagnosis is confirmed and inform her colleagues and patients that she may be infectious. This is in line with the principles of nonmaleficence and beneficence [24:4][24:5]. The principle of nonmaleficence requires that Sandra Roberson does not cause harm to her patients, and the principle of beneficence requires that she acts in the best interest of her patients [24:4][24:5]. By staying home and informing her colleagues and patients of her symptoms, she is taking appropriate measures to prevent the spread of infectious disease, and this is consistent with the AMA's guidelines for routine universal immunization of practitioners [24:2]. The other options are not appropriate as they violate the principles of nonmaleficence and beneficence by exposing patients to the risk of harm [24:5]. It is not appropriate as Sandra Roberson to be working in close proximity with patients or colleagues if she may be infectious, as this violates the principle of nonmaleficence [24:5].
CORRECT! 🙂
Explanation: Healthcare workers have a professional obligation to take reasonable measures to reduce and prevent the spread of infectious diseases in the healthcare setting, including being vaccinated [24:1]. Dr. Johnson's refusal to get vaccinated is a violation of the hospital's policy on mandatory vaccination for healthcare workers and puts his patients and colleagues at risk. The hospital has a duty to ensure that its healthcare workers are taking reasonable measures to reduce and prevent the spread of infectious diseases [24:1], and it cannot allow Dr. Johnson to continue working directly with patients without complying with its policy on mandatory vaccination. Reassigning Dr. Johnson to an isolating role until he complies with the policy is an appropriate option as it still ensures that the hospital is taking reasonable measures to reduce and prevent the spread of infectious diseases [24:1], while also providing an opportunity for Dr. Johnson to comply with the policy and return to his usual patient-facing role. This approach is also more appropriate than the other options as it still allows Dr. Johnson to work as a healthcare practitioner and take part in his professional duties while ensuring the safety of patients and colleagues [24:1]. It is important to note that while the hospital has a duty to ensure that its healthcare workers are taking reasonable measures to reduce and prevent the spread of infectious diseases [24:1], it should also take into consideration the concerns and beliefs of its employees. By providing education and resources to Dr. Johnson and other hesitant employees, the hospital can work towards a culture of safety and respect that benefits both its employees and patients.
Wrong 😕
Explanation: Healthcare workers have a professional obligation to take reasonable measures to reduce and prevent the spread of infectious diseases in the healthcare setting, including being vaccinated [24:1]. Dr. Johnson's refusal to get vaccinated is a violation of the hospital's policy on mandatory vaccination for healthcare workers and puts his patients and colleagues at risk. The hospital has a duty to ensure that its healthcare workers are taking reasonable measures to reduce and prevent the spread of infectious diseases [24:1], and it cannot allow Dr. Johnson to continue working directly with patients without complying with its policy on mandatory vaccination. Reassigning Dr. Johnson to an isolating role until he complies with the policy is an appropriate option as it still ensures that the hospital is taking reasonable measures to reduce and prevent the spread of infectious diseases [24:1], while also providing an opportunity for Dr. Johnson to comply with the policy and return to his usual patient-facing role. This approach is also more appropriate than the other options as it still allows Dr. Johnson to work as a healthcare practitioner and take part in his professional duties while ensuring the safety of patients and colleagues [24:1]. It is important to note that while the hospital has a duty to ensure that its healthcare workers are taking reasonable measures to reduce and prevent the spread of infectious diseases [24:1], it should also take into consideration the concerns and beliefs of its employees. By providing education and resources to Dr. Johnson and other hesitant employees, the hospital can work towards a culture of safety and respect that benefits both its employees and patients.
CORRECT! 🙂
Explanation: Healthcare professionals have a professional and ethical obligation to not expose their patients and colleagues to increased risk of harm due to a failure to get vaccinated [24:5]. Dr. Davis's vaccine hesitancy puts her patients and colleagues at risk of hepatitis B transmission and is a failure of her professional and ethical obligations. Requiring Dr. Davis to get vaccinated and not have patient contact until she complies with the policy on mandatory vaccination, is the most appropriate course of action. This ensures that Dr. Davis is taking reasonable measures to reduce and prevent the transmission of infectious diseases in the healthcare setting, while also recognizing her professional and ethical obligations to her patients and colleagues [24:1]. The other options are not appropriate, as they do not adequately address Dr. Davis's professional and ethical obligations, and requiring Dr. Davis to wear additional PPE, may not be sufficient in reducing the risk of transmission [24:4]. It is important to note that while healthcare professionals have the right to make personal medical decisions, they also have a professional and ethical obligation to ensure that their decisions do not put their patients and colleagues at risk [24:2]. By getting vaccinated, Dr. Davis is fulfilling her professional and ethical obligations to her patients and colleagues. The hospital should provide education and resources to healthcare professionals who are hesitant to get vaccinated, in order to promote a culture of safety and respect that benefits both its employees and patients [24:7].
Wrong 😕
Explanation: Healthcare professionals have a professional and ethical obligation to not expose their patients and colleagues to increased risk of harm due to a failure to get vaccinated [24:5]. Dr. Davis's vaccine hesitancy puts her patients and colleagues at risk of hepatitis B transmission and is a failure of her professional and ethical obligations. Requiring Dr. Davis to get vaccinated and not have patient contact until she complies with the policy on mandatory vaccination, is the most appropriate course of action. This ensures that Dr. Davis is taking reasonable measures to reduce and prevent the transmission of infectious diseases in the healthcare setting, while also recognizing her professional and ethical obligations to her patients and colleagues [24:1]. The other options are not appropriate, as they do not adequately address Dr. Davis's professional and ethical obligations, and requiring Dr. Davis to wear additional PPE, may not be sufficient in reducing the risk of transmission [24:4]. It is important to note that while healthcare professionals have the right to make personal medical decisions, they also have a professional and ethical obligation to ensure that their decisions do not put their patients and colleagues at risk [24:2]. By getting vaccinated, Dr. Davis is fulfilling her professional and ethical obligations to her patients and colleagues. The hospital should provide education and resources to healthcare professionals who are hesitant to get vaccinated, in order to promote a culture of safety and respect that benefits both its employees and patients [24:7].
CORRECT! 🙂
Explanation: Healthcare professionals have a professional and ethical obligation to maximize their patients' best interests and not expose them to increased risk of harm due to a failure to get vaccinated [24:5][24:8]. Furthermore, healthcare providers who do not get vaccinated put their patients at risk and violate the social principle of justice [24:7]. Dr. Allen's vaccine hesitancy jeopardizes the health and safety of his patients and goes against his role as a healer. Requiring Dr. Allen to get vaccinated or take a leave of absence until he complies with the policy on mandatory vaccination, is the most appropriate course of action [24:5]. This ensures that Dr. Allen is taking reasonable measures to reduce and prevent the transmission of preventable diseases in the healthcare setting, while also recognizing his professional and ethical obligations to his patients and the principle of justice [24:7]. Reassigning Dr. Allen to non-patient-facing activities, may be feasible and appropriate until he complies with the policy on mandatory vaccination, depending on the needs of the hospital and its patients. The other options are not appropriate, as they do not adequately address Dr. Allen's professional and ethical obligations to his patients and the principle of justice [24:7]. It is important to note that while healthcare professionals have the right to make personal medical decisions, they also have a professional and ethical obligation to ensure that their decisions do not put their patients at risk and violate the principle of justice [24:8]. By getting vaccinated or taking a leave of absence until he complies with the policy on mandatory vaccination, Dr. Allen is fulfilling his professional and ethical obligations to his patients and the community [24:5][24:8]. The hospital should provide education and resources to healthcare professionals who are hesitant to get vaccinated, in order to promote a culture of safety and respect that benefits both its employees and patients [24:1].
Wrong 😕
Explanation: Healthcare professionals have a professional and ethical obligation to maximize their patients' best interests and not expose them to increased risk of harm due to a failure to get vaccinated [24:5][24:8]. Furthermore, healthcare providers who do not get vaccinated put their patients at risk and violate the social principle of justice [24:7]. Dr. Allen's vaccine hesitancy jeopardizes the health and safety of his patients and goes against his role as a healer. Requiring Dr. Allen to get vaccinated or take a leave of absence until he complies with the policy on mandatory vaccination, is the most appropriate course of action [24:5]. This ensures that Dr. Allen is taking reasonable measures to reduce and prevent the transmission of preventable diseases in the healthcare setting, while also recognizing his professional and ethical obligations to his patients and the principle of justice [24:7]. Reassigning Dr. Allen to non-patient-facing activities, may be feasible and appropriate until he complies with the policy on mandatory vaccination, depending on the needs of the hospital and its patients. The other options are not appropriate, as they do not adequately address Dr. Allen's professional and ethical obligations to his patients and the principle of justice [24:7]. It is important to note that while healthcare professionals have the right to make personal medical decisions, they also have a professional and ethical obligation to ensure that their decisions do not put their patients at risk and violate the principle of justice [24:8]. By getting vaccinated or taking a leave of absence until he complies with the policy on mandatory vaccination, Dr. Allen is fulfilling his professional and ethical obligations to his patients and the community [24:5][24:8]. The hospital should provide education and resources to healthcare professionals who are hesitant to get vaccinated, in order to promote a culture of safety and respect that benefits both its employees and patients [24:1].
CORRECT! 🙂
Explanation: Ms. Williams' concerns about the safety of vaccines are understandable, but it is important to consider the potential risks and benefits of vaccination in the context of her daughter's health [24:1]. While Ms. Williams has the right to make decisions regarding her daughter's health care, she also has a responsibility to reduce the risk of harm to her daughter and others [24:1]. Vaccines are important for protecting individuals from serious diseases and for preventing outbreaks of infectious diseases in the community [24:1]. Ms. Williams should be allowed to make her own decision regarding vaccination for her daughter, but it is important that she is informed of the risks and benefits of vaccination and the potential consequences of not vaccinating [24:1]. It is also important that her practitioner address her concerns about vaccine safety and provide accurate information to help her make an informed decision [24:1]. Ultimately, it is Ms. Williams' responsibility to make a decision that is in her daughter's best interest and the best interest of public health [24:1].
Wrong 😕
Explanation: Ms. Williams' concerns about the safety of vaccines are understandable, but it is important to consider the potential risks and benefits of vaccination in the context of her daughter's health [24:1]. While Ms. Williams has the right to make decisions regarding her daughter's health care, she also has a responsibility to reduce the risk of harm to her daughter and others [24:1]. Vaccines are important for protecting individuals from serious diseases and for preventing outbreaks of infectious diseases in the community [24:1]. Ms. Williams should be allowed to make her own decision regarding vaccination for her daughter, but it is important that she is informed of the risks and benefits of vaccination and the potential consequences of not vaccinating [24:1]. It is also important that her practitioner address her concerns about vaccine safety and provide accurate information to help her make an informed decision [24:1]. Ultimately, it is Ms. Williams' responsibility to make a decision that is in her daughter's best interest and the best interest of public health [24:1].
**
24. Reflection Vignette
1. Ms. Samantha Lee, a 35-year-old nurse practitioner, has decided not to get the COVID-19 vaccine. She believes that being forced to be vaccinated would violate her constitutional rights and liberties. The differential diagnosis includes vaccine hesitancy, individual rights, and public health. The practitioner explains to Ms. Lee that getting vaccinated not only protects herself but also those around her, including vulnerable patients and colleagues. The practitioner emphasizes that the COVID-19 vaccine has been rigorously tested and approved by the FDA for emergency use, and the benefits outweigh the risks. The practitioner also emphasizes that vaccination is a crucial public health measure to control the spread of the virus and prevent further illness and death. The practitioner offers to provide additional information and resources to Ms. Lee to address her concerns and make an informed decision about vaccination. The practitioner reiterates that getting vaccinated is a personal and professional responsibility to protect oneself and others in the community
Think
Assess
Patient: Autonomy
Practitioner: Beneficence & Nonmaleficence
Public Policy: Justice
Conclude
**
2. Dr. John Smith, a 45-year-old physician, has decided not to get the COVID-19 vaccine. He believes that there is a government conspiracy for the vaccination and that the vaccine's safety and efficacy are fraudulent. The differential diagnosis includes conspiracy theories, vaccine misinformation, and public health. The practitioner explains to Dr. Smith that the COVID-19 vaccine has been rigorously tested and approved by the FDA for emergency use, and the benefits outweigh the risks. The practitioner emphasizes that vaccination is a crucial public health measure to control the spread of the virus and prevent further illness and death. The practitioner also acknowledges that there is a lot of misinformation and conspiracy theories circulating about the vaccine and offers to provide accurate information and resources to address Dr. Smith's concerns. The practitioner reiterates that getting vaccinated is a personal and professional responsibility to protect oneself and others in the community. The practitioner encourages Dr. Smith to consult with other trusted healthcare professionals and reliable sources to make an informed decision about vaccination.
Think
Assess
Patient: Autonomy
Practitioner: Beneficence & Nonmaleficence
Public Policy: Justice
Conclude
***
