Patient Safety and the Right of Patients to Refuse Care of Unvaccinated Staff

Jhe question of whether to impose a policy requiring compulsory vaccination for NHS staff has raised countless ethical and practical considerations, but while the deadline for healthcare workers to get bitten or face a dismissal is approaching, have we sufficiently thought about the point of view of the patients?

Various legal experts and health groups have argued that while doctors and nurses can reject the offer of vaccination, patients should also have the right to refuse treatment from a medical professional who is not bitten, asking instead that their care be entrusted to someone. which is protected.

Under current plans, 70,000 NHS workers are set to be made redundant from February 3 for failing to vaccinate. However, there has been reports that the government is considering suspending the policy in light of concerns over staffing shortages in the NHS, with Health Secretary Sajid Javid admitting on Thursday that the government was “thinking” about the situation.

A backlash from the reveal is also to be expected, as first reported The Independentthat trusts have been asked to ‘trace’ employees’ personal NHS numbers and create a database of mobile phone numbers and emails in a bid to identify unvaccinated staff – a move which has been described as a “grotesque abuse of power”.

In a scenario where the box is effectively rejected, with the February deadline pushed back, could patients begin to tire of staff who have not been vaccinated? Will they feel that the opportunity for refuseniks to be bitten has passed and that it is therefore justified that they be deprived of their right to treatment?

“Patients have a right to safe care, so it is reasonable that they would expect any health or social care professional caring for them to have received a Covid-19 vaccine,” Rachel says. Power, executive director of the Patients’ Association.

Most patients may not be overly concerned about the vaccination status of those caring for them, but in a world where we are meant to live alongside the threat posed by Covid, there is undoubtedly certain groups who will be more invested in these issues.

“A person who is ‘vulnerable’ through disability or chronic illness (e.g. immunocompromised) may well have an argument under the Equality Act that the NHS is not providing them with vaccinated staff constitutes discrimination on the basis of disability”, declares a specialized lawyer. in mental health capacity law.

After all, these people are most at risk from Covid-19 – and will be for years to come. Clinically vulnerable people who end up in hospital for any reason will know that a Sars-CoV-2 infection could further worsen their condition or be life-threatening.

Of course, vaccines do not completely stop transmission – they are most effective in providing high levels of protection against serious illness and death – but the likelihood of a Covid outbreak in a ward, including among patients, will be higher if some staff are not stung.

Understandably, patient groups want to see 100% vaccination coverage across the NHS and avoid any situation in which they are treated by staff who are more likely to pass on potential infection.

“Government advice has already advised people whose immune systems mean they are at higher risk of serious illness to avoid anyone who is unvaccinated,” the Clinically Vulnerable Families Group says. “It’s hard to understand how that would be possible if your clinician or nurse isn’t vaccinated.”

The group also called for clinically vulnerable patients to receive mitigation measures in hospitals and to be cared for “where possible” by vaccinated staff with the highest quality face masks.

Concerns about patients contracting Covid-19 while in healthcare facilities are not unfounded. At the height of the recent Omicron wave, more than 16% of daily infections in England were based in hospitals, with the virus spreading between staff and patients who were receiving treatment for non-Covid issues.

As controversial as the current plans are, requiring health workers to be vaccinated against an infectious disease, in an effort to ensure patient safety, is not unprecedented in the UK.

At the turn of the millennium, the NHS was hit by a scandal in which heart surgery patients were infected by a doctor with hepatitis B.

“It obviously caused great concern with the NHS because the number of patients seen by consultants and doctors was quite large,” says Dr Claas Kirchhelle, medical historian and senior lecturer at University College Dublin.

The fear has led the government to strongly recommend vaccination against the virus for healthcare workers who deal with operations and patient blood. However, this did not go so far as to legalize a warrant – as seen with Covid-19.

In the years and decades to come, concerns about whether staff are vaccinated against Covid may eventually fade – as they have with hepatitis B – but don’t bet the problem will soon disappear.

For now, patients who object to being treated by unvaccinated NHS workers will be reassured that they have a strong legal basis to rely on.

Patient safety expert Dr Brian Toft cites the example of a 2015 court case – Montgomery v Lanarkshire Health Board – in which the Supreme Court ruled that a patient’s informed consent is based on disclosure of risk by a doctor.

“An adult person of sound mind has the right to decide what forms of treatment, if any, are available to undergo, and their consent must be obtained before any treatment that interferes with their physical integrity is undertaken,” said the court.

In the eyes of the law, explains Dr. Toft, an unvaccinated nurse or doctor should therefore communicate their vaccination status when caring for a patient. “Patients should be asked if they consent to being exposed to this risk,” he says.

“It should also be remembered that the ethical position of all physicians – and in my view, all health care workers – is that they must ‘first do no harm’. So where staff are not vaccinated, they put the patients they interact with at risk.

Ultimately, the conversation about patient safety and the dangers that unvaccinated staff pose to the people they care for could play a useful role in helping change the minds of healthcare workers who still do not want not get vaccinated.

“On the one hand, it may seem dangerous to be cared for by staff who choose not to follow strongly evidenced guidelines that vaccinations are safe and effective; on the other hand, people who need services will suffer if an understaffed service loses even more staff,” says Charlotte Augst, CEO of National Voices, a coalition of health and social care charities in England.

“We wonder if it would be helpful for health and care staff to hear more directly from people who feel vulnerable to the virus, the efforts they are making to protect themselves and how reluctance to take the vaccine can undermine trust. .”

About Antoine L. Cassell

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