A growing number of doctors have threatened to withhold treatment from the unvaccinated, sparking backlash from doctors and bioethicists who say such sentiments violate the Hippocratic Oath. Those critics are even more troubled by the silence from professional organizations tasked with upholding medical ethics.
Doctors in Tennessee, Florida, and Alabama have announced they will refuse to treat unvaccinated patients, while Dallas hospital workers reportedly discussed considering vaccinated status when delegating ICU beds. Such comments have infuriated top medical professionals. Dr. Brian Callister, governor of the Nevada chapter of the American College for Physicians, said doctors should never blatantly refuse to treat unvaccinated patients who are otherwise willing to comply with the rules set out by the practice.
"It is absolutely unethical, period, end of story, to not treat a patient in need," Callister told the Washington Free Beacon. "It is absurd and amoral for any physician to say they will not treat unvaccinated patients."
Callister has served as the state chairman of the American Medical Association, the largest doctors lobby in the country. The group sets the standard for not only medical professionals and ethics, but also shapes public policy as a resource for lawmakers and regulators. While the AMA has publicly supported vaccine mandates, it has remained silent on the public campaign to refuse treatment to people based on vaccination status. An AMA spokesman declined to address the issue, though he did refer the Washington Free Beacon to a webpage outlining traditional reasons for refusing patients.
"The simple fact is unless a significant percentage of our population is vaccinated against COVID-19—we could be stuck fighting this virus for many more months or even years to come," Gerald Harmon, president of AMA, said in a statement. "Now is the time for the public and private sectors to come together, listen to the science, and mandate vaccination."
AMA has more than 200,000 members, representing roughly one sixth of all physicians in the country. It represented three-fourths of physicians in 1975 then saw a sharp decline in membership in the coming decades. The organization spends roughly $20 million on lobbying annually, according to the Center for Responsible Politics.
Michael Shapiro, a retired professor at the USC Gould School of Law who focused on ethical medical treatment, criticized AMA for not speaking out on a key matter of medical ethics. He said the organization's stance leaves open questions as to whether vaccination status is a justifiable reason for refusing service.
"Such ‘guidelines’ generally serve as matters of show," he told the Free Beacon. "They sound good, but say little."
The AMA's Code of Medical Ethics Opinion 1.1.2 states that doctors cannot decline services based on infectious disease status, race, gender, or any other characteristics irrelevant to needed care. Doctors are allowed to deny patients for other reasons so long as they are not seeking emergency care.
"Physicians should not decline patients for whom they have accepted a contractual obligation to provide care," the opinion states. "However, physicians are not ethically required to accept all prospective patients. Physicians should be thoughtful in exercising their right to choose whom to serve."
Roy Spece Jr., a professor at the University of Arizona James E. Rogers College of Law who focuses on medical ethics, cited a number of additional AMA ethics opinions that he said create confusion on when exactly doctors should be able to deny care. A common theme in the opinions, he said, is that doctors get the benefit of the doubt.
"Many people believe that the AMA is an organization devoted to helping doctors first rather than advancing quality, access, and fairness in health care distribution," Spece told the Free Beacon. "Most of its opinions are written in subtly contradictory ways that bear at least one interpretation generally allowing the physician to do what she wants."
Kevin Pham, MD, who advised the National Coronavirus Recovery Commission, said the debate over refusing care to unvaccinated patients is hurtful to the medical profession because it divides doctors into opposing camps. This, he said, is why the AMA should still take a specific stance on the issue to clear up any potential confusion.
"A code of ethics is meant to cover a wide variety of issues, scenarios, and matters, but when the narrative of dividing vaccinated from unvaccinated is gaining momentum, the AMA and every medical association ought to come down on the side of patients against the virus," Pham told the Free Beacon. "The public's trust needs to be earned, and if physicians hope to convince holdouts to take the vaccine, they cannot join in on the needless partisanship."
Published under: AMA , Bioethics , COVID-19 , Vaccine Mandate