Category: Ethical Commentary

Is mandatory vaccination ethically justifiable?

Yes — the flow-on harms are too great.

MercatorNet

Margaret Somerville

Is mandatory vaccination ethically justifiable?

What ethical issues do mandatory interventions to limit the spread of the Covid-19 virus raise — in particular, mandatory vaccination? Asked another way, what weight should be given to the arguments of “anti-vaxxers” who oppose mandatory vaccination?

I am not addressing here “involuntary vaccination” — namely, rounding up people and vaccinating them against their will, although in highly dangerous infectious disease situations, Public Health authorities can have powers to impose treatment. Rather, I am focussed on what could be described as “non-voluntary vaccination”, the person can avoid vaccination, but only by making a choice they do not want to make. . . continue reading

Covid vaccination and the common good

Eternity

Patrick Parkinson

Covid vaccination and the common good

A couple of decades ago, there were hardly any anti-vaxxers in Australia. Those who held the belief that it was wrong to prevent illness by receiving a vaccine typically rejected other aspects of modern life and government regulation as well.

The anti-vaxxer movement gathered pace with the publication of an article in a medical journal, since retracted and thoroughly discredited, that purported to make a link between vaccination and autism.

Since then the movement has become widespread. Now, vaccination against Covid has emerged as a religious issue – at least in some theologically conservative circles. . . continue reading

Submission to the World Medical Association

Public Consultation on a draft devised version of the International Code of Medical Ethics

The Anscombe Bioethics Centre

The Anscombe Bioethics Centre

The Anscombe Bioethics Centre is the oldest national bioethics centre in the United Kingdom, established in 1977 by the Roman Catholic Archbishops of England and Wales. It was originally known as The Linacre Centre for Healthcare Ethics and was situated in London before moving to Oxford. The Centre engages with the moral questions arising in clinical practice and biomedical research. It brings to bear on those questions principles of natural law, virtue ethics, and the teaching of the Catholic Church, and seeks to develop the implications of that teaching for emerging fields of practice. The Centre engages in scholarly dialogue with academics and practitioners of other traditions. It contributes to public policy debates as well as to debates and consultations within the Church.

A key issue: conscientious objection

For the first time this draft Code introduces the idea of “conscientious objection”:

Paragraph 27 reads:

Physicians have an ethical obligation to minimise disruption to patient care. Conscientious objection must only be considered if the individual patient is not discriminated against or disadvantaged, the patient’s health is not endangered, and undelayed continuity of care is ensured through effective and timely referral to another qualified physician.*

* This paragraph will be debated in greater detail at the WMA’s dedicated conference on the subject of conscientious objection in 2021 or 2022. However, comments on this paragraph are also welcome at this time.

Unfortunately, this is deeply problematic as a statement of the rights of conscience in medicine. In the first place it utterly fails to establish the duty of doctors to object to practices and procedures that are unconscionable because harmful, discriminatory, unjust or unethical. The right to conscientious objection is based on the duty to be conscientious which is fundamental to medical ethics. . . continue reading

Comment on the draft International Code of Medical Ethics of the World Medical Association

European Institute of Bioethics

In the context of the International Code of Medical Ethics’ revision, the European Institute of Bioethics (EIB) would like to share some comments with the World Medical Association (WMA) Assembly on paragraph 27 of the draft.

Since 2001, the European Institute of Bioethics has developed an expertise in healthcare ethics, with a special focus on the right of healthcare practitioners to freedom of conscience in their practice.

We acknowledge that the International Code of Medical Ethics (hereafter: the Code) is not a binding instrument for the WMA member states. However, one cannot deny the considerable influence the Code may have on national codes of deontology and even on national laws. Moreover, physicians and healthcare organizations expect from the WMA to promote the highest quality of healthcare relationship between physicians and patients.

Paragraph 27 of the Code is drafted as follows:

Physicians have an ethical obligation to minimise disruption to patient care. Conscientious objection must only be considered if the individual patient is not discriminated against or disadvantaged, the patient’s health is not endangered, and undelayed continuity of care is ensured through effective and timely referral to another qualified physician.

In the following note, we discuss one by one the different parts of this paragraph which we consider, written as such, highly problematic for the physicians’ rights and the patients’ care. . . continue reading

The ethical minefield of COVID-19 vaccination: Informed consent and the obligations of doctors

Australian Broadcasting Corporation

Margaret Somerville

The ethical minefield of COVID-19 vaccination: Informed consent and the obligations of doctors

The COVID-19 pandemic has raised a multitude of complex ethical issues — and new ones present themselves daily. These issues, including those related to vaccination, arise at four levels: micro or individual (for example, when a doctor vaccinates a patient); meso or institutional (regarding, for instance, a hospital’s or aged care residence’s policy on vaccinating staff); macro or societal ( a government’s decisions or public health regulations governing distribution of vaccines and access to vaccination); and mega or global (such as a nation’s obligations to provide vaccines to those in developing countries, which are without vaccines).

In many COVID-19 related decision-making situations at each of these levels, decision makers face what is called in bioethics a “world of competing sorrows” — that is, decision making in which there is no “no harm” option, but in which, instead, they must choose to whom harm will be allocated. The ethical difficulties are exacerbated when the harms and benefits do not accrue to the same people or, at least, not in equal measure. A striking example of such a situation at the macro or societal level would be the use of “lockdowns”, when the choice is between protecting public health and inflicting serious economic harm.

What I want to focus on here is a particular micro- level issue: that of a healthcare professional’s obligation to obtain a person’s informed consent to COVID-19 vaccination.

Failure to obtain an informed consent to, or an informed refusal of, medical treatment — which includes vaccination — is medical negligence (medical malpractice). Informed consent to or refusal of medical treatment has three requirements: competence, information, and voluntariness. There is a wealth of research on what is needed to establish each element, but here is a brief summary. . . Continue reading