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Tuesday, August 31, 2021

Why Denying Hospital Beds to the Unvaccinated is a Terrible Idea

Several times on Twitter I have seen the notion that in emergency medicine people who have not received one of the Wuhan Flu* vaccines either should not receive treatment, or should be demoted in triage.  For instance, Allapundit once reacted to a story that this was happening in North Texas--before they declared it would not occur--by writing: "why shouldn’t a grandma who got her shots lose a bed to someone who convinced themselves that the vaccine has a microchip in it[?]" But he is hardly the only one, and I thought it was important to explain why this is a monumentally bad idea.

Now, before I begin, let me tell you where I come from on the WuFlu vaccine. I have taken it. I believe in most cases, you should probably take it if you doctor recommends this. In all frankness, I am a lawyer, not a doctor and all I can say with reasonable certainty is that your doctor is probably the best person to advise you. But I believe that for most of you dear readers, your doctor will tell you the benefits outweigh the risks of getting the vaccine. But I am also against coercion when it comes to the vaccine--no one should be forced to get it.

My first problem with this is wondering why are we singling out this one issue? People engage in risky behavior that endanger themselves and others all the time. Do you smoke? Then you increase your chances of lung cancer, heart problems and a bunch of other health problems . Plainly cigarette smokers have decided to risk their health for the pleasure of smoking (I say as a non-smoker but also without judgement). And most people drive and by driving you expose yourself constantly to severe risks of accidents. Even if you are a good driver, not everyone is. Furthermore, most people drink, risking harm to themselves and others for the pleasure of that substance. And of course if you not only drink but own a car, statistically speaking, your risk of getting hurt go up even further. Or perhaps you have unprotected sex? Well, then if you get AIDS, are we going to deny you treatment for that? And really, there are hundreds of things we do that might have an effect on our risk of harm to ourselves and others.

I have seen at least one person say that the Wuhan Virus is different because it is contagious. First, when discussing whether or not a person should be denied treatment because he or she refused to take the vaccine, that has nothing to do with the question. The theory is that that he or she is in the hospital because of their own allegedly poor choices, and so they should be denied care or demoted in triage.

Second, while a car accident is not contagious, it can still hurt third parties--many of whom do not in any sense consent to the risk. So do the harms that flow from smoking or drinking. Third, obviously, AIDS is a communicable disease--just not as easily communicable.

But even if we accept that we should consider whether or not a person is vaccinated, surely we are not going to punish people who, for medical reasons, should not take the vaccine, right?

For instance, earlier this month, Pete Parada, the drummer for the punk band The Offspring, was fired because he refused to get vaccinated. He explained why not as follows:

Given my personal medical history and the side-effect profile of these jabs, my doctor has advised me not to get a shot at this time. I caught the virus over a year ago, it was mild for me — so I am confident I’d be able to handle it again, but I’m not so certain I’d survive another post-vaccination round of Guillain-BarrĂ© Syndrome, which dates back to my childhood and has evolved to be progressively worse over my lifetime. Unfortunately for me (and my family — who is hoping to keep me around a bit longer) the risks far outweigh the benefits.”

I mean, you can read about what the CDC says about Guillain-Barré Syndrome, here, but if this is true, this sounds like an entirely reasonable reason not to take the vaccine, right? Surely we wouldn't want to punish him for this utterly reasonable decision--especially since he had the disease before and is likely to have natural immunity.

So if you agree that a man like Mr. Parada shouldn't face this discrimination, then what exactly are you picturing in the E.R.? How do you expect to separate the vaccinated, from the reasonably unvaccinated and the unreasonably vaccinated?

Do we expect a vaccine passport in the E.R., with exemptions. So here the person is, sick enough that they have come to the hospital. I don't know about you, but I don't go to the hospital lightly. When I go, I go in because I am in really bad shape. And at a moment like that you expect me to have proof of vaccination, or a valid excuse not to get vaccinated? Right now, I have a piece of paper saying that I have been vaccinated. Frankly, would be child's play to forge it--and if you don't think people will forge them if they matter, you are kidding yourself. Moreover, I don't keep it with me--I keep it in a safe place where I don't worry about it being destroyed--but that means I might find myself in a situation where I am sick enough to go to the hospital and too sick to retrieve it. And, moreover, it would be very easy for a genuinely vaccinated person to accidentally destroy it--for instance, if you are caught out in a downpour when it is in your pockets.

So, what would they do? Turn it into miniature trial in the E.R.? "Mr. Walker, you stand accused of not having been vaccinated without valid excuse. How do you plea?" If I have it at home, will life saving treatment be denied to me while I am forced to retrieve it? And what if I am too sick to drive? Surely no cab company would want to pick up a person who actually has the WuFlu, even if they are masking and socially distancing in the cab.

The fact is if you are sick enough to go to the hospital, you are rarely in the best state to gather evidence and make a case for yourself. Alternatively, I guess we could give you a free lawyer--your life is on the line, after all--which would be great for my profession (more work!), but its pretty incompatible with providing timely care. We try not to delay justice too long in the legal profession, but "speedy" in the law, and "speedy" in medicine are two very different concepts. And even then, the lawyer would have to be willing to expose him or herself to the danger of catching the Wuhan Virus and that lawyer still might not be capable of locating the relevant evidence.

And that's just for vaccinations. If we decide to judge you for all of the life choices that might have put you in the hospital--drinking, smoking, unprotected sex and so on--this could end up being very complicated at a time when decisions on treatment need to be made quickly. 

So maybe you are starting to understand that independent determination of vaccinated status is a terrible idea, but maybe you would retreat to "what if they just admitted it? What if they admitted they didn't have the vaccine, and didn't have a good excuse for not getting it?" That would eliminate the due process problems of such an approach, but it creates a new problem. You see if the patient thinks he or she might be denied care based on their answer, they might not tell the truth. And in a life or death situation, the people treating the patient need the most accurate answer as quickly as possible. It is precisely for this reason that we can't force your doctor to testify against you most of the time**--so that you can tell your doctor the truth about your health without worrying about it coming out in court. The vaccines not only reduce the chances you will get the WuFlu, but allegedly reduce its severity, so it seems logical to think a truthful answer to the question "did you get a vaccine?" might be vital.

In short, denying treatment to the unvaccinated is a bad idea through and through. We should not be adding judgmentalism to emergency medicine.


* I refuse to call this plague anything that doesn't call attention to the fact that this came from China, and, judging by the regime's attempt to cover up the disease and its refusal to cooperate in the investigation of its origins, the high probability that it is somehow the fault of this murderous regime.

** Of course, I am not your lawyer and this is not legal advice. I believe the doctor-patient privilege exists throughout the United States, but you should consult your local law and possibly even a lawyer to determine 1) whether it exists, 2) what requirements are necessary to invoke it, and 3) what exceptions might apply.

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