Over the last few weeks, we’ve seen more online discussions about whether or not it’s okay for doctors to refuse to see patients who are unvaccinated against COVID-19. Recently, we had the case of a physician in Alabama who declined to see patients who are not vaccinated. I also heard last week from a trusted contact in the northeast, saying that her specialist physician, had written to patients basically saying she would ditch them if they were not vaccinated.
This raises an interesting discussion, and one that I have strong feelings about.
Firstly, it’s likely that only small numbers of physicians think like this, so let’s not conflate the figures. It is certainly enough though to be noticed as of August 2021—and that number only seems set to grow.
These sorts of discussions get to the fundamentals of the Hippocratic oath and what it means to be a physician. My uncle once sent me a Christmas card with the following quote:
“Doctors are subject to certain professional obligations. The Hippocratic Oath demands that they treat everyone to the same high standard regardless of gender, nationality, religion or politeness! They must even afford the same standards of care to a murderer and the victim’s family. Sometimes, this must be challenging. Sometimes, it must seem unfair. But they have a duty — one that must be done without prejudice or discrimination”
I can’t say who the quote comes from, but I like it. The Hippocratic oath demands that we as physicians exercise our duties in the utmost non-judgmental way. Leave the judgement to God. We are there to treat our patients regardless of their life choices.
Think about it; we treat murderers, rapists, people who have committed the most heinous crimes. In the hospital, we frequently see patients who are chained to the bed, coming to us from jail, surrounded by police officers. We don’t refuse to treat them. Neither do we check patients’ criminal backgrounds before they register at a practice.
A decision regarding being vaccinated is one that we can only help with education and gentle persuasion. I have had many conversations over the last several months, recalling a few notable ones in particular—when people with major risk factors such as diabetes or advanced lung disease, have declined the COVID vaccine. I have looked into their eyes and told them that in my honest opinion they are making a mistake, and to keep thinking seriously about it. But in the end, it’s their choice. Nothing for me will supersede civil liberties, informed consent, and adults never being coerced into any medical therapeutic or procedure. That’s as far as we can take it. We don’t treat them differently in the future, any more than someone who has made a decision to keep smoking, drinking, doing drugs, riding a motorcycle, or filling their bodies with the wrong food every day. Adults make their own decisions, rightly or wrongly, all the time.
Finally, if COVID-19 was a stable virus like smallpox or polio, where vaccines show almost 100 percent efficacy, with a realistic complete elimination strategy—then maybe (maybe) this would be a different argument. But I’m afraid that is not the case from all the data so far. Albeit different viruses, the COVID-19 vaccines look set to be more like influenza vaccines—with the aim of significantly reducing disease severity for an endemic virus. If people are not vaccinated, other precautions can continue to be taken including screening and testing.
I would suggest any physician who is refusing to treat patients because they are not vaccinated against COVID-19, takes a long hard look in the mirror.
Suneel Dhand is a physician, writer, and YouTuber. He is Founder at MedStoic Lifestyle Medicine and DocsDox . Follow him on YouTube and Facebook.
As a former nurse, I find it shocking that any physician would refuse to see patients who are hesitant about this vaccine because there are many researchers around the world who also have valid concerns, and there are also many highly trained and credible physicians who are quite outspoken in their hesitancy as well. I will say that I would welcome finding out if my personal physicians were among this group refusing to treat the unvaccinated because it would make for a very easy decision for me to immediately find new physicians. The longer I am away from the active health care scene in America, the more I believe that people need to take accountability for their health and do all they can to optimize their condition with good nutrition, exercise, and other health-promoting practices. The time for blind trust and uninformed popping of prescriptions is over.
Amen. Withholding treatment because the patient didn’t do what you wish is the height of arrogance. If George Washington refused to be bled and the doctors left him alone, he may have lived longer. The point being that we may often be certain that we are right but being certain does not make it so. Just imagine this vaccine turns out to be like the one developed for dengue……
Not every physician works in a hospital or a big clinic. My little independent practice offers an alternative to our regional hospital network’s monopoly on most health services. I have small staff and a small office yet we still see our patients with respiratory symptoms and test patients for COVID. We’ve reconstructed our spaces and improved ventilation to reduce airborne transmission of virus to protect my staff, other patients and to reduce the risk I’ll bring the virus home to my family.
In that context, it’s ethical and reasonable to consider requiring patients to vaccinate if they want care at our office since that reduces these risks as well.
I’m strongly considering this for new patients. My current patients who haven’t vaccinated trouble me but I’m working hard at improving my Motivational Interviewing skills and working with them on their decision.