Should Unvaccinated Be Denied Health Care?
Hospitals facing medical triage should consider adopting this policy.
This isn’t the first time medical staff and hospital beds were in short supply during the pandemic. There is, however, something notably different this time.
In the early stages of COVID-19, patients overflowed hospitals at alarming rates. This forced physicians to make tough decisions, some likening it to conducting triage during war. Patients with the best chance of survival got the bed. The rest did not. It was a death sentence few health care providers wanted to write, but that the virus necessitated.
When there was no vaccine, medical triage was straightforward. But now, the situation is changing. It’s not a level playing field — many of the sick needing care have turned down a vaccine that could have prevented them from needing hospital care.
This raises an uncomfortable ethical question: Should eligible, unvaccinated people be medically triaged at the same priority level as the vaccinated?
If medical capacities weren’t being reached, it’d be simple. In medicine, everyone receives equal access to treatment regardless of personal choices — even a convicted murderer on death row will be given a life-saving surgery the night before lethal injection. The same is true for decisions that knowingly shorten lifespan or create disease. It’s all part of the job.
But it’s not so simple anymore.
It feels different when hospital resources become so scarce that the decision not to vaccinate against medical recommendation can kill someone else. For example, if someone makes the choice not to get vaccinated, and that choice results in occupying a bed that someone else who got vaccinated needs, and without it they could die, is that ethically fair?
This hypothetical situation is already happening in real life.
What if two people enter a hospital at once. One was eligible for the vaccine but denied it and now needs treatment for severe COVID. At the same time, another vaccinated individual is in heart failure. If there’s only one bed left, who gets it? What’s fair?
In Arkansas, only 37.6% of the population is fully vaccinated. Due to the influx of patients infected with the delta variant, there are now only eight intensive care unit beds available statewide. This means that anyone — including the vaccinated — in need of urgent critical care have essentially nowhere to go in this region without expensive and medically risky out-of-state transfers.
Meanwhile, an eligible, unvaccinated person is receiving ICU care.
Is this right? Is it fair?
It’s not only adults.
The delta variant is now infecting children at significantly higher rates. Children’s hospitals are seeing rapid increases as schools reopen, and thousands of children have already tested positive and been quarantined.
Is this fair?
Predictably, these regions now expect assistance from other states that, due to higher vaccination rates, do not have hospitals overflowing. This means low-vaccinated states are offloading patients to more highly vaccinated regions, all while requesting that medical personnel come in and assist them. This puts a massive dent in the hospital capacities of the vaccinated regions — and some governors of unvaccinated states have even requested that vaccinated regions postpone elective procedures to accommodate.
Is this fair?
There’s no doubt that access to health care should be a human right. There’s also no doubt that we need to reevaluate our health care system in the future. However, today’s reality is that hospitals are nearing capacities due to people refusing to get vaccinated, and we must decide what is fair now.
As controversial as it may be, we should deprioritize the eligible unvaccinated patients during medical triage. It’s a free country, and you can absolutely choose not to get the vaccine. But choices have consequences, and the willingly unvaccinated have made this consequence necessary.
Trish Zornio is a scientist and lecturer in behavioral neuroscience and research methodology at the University of Colorado Denver. She has worked for some of the nation’s top universities and hospitals and has focused her personal efforts on enhancing the intersection of science and policy, as well as women in STEM. Zornio is an avid rock climber and was a 2020 candidate for the U.S. Senate in Colorado.
Colorado Newsline is part of States Newsroom, a network of news bureaus that includes the Wisconsin Examiner, supported by grants and a coalition of donors as a 501c(3) public charity. Colorado Newsline maintains editorial independence.
Should the unvaccinated be denied health care? was originally published by the Wisconsin Examiner.
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If we’re going to deny health care to unvaccinated COVID patients then we must also deny health care to tobacco users and obese people.
In 2014, there were an estimated 461,295 annual tobacco-related cancer hospitalizations at a cost of $8.2 billion in the U.S. Tobacco-related cancers accounted for 45% of total cancer hospitalizations and cancer hospitalization costs.
According to the National Institutes of Health, obesity is the second leading cause of preventable death in the United States, close behind tobacco use. An estimated 300,000 deaths per year are due to the obesity epidemic.
https://www.wvdhhr.org/bph/oehp/obesity/mortality.htm
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6080196/
Yes, they should.
Smoking is already regulated so it does not interfere with the health of others and if someone is obese, that affects no one else but them. Yes, there are medical costs associated with obesity and smoking, but what about alcoholism or people who injure themselves running — they incur medical costs (particularly drinkers) from a situation they entered into voluntarily. By your way of proving your point, if we deny coverage to non-vaccinated people, we should deny coverage to anyone who willingly enters into a situation that results in medical costs incurred by our healthcare system. That’s extreme, but you made your point. However, this virus affects everyone who comes in contact with a non-vaccinated person. It is about the health of the community, there is a way to control it and they opt out.
While the unvaccinated get critically ill with covid and take up all of the resources of our medical systems, scheduled and needed medical procedures for non-covid patients are cancelled and could be endangering their physical health. These unvaccinated shout that this is their choice but have a crass disregard for health care providers who might have to treat them and the persons who can’t get the hospital care they need.
Comparing smoking and obesity to refusing to get a COVID vaccine is comparing apples to oranges. We know that nicotine is one of the most addictive drugs. Cigarette manufacturers enhanced its addictive nature to sell more cigarettes. A decision made at age 17 (when we know the brain has not fully developed) can trap an individual in nicotine addiction for a life time.
As for obesity, the overuse of sugars (think high fructose corn syrup) and salts to extend the shelf life of our food stock bears significant responsibility for our obesity epidemic. Bottom line, not everyone has access to healthy foods.
However, everyone 12 years old and older has access to COVID vaccines. There are even cash incentives being offered. There are no cash incentives to quit smoking. Efforts to bring healthy foods to food deserts are at best piecemeal. Nobody chooses to be poor. People are choosing to forego the COVID vaccine. As one who has a compromised immune system, I find that difficult to comprehend. While the headline asks if the unvaccinated be denied health care, in fact it is not health care but a hospital bed in an ICU unit that is in question. The question really is: in these times of healthcare shortages caused by the COVID pandemic, should vaccination status be one of the criteria used to triage sick patients? For me, the answer to that question depends a great deal on whether I am able to get out of bed.
Let the free market decide and have for profit insurance rob their customers blind by not covering their bills for not getting vaccinated.