Do vaccine refusers have an ethical duty to pay for their own Covid care?

[GO-NAD!]

There is a social trend now about gatherings/functions and only vaccinated people are to attend. This makes sense for several reasons including while vaccination is great
it's not a 100% guarantee that the co-mingling unvaccinated still can't be infected. That means the other wise manageable risks aren't adhered to and valuable hospital resources taken for an otherwise preventable illness. Resources that should be used for people in medical need through no fault of their own.

I'd be interested in hearing what a medical ethicist would have to say on the matter.

If you are refusing the vaccine, that the efficacy of is now beyond reproach, I don't want it coming out of the societal pocket book. I want you to bare 100% of your own costs on this choice you are making.

While the COVID pandemic is front and centre amongst public health issues today, I don't think we can put it in a separate category when it comes to who deserves care and who should pay for it. People engage in activities generally regarded as risky all the time. And, what's perceived as risky can vary from person to person. I can envision a couch potato not wanting to pay for the care of a bicyclist who was hit by a car, because "riding a bike on public roads is stupid".

If the resources of a hospital should be taxed to the point where patients have to be triaged, I can't imagine a COVID patient being pushed down the care que because he had refused the vaccine, as that would be a level of granularity that triage staff would not spend time on.
"So, how did this guy get so badly mangled?"
"He was skydiving."
"OK, back of the line, just ahead of the anti-vaccer."

I'm not in the medical field, but I would think that consideration and priority for care hinges entirely on the condition of the patients, not the circumstances behind their presence in an ER.

As for who pays for the care, I have some sympathy for your position. However, it's such a can of worms, I don't know how making a vaccine refuser pay out-of-pocket for their care can be justified. We all pay fire departments to put out fires caused by careless smokers and campers*. We don't make criminals pay for their own arrest and imprisonment. We all bailed out banks and car companies after the last financial crisis. It's a much larger issue than just vaccine refusniks.

*Some jurisdictions may have cost recovery policies, but I doubt that it's universal or very effective.

 

[Mr._Clark]

From the court opinion in the Houston Methodist Hospital case: "The Supreme Court has held that (a) involuntary quarantine for contagious diseases and (b) state-imposed requirements of mandatory vaccination do not violate due process." citing Jacobson v. Massachusetts, 197 U.S. 11 (1905), and Compagnie Francaise de Navigation a Vapeur v. Louisiana Board of Health, 186 U.S. 380 (1902).

In the real world, courts follow the Constitution and U.S. Supreme Court decisions.

There seems to be a very strong tendency to conflate policy preferences and existing law (i.e. people who oppose something for policy reasons often declare it to be unconstitutional even though the thing in question is clearly constitutional). These people seem to live in a fairy tail world where the law is whatever they want it to be.

https://int.nyt.com/data/documenttools/houston-methodist-court-ruling/3468984fc566cea5/full.pdf

 

[jinjuku]

While the COVID pandemic is front and centre amongst public health issues today, I don't think we can put it in a separate category when it comes to who deserves care and who should pay for it. People engage in activities generally regarded as risky all the time. And, what's perceived as risky can vary from person to person. I can envision a couch potato not wanting to pay for the care of a bicyclist who was hit by a car, because "riding a bike on public roads is stupid".

If the resources of a hospital should be taxed to the point where patients have to be triaged, I can't imagine a COVID patient being pushed down the care que because he had refused the vaccine, as that would be a level of granularity that triage staff would not spend time on.
"So, how did this guy get so badly mangled?"
"He was skydiving."
"OK, back of the line, just ahead of the anti-vaccer."

I'm not in the medical field, but I would think that consideration and priority for care hinges entirely on the condition of the patients, not the circumstances behind their presence in an ER.

As for who pays for the care, I have some sympathy for your position. However, it's such a can of worms, I don't know how making a vaccine refuser pay out-of-pocket for their care can be justified. We all pay fire departments to put out fires caused by careless smokers and campers*. We don't make criminals pay for their own arrest and imprisonment. We all bailed out banks and car companies after the last financial crisis. It's a much larger issue than just vaccine refusniks.

*Some jurisdictions may have cost recovery policies, but I doubt that it's universal or very effective.

There are key differences with your comparison though and it has to do with scope.

Smokers as an example: Public health campaign on on side, cessation programs often paid for by insurance providers, and on the other: Higher health care premiums and reduced coverage by insurance for smokers with complications related directly to smoking. Much higher taxation on tobacco products.

The same restrictions aren't applied to bicyclist or sky divers because they aren't ubiquitous.

 

[Swerd]

From the court opinion in the Houston Methodist Hospital case: "The Supreme Court has held that (a) involuntary quarantine for contagious diseases and (b) state-imposed requirements of mandatory vaccination do not violate due process." citing Jacobson v. Massachusetts, 197 U.S. 11 (1905), and Compagnie Francaise de Navigation a Vapeur v. Louisiana Board of Health, 186 U.S. 380 (1902).

In the real world, courts follow the Constitution and U.S. Supreme Court decisions.

There seems to be a very strong tendency to conflate policy preferences and existing law (i.e. people who oppose something for policy reasons often declare it to be unconstitutional even though the thing in question is clearly constitutional). These people seem to live in a fairy tail world where the law is whatever they want it to be.

https://int.nyt.com/data/documenttools/houston-methodist-court-ruling/3468984fc566cea5/full.pdf

Thanks for the pdf of the Houston Methodist Hospital judge's opinion. And thanks for the citation of the 1905 Supreme Court ruling.

In your opinion, is that 1905 ruling the same Supreme Court ruling that applied to the 1991 Philadelphia court ordered measles vaccination? See my post #29

Do vaccine refusers have an ethical duty to pay for their own Covid care?

One issue is that the vaccines are not 100% effective. It would not be possible to know with certainty that particular person would not have gotten sick if they’d gotten the vaccine. I realize that wouldn’t necessarily rule out the idea but reduces the force of the equitable argument somewhat...

forums.audioholics.com

 

[GO-NAD!]

There are key differences with your comparison though and it has to do with scope.

Smokers as an example: Public health campaign on on side, cessation programs often paid for by insurance providers, and on the other: Higher health care premiums and reduced coverage by insurance for smokers with complications related directly to smoking. Much higher taxation on tobacco products.

The same restrictions aren't applied to bicyclist or sky divers because they aren't ubiquitous.

I understand, but scope doesn't change the principal in question. Are you saying that if bicycling on public roads and/or skydiving were as common as vaccine refusals, we should lump them in with anti-vaccers and make them pay for their own care if they are injured as a result of such activities?

If, as you say, it's a matter of scope, where do we draw the line?

Yes, smokers pay higher premiums and have reduced coverage, but if one develops cancer, are the costs incurred for care fully compensated by those measures?

While I have little patience for anti-vaccers, I can't see singling them out to pay for their own care as being fair. The number of risky behaviors that the public end up paying for are too numerous to list.

 

[Trebdp83]

You seem a bit tense. Have you checked your blood pressure lately...?

Are they not supposed to be four digit numbers? Seriously, I'm more like a carnival barker, "Step Right Up Folks!" It's just another insidious seed being planted out there. If anybody wonders why and how anything gets down in this country, they need only follow the money. The war on anything is very unpopular these days but you still need a common enemy. So, what better than one you can't see, hear, feel or smell to touch? It is comical to hear some cry about those who do not want to wear masks. They were the first to scream when Muslim women refused to remove their masks. But, I digress. Heart disease is the number one killer of people in this country, period. Instead of believing the hype, get in touch with some doctors, nurses and other health care professionals and ask them about what is going on. This campaign, and that is what it is, attempts to divert attention from the real healthcare issues facing this and other countries. The worst kinds of "junk food" in this country are the easiest and cheapest to purchase. Interestingly, some are illegal in other nations because they are so harmful. So, those "essential" poison pushers stayed open during the pandemic and some contracted with companies who misclassified workers to get them on the cheap to deliver that s#%t to peoples' doors. Public schools kept paying for slop to be delivered and, while classrooms were closed, many school kitchens stayed open for pickup of warmed up crap from a box. If this campaign is successful, it will only lead to others. It is more than a little frustrating to listen to some on this issue. There are more than a few people out there filling their scrip' trays up for the week on Sunday evening while waiting for the frozen pizza to come out of the oven. They curse the anti-vaccers on the TV while guzzling down their "juice" and screaming, "Those f#%kers are going to be the death of me!" Nobody seems willing to tell these people otherwise. And, why would they tell them? They are a hell of a revenue stream for some, only we all get the bill. Again, the most common cause of the poor health of the American people is NOT what some choose not to consume, but rather what far too many choose to consume on a daily basis. Didn't this thing supposedly originate in a place where animals were poorly treated while waiting to be sold for consumption? It is a very unpopular opinion to have these days for sure and is exactly the reason no elected official will touch it. It's easier to shut down small businesses and starve people out until they agree to the terms of the "new normal." It really is one hell of an ad campaign.

 

[lp85253]

This is a good place to start. Cite a U.S. Supreme Court case that supports your assertion.

No thanks.. Too much research ( any that is) for an on line discussion.. I can state in theory that the make up of the sc is such to back my theory.. Note : this is only in regards to fed mandate, or state local mandate, not school / employers mandates.It would be indicated historically you are right, shots can be required.. I'm saying that's not gonna fly, to the point of rabbit hole dweller violence across much of the country.. And as we saw in the insurrection angry white folks get a pass on prosecution and police intervention in many cases..

 

[Mr._Clark]

Actually you can. But the laws will be state or local, not federal.

In 1990-91 there was a measles outbreak in Philadelphia. More than 1,400 people, mostly children, became sick with measles, and nine children died. Six of those nine deaths were associated with a fundamentalist church, the Faith Tabernacle Congregation, that believed in faith-based rather than medical interventions of any kind, including vaccinations. The church ran a school with about 1,000 kids, none of whom were vaccinated.

A law protects these church members' right to refuse vaccination on religious ground. However, the US Supreme Court had ruled years earlier that parents cannot deny lifesaving medical treatments to their children for religious reasons. That ruling set a precedent that made it difficult for Faith Tabernacle to find legal representation. Local public health officials succeeded in getting court-orders to vaccinate the children in that school.

I'm not certain this legal precedent applies for the corona virus vaccines. @Mr._Clark , comments?

1990–1991 Philadelphia measles outbreak - Wikipedia

en.wikipedia.org

Why A Court Once Ordered Kids Vaccinated Against Their Parents' Will

Measles infected hundreds of children at a Philadelphia church whose members didn't believe in modern medicine. In a rare step, health officials moved to compel the families to vaccinate the kids.

www.npr.org

The statement in the article "However, the US Supreme Court had ruled years earlier that parents cannot deny lifesaving medical treatments to their children for religious reasons" is somewhat vague. I'm not aware of a US Supreme Court case that directly states this. I suspect the news reports do not accurately state the holding of the case in question.

The legal issue in the Philly measles case was limited to parental rights to refuse a vaccine on religious grounds. The legal issues are different in a typical case involving an adult.

Here's a snip from Prince v. Massachusetts that covers the general topic of religious liberty vs the parens patriae doctrine:

"But the family itself is not beyond regulation in the public interest, as against a claim of religious liberty. Reynolds v. United States, 98 U. S. 145; Davis v. Beason, 133 U. S. 333. And neither rights of religion nor rights of parenthood are beyond limitation. Acting to guard the general interest in youth's wellbeing, the state, as parens patriae, may restrict the parent's control by requiring school attendance, regulating or prohibiting the child's labor and in many other ways. Its authority is not nullified merely because the parent grounds his claim to control the child's course of conduct on religion or conscience. Thus, he cannot claim freedom from compulsory vaccination for the child more than for himself on religious grounds. Jacobson v. Massachusetts, 197 U. S. 11. The right to practice religion freely does not include liberty to expose the community or the child
to communicable disease or the latter to ill health or death. People v. Pierson, 176 N.Y. 201, 68 N.E. 243. The catalogue need not be lengthened. It is sufficient to show what indeed appellant hardly disputes, that the state has a wide range of power for limiting parental freedom and authority in things affecting the child's welfare, and that this includes, to some extent, matters of conscience and religious conviction."

Prince v. Massachusetts, 321 U.S. 158 (1944)

Prince v. Massachusetts

supreme.justia.com

 

[Mr._Clark]

No thanks.. Too much research ( any that is) for an on line discussion.. I can state in theory that the make up of the sc is such to back my theory.. Note : this is only in regards to fed mandate, or state local mandate, not school / employers mandates.It would be indicated historically you are right, shots can be required.. I'm saying that's not gonna fly, to the point of rabbit hole dweller violence across much of the country.. And as we saw in the insurrection angry white folks get a pass on prosecution and police intervention in many cases..

Close your eyes and keep repeating "I really want the Constitution to say vaccine mandates are prohibited." If you keep wishing long enough, the constitution fairy will grant your wish.

 

[Danzilla31]

No thanks.. Too much research ( any that is) for an on line discussion.. I can state in theory that the make up of the sc is such to back my theory.. Note : this is only in regards to fed mandate, or state local mandate, not school / employers mandates.It would be indicated historically you are right, shots can be required.. I'm saying that's not gonna fly, to the point of rabbit hole dweller violence across much of the country.. And as we saw in the insurrection angry white folks get a pass on prosecution and police intervention in many cases..

Man I really can't resist this. It looks like the last year and a half it's not just angry white folks that are getting a pass anymore at prosecution and police intervention these days. When you look at it that way were starting to get a lot closer to equality then ever before. Progress right? OK before you go off on a rant just know I'm screwing with you. You just left that out there and I couldn't resist

 

[jinjuku]

understand, but scope doesn't change the principal in question. Are you saying that if bicycling on public roads and/or skydiving were as common as vaccine refusals, we should lump them in with anti-vaccers and make them pay for their own care if they are injured as a result of such activities?

I'm not going to argue straw men with you. Riding a bicycle is a choice. Catching Covid 19 is a crapshoot. Look at municipalities that have laws on the books for helmets.

 

[BoredSysAdmin]

I don't always have an original thought, but I can see where someone's opinion clearly supports my own and put in better words, like this Arstechnica comment on the Houston Methodist Hospital case from today by "Jarvis":

I've said it before and I'll say it again. You are "free" to choose not to accept the vaccine, but you are not "free" from the consequences of your decision. You WORK in the medical field. There is a global pandemic and if you want to work in that field then this is a requirement. Like a license to perform engineering work. Deal with it. Or don't work there. Your call. But you don't get to complain about it, and these arguments are just ridiculous. I'm sure there are plenty of others who can fill your shoes that won't serve as a conduit to spreading Covid while patients seek treatment at your hospital. What is wrong with people?

Source: https://arstechnica.com/science/202...azi-atrocities/?comments=1&sort=high#comments

 

[GO-NAD!]

I'm not going to argue straw men with you.

I never raised a straw man, so no argument to be had on that front.

Riding a bicycle is a choice. Catching Covid 19 is a crapshoot. Look at municipalities that have laws on the books for helmets.

Riding a bike and avoiding a vaccination are the choices. Getting run over by a truck and catching COVID are the gambles.

I'm not suggesting that people not ride a bike, as the benefits outweigh the risks. There really isn't any upside to avoiding the vaccine, so it's a no-brainer in my book.

We've both stated our opinions on hospital care for non-vaccinated COVID patients and whether they should have to pay out-of-pocket for their treatment. I won't beat a dead horse, so here endeth my input on the question.

 

[highfigh]

While the COVID pandemic is front and centre amongst public health issues today, I don't think we can put it in a separate category when it comes to who deserves care and who should pay for it. People engage in activities generally regarded as risky all the time. And, what's perceived as risky can vary from person to person. I can envision a couch potato not wanting to pay for the care of a bicyclist who was hit by a car, because "riding a bike on public roads is stupid".

If the resources of a hospital should be taxed to the point where patients have to be triaged, I can't imagine a COVID patient being pushed down the care que because he had refused the vaccine, as that would be a level of granularity that triage staff would not spend time on.
"So, how did this guy get so badly mangled?"
"He was skydiving."
"OK, back of the line, just ahead of the anti-vaccer."

I'm not in the medical field, but I would think that consideration and priority for care hinges entirely on the condition of the patients, not the circumstances behind their presence in an ER.

As for who pays for the care, I have some sympathy for your position. However, it's such a can of worms, I don't know how making a vaccine refuser pay out-of-pocket for their care can be justified. We all pay fire departments to put out fires caused by careless smokers and campers*. We don't make criminals pay for their own arrest and imprisonment. We all bailed out banks and car companies after the last financial crisis. It's a much larger issue than just vaccine refusniks.

*Some jurisdictions may have cost recovery policies, but I doubt that it's universal or very effective.

Fire departments send a bill to the address/property owner where fires occur- they don't just let the money come from taxes and fees. It's covered by insurance unless arson by the property owner can be proved.

 

[jinjuku]

We've both stated our opinions on hospital care for non-vaccinated COVID

I don't remember taking any such position in any manner other then if you contract Covid you should get top notch care regardless of if you played Covid roulette or no.

 

[GO-NAD!]

I don't remember taking any such position in any manner other then if you contract Covid you should get top notch care regardless of if you played Covid roulette or no.

Do you remember saying this?

If I've one ICU bed do I use it for someone that just got in a car accident or for someone that 100% could have prevented their illness?

Yes, it's a question, not a statement. But, it's a suggestive question. It implies an opinion, but I may be wrong.

 

[MalVeauX]

Hi,

I'm long time medical. I deal 100% with COVID on the front and back. I'm not political about it, I'll just give you some other perspectives.

Someone refusing the vaccine is no different than someone refusing the vaccines for anything offered. Including all your childhood vaccinations, or the yearly influenza that is constantly refused and has been around for a very long time. Pick any vaccine you want, and there are people who refuse them every single year. This logic applies to anything we know that is a preventable (including at risk behavior for life style and diet). So if you continue this logic of thinking that someone that refuses something that is optional, you eventually come to everyone refusing something and everyone having to then be responsible, 100%, for their medical care as a result of that refusal. So now what? You now have abandoned most people. COVID? Influenza? Polio? Measles/Mumps/Rubella? Chickenpox? Hepatitis A/B? Tetanus? Diphtheria? We do these vaccines here in the USA for the first 18 years of your life and are often required in most schools/universities. They too get refused or circumnavigated as nothing is 100% required and is your choice. But do we force anyone who refuses any of these to then be 100% liable for their medical care due to this refusal? No.

To force people to be liable for all their medical care with no help due to a refusal of a vaccine, for anything, is just emotional response to the idea of vaccines and the situation with COVID (or insert any pathogen here). But none of it is new. We've been doing this, just pick a different pathogen to target. So to answer fairly certainly to burden someone who refuses vaccine(s) in general with 100% of their medical care is not ethical.

Yes, there's tremendous evidence for the benefit of vaccines. And lots of evidence of issues with vaccines. But to make it required, or you suffer a massive penalty (100% health care liability in USA is total financial ruin; it is a death sentence, think of the long term results of this, destruction of your financial stability, wrecked credit, the resulting mental health, the desperation that it may push someone into; when you're liable and cannot or refuse to pay, you will recieve litigation and if awarded, your wages are garnished, it's not as simple as just not paying the bill). So then these people are forced to need even more assistance from the greater public economy. The end result? You got to smite someone for refusing a vaccine and destroyed the economy and indirectly other people who did take the vaccine along with it. No one wins.

This logic, or ethics if you will, also applies to anything else that is knowingly potentially preventable. That list is too long to even get into. But seat belts, texting while driving, or how about destructive life habits like alcoholism, smoking or poor diets full of salt and sugar? Smite them all? They could have chosen to do the right thing? It obviously doesn't work that way. And I'm willing to bet confidently that someone who thinks someone who refuses the COVID vaccine should be liable for their health care and not drain the system (which they will anyways despite that) probably has plenty of preventable disease states or will have them in a few more years and are completely hypocritical about it. Medically these very people should be following a dietician to ensure preventable diseases secondary to diet, preventable measures over a life time, are informed and followed and if they refuse, and they're at all overweight or pre-diabetic or at risk for heart disease, well, they're now medically liable for their lifetime for virtually everything. For everyone that wants to drop the hammer on someone who refuses the vaccines, they're probably unhealthy from diet or lifestyle and will be a burden to us on medicaid when they're older, and it was preventable, they could have informed themselves, and they are then held liable instead of being allowed to have medcaid? This is the exact same logic string as vaccination and COVID, but with even more evidence behind it. And this is precisely why we must have the idea of ethics in these things.

Despite all that, the concept of ethics in medicine is a duality. It went from subsidized by the government, to being legal to become for-profit as a business in the 1973 (Nixon). So like any business, whether you want to talk about ethics or how something comes to be, follow the money. Anyone who thinks a practioner in a health care facility follows some code or moral thing unforutnately has no clue. These health care facilities absolutely tell you what you will and will not handle, and have commities for it, because it's liability. Do you not treat someone? Depends on the liability. A physician doesn't make that choice on their own like some warzone battlefield situation in triage. The hospital administration and legal team does, with a little input from an ethics committee.

Very best,

 

[jinjuku]

Yes, it's a question, not a statement. But, it's a suggestive question. It implies an opinion, but I may be wrong.

It's 100% a question. I have no idea how this stuff is ethically decided. I would think there is some conditional rubric for this.

 

[jinjuku]

Do you remember saying this?

I remember saying this:

"You should get top shelf care even if you refused to get vaccinated, I just don't want it coming out of my pocket book."

That was right above what I hope you didn't purposefully didn't quote out the context. I made my opinion quite clear. So why would you take my question and intimate that it's actually an opinion about what level of medical care a Covid patient should receive when the preceding statement made my position 100% clear?

I find your interaction disingenuous.

 

[Trebdp83]

Do you remember saying this?

Yes, it's a question, not a statement. But, it's a suggestive question. It implies an opinion, but I may be wrong.

You are not wrong. It is also a vaguely disguised judgement, and not one associated with the hippocratic oath. Without making silly and radical statements, I am in agreement that people the world over need to think more about personal responsibility in regard to their health and that includes vaccines of various kinds. Being responsible with one's health begins with maintaining it with a healthy diet and exercise from the get go. Hospitals are overrun with the chronically ill. Many of them are there as a result of very bad life decisions made long before COVID-19 came around. This has made dealing with those in an emergency situation especially difficult. But, a physician has taken an oath to treat the sick, not treat the sick depending on the causes of their illness. "Do vaccine refusers have an ethical duty...?" No more or less than everybody else.

Medical Definition of Hippocratic Oath

Read medical definition of Hippocratic Oath

www.medicinenet.com