Where Does the Liberty of Health Care Workers End?

"The right to swing my fist ends where the other man's nose begins," wrote Oliver Wendell Holmes, Jr. Your liberty is constrained by the equal liberty of others to be left unharmed.

Holmes' principle applies when it comes to health care workers who endanger patients by refusing to get vaccinated against influenza. Many Americans acquire influenza infections from health care workers every year. Such infections are especially dangerous for the newborn, the elderly, and the immuno-compromised. Influenza vaccination rates among health care workers in the U.S. hovers around 50 percent. 

University of Pennsylvania bioethicist Arthur Caplan argues in The Lancet that influenza vaccination should be made a mandatory condition of employment for all health care workers. He writes: 

First, every code of ethics adopted by physicians, nurses, nurses aides, social workers, pharmacists, and other health-care professionals states very clearly, succinctly, and loftily that the interests of patients must come ahead of anyone else's…

Second, all health-care workers are obligated to honour the core medical ethics requirement of "First Do No Harm"…

Lastly, health-care workers have a special duty towards the vulnerable who cannot protect themselves…

The case from professional ethics for influenza vaccination mandates is as strong a case as can be built in terms of duties and obligations. However, there is yet still another powerful moral reason to mandate vaccination for all professionals working in health care. By not vaccinating themselves, health-care workers feed vaccine fears, reinforce anti-vaccine sentiments, and set a dismally poor example for the public. Invoking personal choice in the face of obvious patient need for protection and ignoring the overwhelming safety of vaccination simply feeds public distrust of vaccination. At a time when epidemics of measles, whooping cough, and mumps are sweeping through many nations as a result of parental decisions not to vaccinate their children, is it not the duty of every health-care worker to provide a role model of what the right course of action is to take with respect to vaccination? 

I think that Caplan makes a strong moral case for a vaccination mandate. In any case, I protect myself against careless health care workers by getting a flu vaccination every fall. 

Comments

[Eric Cartman]

As long as it is forced on the unwilling then it ok with you? fucking twit bailey

[affenkopf]

Health care workers should be free not to vacinate and their employers should be free to fire them for not vacinating.

[yonemoto]

exactly.

What if you had an identical twin who got the flu vaccine and wound up with a really horrible side-effect. Should you be forced to do it? No. You should have recourse to talk to your manager and decide if you should switch jobs, or if you were really good at your job, create an exception.

[ScienceSkeptic]

Ron Bailey is to science and health reporting as military music is to music. His faith in the fear-mongers at the CDC is appalling.

[CDC]

We're quite adept at fear-mongering.

[Metazoan]

What fear-mongering? Every time I've seen a press release from the CDC, it's been quite calm. Is urging people to get vaccines fear-mongering, or is pretending that vaccines are hell-sent agents of the antichrist fear-mongering?

[Mnemone Jones]

Ron Bailey is to science and health reporting as military music is to music.

Taps is kinda nice. Except at funerals, then it's just depressing.

His faith in the fear-mongers at the CDC is appalling.

It takes no faith to know it's a really fucking bad plan to put a person in intimate proximity with sick and/or injured people without taking precautions.

[CSPI]

Hey... we're no slouches in the fearmongering department.

Coming next: The dangers of second-hand salt.

[Harvard's Top Men]

You're falling behind.

[strat]

I love that Wikipedia entry. The simple fact that it contains the phrase "emit toxins" sets off a few pseudoscience alarm bells.

Someone send these people a copy of Paracelsus' writings.

"Alle Ding' sind Gift, und nichts ohn' Gift; allein die Dosis macht, da? ein Ding kein Gift ist."

[Tacos mmm...]

Next, they'll be making surgeons wear GLOVES. What kind of world would that be?

[Agammamon]

"...Lastly, health-care workers have a special duty towards the vulnerable who cannot protect themselves..."

I strongly disgree with this part - It sets health care workers for a lot of legal trouble if the violate some prosecuter's idea of their standard of duty is.

Other than that, if their employer was allowed to set this as a requirement of employment and actually *be able* to fire those who fail to comply this would be a minor issue.

As it is, nowadays we have to accomodate increasingly stupid personal choices in the workplace by law.

[robc]

Despite CMS's comment below, I think we are done. The King of Greece (or whatever part of greece) has it right.

[Episiarch]

Exactly. If employers simply mandated vaccination as a condition of employment, I don't see where there would be a problem. Smart people would go to places where it was mandated, and no one would be "forced" to do anything.

But that's a little too simple for statists.

[Tacos mmm...]

It pretty much is already. Discussion of these mandates are a little behind the ball.

[rather]

health care workers are under the impression that the gloves they wear are strictly for their protection. Dirty hands/gloves are the riskiest factor

[ClubMedSux]

This is gonna be good... Can somebody pass me the popcorn?

[robc]

Speaking of popcorn, my garage may actually be too warm for my sorta-saison.

[Mark Bittman]

Enjoy that beer and popcorn while you can, lard-ass. If I get my way, you'll be eating unsalted tofu and washing it down with bottled water.

[BigBob]

Too warm for saison? Do you live in hell?

[Brett L]

Show me flu vaccines cause lower occurance of flu in healthy, low-risk adult populations, to which most health care workers belong, and I'll get up there on the bandwagon with you. I work with a bunch of epidemiologists and the evidence they've presented thus far is poor.

[Smallpox]

Yeah, vaccinations are worthless.

[Rev. Blue Moon]

Show me flu vaccines cause lower occurance of flu in healthy, low-risk adult populations, to which most health care workers belong

Well, it is not about the workers, it is about the patients, many of whom are elderly, young, or immuno-compromised, which was right there in the post. Influenza is spread largely in the asymptomatic period, so there is that, too.

[Brett L]

Right. So in the 1% of vaccinated workers who become symptomatic who get a shot and go back to work they are spreading flu. The point of vaccination is that it will prevent active infections from being a vector when, as pointed out above, the primary method of transmission is often not active infection. Vaccinating health workers is about as effective as wiping down the light fixtures in preventing influenza transmission. As best the epidemiologists can tell, it is statistically inconsequential.

[SIV]

Move those goal posts!

Show me flu vaccines cause lower occurance of flu in healthy, low-risk adult populations, to which most health care workers belong, and I'll get up there on the bandwagon with you.

Overall, in years when the vaccine and circulating viruses are well-matched, influenza vaccines can be expected to reduce laboratory-confirmed influenza by approximately 70% to 90% in healthy adults

[Ron Bailey]

SIV: Thanks.

[SIV]

You're welcome.

[Brett L]

From your post:
"For example, a study by Bridges et al. (JAMA 2000) among healthy adults found that the inactivated influenza was 86% effective against laboratory-confirmed influenza, but only 10% effectiveness against all respiratory illnesses in the same population and year."

The important component is whether current flu strains in the wild are "well-matched" with strains in the vaccine and that is a total crapshoot.

[Tacos mmm...]

but only 10% effectiveness against all respiratory illnesses in the same population and year.

Most respiratory illnesses are not influenza. You wouldn't expect an influenza vaccination to be effective against a rhinovirus, metapneumovirus or RSV. But those aren't major slayers of the elderly, either.

[Mensan]

The important component is whether current flu strains in the wild are "well-matched" with strains in the vaccine and that is a total crapshoot.

Of course, it's a guess; it's impossible to predict the exact mutations the viruses will undergo. However, by tracking current infections and recorded genetic drift, most of the time the vaccine producers make fairly accurate educated guesses. It's when there is a major shift, such as when an influenza jumps species, that the vaccines are completely ineffective.

[Brett L]

I guess the other important thing is that I am in no way opposed to producing a vaccine for interested parties, and I strongly agree that at-risk people should (if not at such high risk that even the vaccine would be dangerous) get vaccinated. However, this is neither as effective or as likely to save huge numbers of lives as MMR or other infant/child vaccinations.

[Tacos mmm...]

It's less effective to vaccinate the populations most at risk of severe complications - the elderly and immunsupressed, as they're least likely to develop and effective response following vaccination. Herd immunity is how vaccines work; we need to be vaccinating the most common vectors of respiratory infections, children and healthcare workers.

[Ron Bailey]

BL: Foiled by threading -- See my intended response to your first posting on the evidence that vaccination works to prevent mortality among patients below. I cite just one review study, but there are others.

[Lost_In_Translation]

And what are the risks posed by having patients sit in waiting rooms full of sick people for over an hour a visit. I imagine the risk of a single heathcare worker pales in comparison to the breeding ground of death and disease that is the wiating area.

[Libertymike]

Should the failure of a health care worker to vaccinate be the direct and proximate cause of injury or death to a patient actually treated by the unvaccinated health care worker, the tort system can handle it.

Observe how Messrs. Bailey and Caplan have no problem resorting to the same totalitarian scare tactics employed by smelly, tax feeding statists.

[tarran]

One need not wait for the tors system to handle injuries. Voluntary regulation will do the tric nicely.

For example, if Blue Cross Blue Shield refuse to pay for treatment at hospitals that employ unvaccinated people, hospitals could rationally and freely choose whether to honor Blue Cross Blue Shield's demands or to tell them to pound sand.

[Tacos mmm...]

The TJC will do this for medicare.

[Brian E]

"Should the failure of a health care worker to vaccinate be the direct and proximate cause of injury or death to a patient actually treated by the unvaccinated health care worker, the tort system can handle it."

Are you trolling, or do you honestly believe that the tort system can raise the dead?

[R C Dean]

I don't know how you could determine that sick patient X caught the flu from unvaccinated employee Z.

[Tacos mmm...]

The tort system can do anything, apparently.

[Libertymike]

Vaccinations save lives!

HAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA!

[Rev. Blue Moon]

You are the Dumbest thing since Dumb came to Dumbtown.

[tarran]

LM, perhaps you can enlighten me. If the polio vaccine, for example, does not work, why are the number of new cases so many orders of magnitude less than they were in the 40's?

[JD]

The decrease in polio can largely be explained by improved sanitation--witness the issues with eradicating it in India despite an intensive vaccination effort.

However, the same can't explain the virtual eradication of measles, rubella, pertussis, diphtheria, etc. over the last 50 years, and how they reappear so quickly once vaccination rates drop--witness the reemergence of measles in the UK after the MMR vaccine scare there.

[Libertymike]

Do you really buy all of the propaganda?

[Mnemone Jones]

When's the last time you ran into someone with diphtheria?

Or do you think they round up all the sick into camps, in furtherance of "the conspiracy"?

[Libertymike]

Yeah, those measles and diptherias were threatening to wipe out the human race before them thar new fangled medicines they call vaccseeens came hither.

[tarran]

LM,

Way to move the fucking goalposts. Measles won't wipe out the human race. It can kill individuals though and is a major nuiscance to the fit.

If I walked through the city firing a gun at someone every 15 minutes, I wouldn't threaten the human race, but the death toll over a lifetime would be horrific.

The fact that the incidence of disease seems to collapse after the application of vaccines and returns after people start avoiding them in sufficient numbers is one hell of an indication that they work.

[Metazoan]

HURR DURR SCIENCE IS PROPAGANDA!! DURR

[Tacos mmm...]

Clearly, because infections in the US didn't abate until Jonas Salk announced the invention of the toilet in 1955.

[uaware?]

Is Bailey trolling us?

[Jenny McCarthy]

Vaccines cause autism you know.

[Libertymike]

For some reason, it is said that, back in the day, you actually caused erections.

[Nipplemancer]

tits or gtfo

[Old Mexican]

Holmes' principle applies when it comes to health care workers who endanger patients by refusing to get vaccinated against influenza.

Regardless of the effectiveness of such vaccines...

Invoking personal choice in the face of obvious patient need for protection and ignoring the overwhelming safety of vaccination simply feeds public distrust [???] of vaccination.

Yet another utilitarian argument. Despite the fact that one cannot control minds, some utilitarians will seriously forward such Galbraithian arguments like the above.

is it not the duty of every health-care worker to provide a role model of what the right course of action is to take with respect to vaccination?

Not at all. Healthcare workers are supposed to deliver a ware for which they are being paid, and be held liable if any action on their part irreparably damaged a person's property - in this case, his or her own body.

If the threat of legal action or higher insurance premiums entices a healthcare provider to get vaccinated, then there will be no need for mandates.

[tarran]

^^^^^THIS

[Tacos mmm...]

If the threat of legal action or higher insurance premiums entices a healthcare provider to get vaccinated, then there will be no need for mandates.

People infected by healthcare providers will likely never know it, as the doctor or nurse would have bee in the asymptomatic infectious stage, and influenza present in the community at large. This makes tort a poor solution.

[Old Mexican]

Re: Tacos mmm...

People infected by healthcare providers will likely never know it, as the doctor or nurse would have bee in the asymptomatic infectious stage, and influenza present in the community at large. This makes tort a poor solution.

You just undermined the very point you were trying to make, THmmm...

* If you cannot know you were wronged, how can you prove it?
* If you cannot prove you were wronged, how can you know it?
* And if you cannot know nor prove, then WHY THE FUCK WOULD YOU ASK ANOTHER UNRELATED PERSON TO DO SOMETHING HE OR SHE DOES NOT WANT TO DO, JUST TO GIVE YOU "PEACE OF MIND"?

[Ray]

Do I know any jokes about sodium?

Na...

[Consumptive]

There is also lots of non-healthcare workers working at hospitals - janitors, maintenance - bio-engineering, security - and they are often in patients rooms or right nearby - the biggest problem in hospitals of course isn't healthcare workers but patients and their families - you can't stop people seeing their family members in their rooms because they refused a flu shot.

People should get their flu shots.

And actual healthcare workers are forced to do a lot of things like wash their hands - should surgeons not be forced to wash their hands before surgery because they have some silly belief in infections?

Instead of 'forced' why not make annual flu shots a condition of employment?

[SIV]

Instead of 'forced' why not make annual flu shots a condition of employment?

The CDC recommends health care personnel get flu shots. Why would an employer not require it (fucking Unions maybe?)? The shot is cheap, safe, and, when it matches the seasonal flu strain, very effective

[Metazoan]

+100,000. That's exactly what I was thinking- what kind of hospital would allow its employees to work around sick patients and not get immunized?

[Hugh Akston]

Medical workers should have every liberty to refuse vaccinations if they want to.

Medical facilities should have every liberty to fire or refuse to hire medical workers who fail to produce proof of vaccination annually.

[Libertymike]

If such medical facility is not a rent seeking tax feeder. Otherwise, tough shit.

[Rev. Blue Moon]

Wow, LM, never thought I would see you endorse the "ROADZ!" argument.

[Libertymike]

Hardly!

Besides, if you know me, you know that I utterly loathe tax feeding and rent seeking entities, just on general anarcho-free enterprise-individualism grounds.

[Rev. Blue Moon]

Then your implied argument makes no sense. Do you want every business to undergo an extensive review to see if they are a "tax contributor" or a "tax feeder" (as you say) and then determine what their liberties should be when bumped against those designations? Talk about growing the bureaucracy and limiting freedom.

[Libertymike]

Who says I want any bureacracy, any administrative agencies, any tax feeding parasites, any state?

[Rev. Blue Moon]

Hugh Akston said "Medical facilities should have the liberty to..."

You said (impliedly) "only if they are not tax feeders".

Logically, then, you are saying that "tax feeder" institutions should not have liberty. In order to suspend the liberty of a "tax feeder" institution, you have to identify them and use government to enforce the suspension of liberty.

If you can't follow your own argument, then you need to think a little more deeply before posting.

[Libertymike]

Reading comnprehension fail?

In a free society, there are no tax feeders and rent seekers. It is an absolute.

Thus, the US empire and the British empire are not free societies. Therefore, it is the duty of all friends of liberty in such un-free societies to make life hell for all statists and their allies. IOW, it is our duty to derail Leviathan and its legions of rent seekers, tax feeders, regulators, busybodies, snoops, informants, thugs and parasites (that's redundant, I know).

Of course, defending liberty means that one must oppose each and every initiative of the state to further control, monitor, regulate, restrict and tax individuals.

Necessarily, this includes forced vaccinations. Thus, if the argument is offered that the mandated vaccinations be made a condition of employment by a tax feeding or rent seeking entity and would, presumably, be harmonious with liberty of contract, a friend of liberty would nevertheless reject such a sophomoric argument as it contains a false premise.

The tax feeder or rent seeker is the state. It would be furthering the state's avowed interest in vaccinating us all.

The rent seeker and the tax feeder are the state. They want to impose their will upon you by force.

Thus, your point is frivolous as I have not advocated the creation of a new agency or bureaucracy nor have I advocated for the diminution of any individual liberty.

Remember, reading comprehension. The state does not have "rights" or "liberty" - Get it?

[Old Mexican]

Re: Hugh Akston,

Medical facilities should have [the right] to fire or refuse to hire medical workers who fail to produce proof of vaccination annually.

/\ This /\

[tarran]

^^^^^^^ THIS TOOO!

[SugarFree]

Some vaccinated doctor gets the flu. Doctor sneezes on some guy's junk during a scrotum ablation. Dude sleeps around. Dickfluenza ravages America, and then the world.

Think about it.

[Episiarch]

No one wants to hear how you started the AIDS epidemic, dude.

[Pro Libertate]

That was started by humans sleeping with monke--hey, wait a second. You mean it was SF?

[Episiarch]

NutraSweet's sole mission in life is to give AIDS back to the monkeys.

[SugarFree]

I told you you didn't want to know why I spent so much time in monkey bathhouses.

[Pro Libertate]

He'd better hurry up--they're apparently planning some sort of, I dunno, world of monkeys?

[T]

So I'm the only one disturbed by the phrase "scrotum ablation"? And really, does such a procedure require a licensed MD? More rent-seeeking by the AMA, I tell you.

[Pro Libertate]

Scrotum ablation has something to do with rear entry from space.

[Hugh Akston]

Nature adores a vacuum.

[Pro Libertate]

LEO: Low-Earth Oral.

[NoVAHockey]

Opens August 5
http://www.imdb.com/title/tt1318514/

[Pro Libertate]

Sphere of Simians?

[Chupacabra]

Wasn't that a Michael Bay movie?

[capitol l]

Holmes' principle applies when it comes to health care workers food workers, retail clerks, bank tellers, cab drivers, baristas, fedex delivery guys, salesmen, lawyers, accountants, mechanics, etc, etc, who endanger patients customers by refusing to get vaccinated against influenza.

So really, mandatory vaccination for all citizens is the way to go. Even though flu shots aren't even close to 100% effective, it will assuage our fears.

[Libertymike]

"Not even close to 100% effective"

Talk about litotes.

[Rev. Blue Moon]

Put up or shut up, fucko.

[capitol l]

Doesn't a litote need to be a double negative.

As in:

"Libertymike's views on the Civil War aren't uninsane."

[Libertymike]

You mean the War of Northern Agression?

The war made by the mass murderers, Lincoln, Grant (the guy who kept his slaves during the war) and Sherman?

The war in which tens of thousands of women and children were murdered by the bluecoat heros?

The very heros who later mass murdered the Sioux and Cheyenne and the Arapaho?

The very same heros who claimed that they made war in order to save the union and not to free the slaves?

The very same heros who frequently owned slaves themselves and who, at any rate, almost universally, relegated the black man to inferior status, both de facto and de jure?

The very same heros who fancied themselves as great humanitarians while slaughtering hundreds of thousands for the grand purpose of keeping the union together?

As if any true libertarian / friend of liberty does not understand that Lincoln was not a mass murderering piece of ugly shit.

[Tacos mmm...]

You mean the War of Northern Agression?

The Confederacy was pretty eager for war; the conflict at Fort Sumter could easily have been avoided. It was probably the worst mistake of the Confederate government to seek military conflict before recognition by European powers like Britain.

The very same heros who claimed that they made war in order to save the union and not to free the slaves?

Because the latter is such a terrible thing? I don't think that reads quite the way you intend.

[capitol l]

Oh Jesus.

[Rev. Blue Moon]

Only a Faustian bargain can save us from the long-running Civil War H&R infighting. Jesus can't help you now.

[Libertymike]

Notice how Blue Moon fails to address the facts. Typical.

[DanD]

I don't know the specific legal status or feasibility of this, but I think the ideal would be for hospitals to mandate influenza vaccinations as a condition of employment. Employees take the job with the understanding that they have to comply.

This is fully in line with what I understand the libertarian philosophy to be: that employers can hire whomever they want under whatever conditions they establish, and the employees choose whichever employer they wish, propose whatever conditions of employment they wish prior to hiring, and leave the job at any time unless contractually obligated.

[MP]

Second, all health-care workers are obligated to honour the core medical ethics requirement of "First Do No Harm"

Are they any more obligated (from a legal standpoint) than the rest of society? Because if we're talking just a moral obligation, then it has no bearing on a legal mandate.

[robc]

They have an ethical obligation.

Which is different from either a moral obligation or a legal obligation.

[Clich? Bandit]

to be padantic, I would argue ethics are a subset of morals.

[Ron Bailey]

BL: You might want to take a look at this 2005 review article[PDF] on the topic. From the article:

3.1. Does vaccinating HCWs protect those at risk?
The main evidence comes from two cluster-randomised controlled trials (RCTs) performed in the 1990s in long- term care geriatric hospitals in Scotland: Carman et al. [10] and Potter et al. [11] (Table 2). Both trials were of reason- able quality, of appropriate cluster design (although small numbers of clusters) and used methods to allow for base- line imbalance in potential confounders. In Carman et al. [10] the method of cluster analysis was not clearly reported. Both demonstrated clinically significant reductions in mor- tality when a staff vaccination programme was introduced. In the Potter trial [11], a reduction from 17% to 10% was reported, with a p-value (adjusted for cluster design) of 0.013. The odds ratio (OR) was 0.56 (95% CI 0.4, 0.8) but these confidence intervals did not appear to take account of the clustered design and should be interpreted with cau- tion. In the main trial, Carman, 20 hospitals were stratified, paired for patient vaccination policy and size, and randomly assigned within each pair to a programme of offering vac- cination to all HCWs, or no programme. In the programme arm 51% of HCWs were vaccinated, and 5% in the con- trol arm. The vaccine was a good match to circulating virus. Uncorrected mortality was 13.6% in the vaccinated arm com- pared to 22.4% in control arm (OR 0.58, 95% CI 0.40?0.84, p = 0.014). The difference remained statistically significant when the analysis was adjusted for individual confounders. When all confounders, i.e., Barthel score, age, sex and vaccination of patients were adjusted for simultaneously, the result was of borderline statistical significance (OR = 0.61, 95% CI 0.36?1.04).

[Lost_In_Translation]

An OR of .61 (which looks like a very slight correlation, .5 meaning 50/50 or no difference) is not a great improvement and certainly not as good as many other correlations (like lung cancer and smoking or skin cancer and sunbathing). Basically, you have a slightly better chance of not getting the flu by taking a vaccine, but you might also have to put up with flu-like symptoms while your body is taking on the vaccine and also the added expense of the vaccine itself. In other words, I agree with BrettL unless I'm reading your post wrong.

[JD]

An odds radio of 0.61 means that patients in hospitals in the program arm experienced 61% of the mortality experienced by those in the control hospitals.

However, the 95% confidence interval (mean +/- 2SD) was wide (0.36?1.04); at an odds ratio of 1.00 there is no difference in mortality between the groups.

[Lost_In_Translation]

So statistically there could be at best a 3:1 ratio of incidents for the control group and the vaccinated and at worst no difference, with the mean being

[Brett L]

You can definitely say that flu vaccines do not induce new net mortality dangers.

[Lost_In_Translation]

Nobody should be forced to get a vaccine of any kind. In fact, some people react very badly to vaccines. Should they be forced to suffer because they might get a disease and "might" come in contact with a susceptible patient? Hell no!

Hospitals already take many precautions with immune system deficient people and vaccines don't always prevent the disease anyway, as they're the crudest form of prevention around, hoping that a body will respond to build up an appropriate immune level.

In other words, the argument is complete bullshit.

[SIV]

Nobody should be forced to get a vaccine of any kind.

Requiring a vaccine as condition of employment is NOT force.

[Lost_In_Translation]

When the premise of the article started with a quote from "Oliver Wendell Holmes" the assumption is that the article is about government mandates of requirements for occupation.

[SIV]

University of Pennsylvania bioethicist Arthur Caplan argues in The Lancet that influenza vaccination should be made a mandatory condition of employment for all health care workers.

In the excerpt he argues for a mandate based on professional ethics.
That doesn't sound like "there oughta be a law" talk.

[Lost_In_Translation]

well first you have to make the moral case. Once that is won, you proceed to legal requirements. Once it becomes "obvious" that people should do something, you have to take care of those "that don't get it".

[Libertymike]

SIV, do you think that professional ethics exist entirely without the realm of the law?

The answer is absolutely NOT. Many of the regulations issued by state licensing boards are taken directly, often by verbatim, from the rules of ethics of the given profession. T

[Rev. Blue Moon]

Obviously the solution is not have ethicists.

LM, how hard is it to post from the short bus?

[Lost_In_Translation]

Um, LM was just pointing out reality and how professionals need to be careful about making the ethical argument, which will be taken as gospel truth by the government, regardless of industrial cost.

[Rev. Blue Moon]

LIT, this is basically akin to saying that inventors and scientists "need to be careful" because, historically, government takes their inventions/discoveries and puts them to horrific use. And that is patent nonsense:

"Gun manufacturers should be careful because other people use their products in a dangerous way!" "Car manufacturers..."

Well, you get the point.

[Lost_In_Translation]

Ummm, No.

Creating something and giving professional opinion with wording that indicates support of government regulation is completely different.

[Libertymike]

The point is the law becomes what a professional society think it ought to be.

For example, the Board of Registration in Medicine regulates the practice of medicine and licenses physicians in Massachusetts. Its regulations are the law and the courts have said on countless occaisons that the regulations promulgated by the Board are entitled to great deference and are presumed to be constitutional.

The Board is dominated by allopathic loving doctors who are members of, and contribuotrs to, the Mass Medical Society and the American Medical Association which, of course, have some opinions of their own. They are called ethics. These have a way of being adopted whole by the Board.

THe same holds true with other professions in Massachusetts as well as other states.

In Massachusetts, a physician can not have sexual relations with a patient - even if the relations are consensual. This is a rule of the Board. It is also a canon of medical ethics of most allopathically based medical organizations.

Thus, I prove my point.

[FuNu]

Number 98

[Paul]

University of Pennsylvania bioethicist Arthur Caplan argues in The Lancet that influenza vaccination should be made a mandatory condition of employment for all health care workers.

It pretty much is. I have to get a flu shot every year, or sign an I'm-utterly-crazy-and-believe-that-aspertame-causes-autism waver to not get it. And I'm not in direct patient care.

[SIV]

Good to hear.Hospitals should freely disclose this to potential patients.

[Hugh Akston]

Just to be clear, though, SugarFree does cause autism. Jenny McCarthy knows this intimately. Her whole anti-vaccine campaign is just a smokescreen to mask her shame.

[Paul]

I thought Sugarfree was autism.

[Hugh Akston]

Yes, but only on the social scale. He is our national learning disability.

[Paul]

We are all Sugarfree, now.

[Binge and Grab]

Mandatory vaccinations, wonderful idea! At least we know they won't ever be used nefariously, because like power it won't be abused because the right people are in charge!

[Night Elf Mohawk]

I think that Caplan makes a strong moral case for a vaccination mandate.

Where?

If having vaccinated employees is so great, why does it need to be mandated other than that other mandates with "strong moral cases" stand in the employers' way on addressing the issue?

[Bar Student]

I guess you're voting for Perry then. He loves forced vaccination.

[T]

He was protecting himself from all the girls who were going to grow up to be sleazy strippers, Bar Student. Pure self-interest.

[Lost_In_Translation]

yeah, but he should have them vaccinated from gonnerhea, that shit stings.

[zoltan]

Perry's gayness protects him from unvaccinated girls.

[Evan from Evansville]

I will never get a flu shot. Granted I am a 24 year old healthy male, but I don't see what the big deal is. I honestly don't think I've ever even had the flue (I know that's probably impossible); if I did get it it just proves to me how much of a pussy-ass invasion the flu really is.

Antibacterial soap will be banned in my household if/when I have children.

I assume that my Wolverine-like immune system comes from risky behaviors such as eating Chinese food out of the trash in my dorm freshman year. Coolest superhero origin story...ever.

[Bar Student]

As another 24 year old male I've also never gotten a flu shot or the flu, I also don't see the point.

Antibacterial soap isn't going to do much good for a viral infection....

[yonemoto]

The flu is actually fun. I was probably throwing a 103 fever and was definitely missing three days, but I got to have amazing dreams about string theory and nucleated crystallization dynamics.

[Evan from Evansville]

I know the flu is a virus, but my anti-anti-bacterial soap stance is in the same vein as my opposition to flu shots. In both instances, it's just better to let your body get used to fighting off illnesses and developing immunity.

And it's a good way to help super hardcore strains evolve.

[Windy City Pundit]

There are hundreds if not thousands of different strains of the influenza virus. The idea that forcing a medical professional to be vaccinated against even a few of them is still only limiting your "danger" by less than a percentage point.

[JD]

There are only a few strains of the virus circulating each year. As SIV said above, a vaccine well-matched to the circulating strains decreases influenza 70-90% in healthy adults.

[Brett L]

Note the quoted excerpt from SIV's quote. Outside the lab it is 10% reduction in transmission.

[Libertymike]

Who sponsored the study?

Note, not a one of them is a purely private sector entity which does not receive any state aid and / or seeks state ordered payola and / or does not seek to impose its will by law upon others. This fact, alone, should always be disclosed and discussed in evaluating any such "study" conducted by the state and /or its rent seeking and tax feeding allies.

[Rev. Blue Moon]

Note that LM is not a "purely private sector entity" because he receives state aid in the form of ROADZ!

[Mr. FIFY]

Like he has a choice over road usage, Rev.

Why don't you toddle back over to DU or whatever liberal rock you usually hide under? You're getting tiresome.

[Rev. Blue Moon]

Liberal? Please. Countering LM's spoutings should not be construed as endorsing any other "side". Because you both seem constitutionally incapable of following a logical and Socratic-style argument, I will spell it out for you: intellectually discrediting a particular study, in this example, on the basis of "who funded it" is a lefty tactic, and can just as easily be employed against reason ("KOCH BROTHERS!"). It's a intellectually lazy and logically fallacious, no matter which "side" uses it.

[Rev. Blue Moon]

I should also add that having a desire to suspend a person's liberties or credibility depending on his/her reliance on government funding is an incredibly slippery slope that leads to nobody having freedom because...wait for it...ROADZ!

[Libertymike]

No one's arguing to suspend anybody's individual liberty.

Again, reading comprehension fail.

BTW, You can't suspend credibility if it does not exist in the first place.

[yonemoto]

a vaccine well-matched to the circulating strain increases the "non-circulating strain", thereby altering the data to cast out the data (because now the vaccine isn't "well-matched").

[yonemoto]

hm someone should do a statistical simulation on this.

[yonemoto]

hm someone should do a statistical simulation on this.

[Ken Shultz]

"University of Pennsylvania bioethicist Arthur Caplan argues in The Lancet that influenza vaccination should be made a mandatory condition of employment for all health care workers."

Does he make an exception for healthcare workers who are immuno-compromised?

And if there is an exception for healthcare workers who are immuno-compromised--who determines what level of immuno-compromised gets the exemption?

Does the government make that determination? ...or is it the immuno-compromised healthcare workers themselves?

P.S. Are there any other situations in which the government mandating that people are injected with things against their will is perfectly consistent with libertarianism--or is this the only one?

[Sam]

I have no trouble with unvaccinated health care workers -- as long as I don't have to deal with them. One remedy would be for health care employers to require their unvaccinated employees to positively distinguish themselves from those that are vaccinated, perhaps with a distinctively-colored armband. Failure to conspicuously wear the armband while on duty or to answer correctly when queried about their vaccination status would constitute fraud. An alternative method has the vaccinated employees wearing armbands so that patients and their families could take care to avoid those without them. In this scenario, wearing an armband would be considered a deliberately fraudulent act by an unvaccinated worker. Either solution would be voluntary for hospitals and other facilities with the expectation that those not participating would lose business to those that are.

[Lost_In_Translation]

That's rediculous. You're more likely to be exposed to disease in the waiting room than from any healthcare worker that sees you afterward.

[Brandybuck]

A friend of mine who is a nurse was complaining that he had to get the flu shot to continue working at a major hospital. I had no sympathy. None at all.

[Libertymike]

You need a shot of empathy.

[Ken Shultz]

Yeah, I can see what you mean.

A lot of people don't have any sympathy for other people being forced to do things against their will--so long as it's something you agree with.

It's all fun and games until somebody injects you with something you don't want to be injected with.

But that's a good reason to stand up for the right of individuals to decide what the government does or doesn't inject into them, isn't it?

And who care if somebody has a genetic proclivity to developing an hyperactive auto-immune disorder? Why should that entitle them to decide that they don't want their immune system beefed up unnecessarily?

[Rev. Blue Moon]

Ken, it was a condition of employment, not a mandate from the State. And if your immunity is that bad, you have no business being in health care in the first place.

[Ken Shultz]

It wasn't a condition of employment when they picked an allied health major. Now twenty years later, you decide they retroactively forfeited their right to decide what's injected into them?

And if they don't like it, then there's always public assistance and the YMCA?

Pu-lease!

[Ken Shultz]

If some private hospital wants their employees to willingly forfeit their right to refuse to be injected as a condition of employment, I have no problem with that.

However, libertarians should object to any attempt to enforce such a mandate with licensing and government regulation.

[Libertymike]

Blue Moon has a hard time with developping an argument or propostion. Ditto for his ability to reason.

[Lost_In_Translation]

And just to head off any rediculous arguments (yeah right), there are obvious prevention methods that don't require such invasive things as vaccines that prevent disease much better. Namely, sterilized instruments and clothing and washed hands. These are much better at preventing the spread of disease than vaccines alone.

[Aelhues]

I'm not a healthcare worker, but were I, and if I were required to get a flu vaccine every year, I'd have 2 weeks of time off about a week or two after the vaccination. I've had the flu maybe 5 times in the past 15 years. 3 of those were bad, two week long episodes, 1-2 weeks after the 3 times I've been vaccinated. I'm sure I'm not representative of the overall population, but requiring something that will make me sick as a condition of employment seems patently stupid.

[ech]

At least one major hospital chain requires all staff get flu shots (provided at no cost) each year as a condition of employment. It also applies to at least some of the physicians. They also have vaccination requirements for diseases such as Hepatitis, along with testing programs.

[R C Dean]

Where does anybody's liberty end?

Under the nearest jackboot, that's where. And who would doubt that "bioethicist"* Caplan fantasizes about wearing a steel-toed pair.

*Bioethicists these days seem mostly to be in the business of apologetics for government control of healthcare decisions. Kind of the opposite of ethics, in my mind.

[NL_]

I think the subjectivity of risk is high enough that a "provider-choice" model is sufficient here. Nobody is going to subject medical professionals to every measure that would reduce their risk of passing infections.

[Neu Mejican]

I have never worked at a healthcare facility that did not require its workers to get a whole host of vaccinations. Some for most school systems. The vigilance with which these rules are enforced varies widely, but they are the norm in the industry.

[Joshua]

Wasn't Holmes the one who ordered the sterilization of that dumb girl?

[Robert Schecter]

It's disappointing and odd that an organization that claims to support libertarian ideals should be so supportive of a vaccination program that is in it's entirety a creature of the state

The above piece contains a number of flaws in reasoning:

Holmes' principle applies when it comes to health care workers who endanger patients by refusing to get vaccinated against influenza.

Ahh, Oliver Wendel Holmes, great friend of liberty and enthusiastic supporter of eugenics programs. Let's look to him for moral guidance. Anyway, a worker endangers no one by being unvaccinated. One need have the flu to endanger someone with the flu

Caplan's reasoning goes beyond flawed, reaching the bizarre:

However, there is yet still another powerful moral reason to mandate vaccination for all professionals working in health care. By not vaccinating themselves, health-care workers feed vaccine fears, reinforce anti-vaccine sentiments, and set a dismally poor example for the public

How does forcing someone to act in a certain way set an example others should follow? The very fact that force is required sends the message that the the "example setters" would, if left to their own devices, set the opposite example.

Regardless. let's let private institutions make their own decisions regarding how they run their businesses

[Healthcare Design]

Every health care workers must be protected.

[Isocort]

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