An increasing number of physicians are growing frustrated with patients who choose not to get their COVID-19 vaccinations. This leads to a dilemma for those physicians who would like to terminate their relationships with unvaccinated patients. They are placed in the challenging position of having to choose between what they feel is best for their own health and the health of their vaccinated patients versus upholding the medical ethics to which they swore allegiance upon becoming physicians. According to an article published in Critical Care Explorations, some physicians are outright refusing to treat unvaccinated patients.
In an article published by the American Academy of Family Physicians, Ryan Neuhofel, DO, MPH, suggests that some physicians establish vaccine requirements in an effort to avoid exposing immunocompromised patients to the virus. Requiring vaccinations for non-immunocompromised patients coming to the practice would offer a level of health assurance for patients who do not have the option to protect themselves with vaccination. Dr. Neuhofel also mentions that physicians may implement a vaccine mandate to keep their waiting rooms as COVID-free as possible.
According to the AMA article, the type of care that a patient requires also plays a role in whether a physician can ethically deny care to unvaccinated individuals. For example, if a patient is establishing a new relationship for long term, routine care with a primary care physician, requiring patient vaccination at the outset is certainly ethical. However, the situation gets murky with patients in need of emergency care.
Assistant professor of medical ethics and health policy at the Perelman School of Medicine Emily Largent, JD, PhD, RN, suggests that organ transplants offer a circumstance in which denial of care for unvaccinated patients would be justified, as the dearth in organ supply warrants transplanting organs into patients who will most likely benefit from the procedure. As risk for severe COVID-19 outcomes increases without vaccination, patients who refuse vaccination should not benefit from scarcely available organs over vaccinated patients, according to Dr. Largent.
Ultimately, the AMA urges physicians to keep the Hippocratic Oath in mind, as ending physician-patient relationships with unvaccinated patients could be significantly detrimental for those patients. Although specific situations may justify denying care to unvaccinated patients, the general recommendation is to offer treatment to all individuals who need it. Dr. Largent suggests using compassionate persuasion, in which physicians acknowledge their own views while trying to educate them on the physician’s views in an effort to change the patient’s opinion.
