Thread by @DeNovo_Fatima

1-Today there was a big protest in Montréal by healthcare workers opposed to mandatory vaccination.

As a healthcare professional & a bioethics I want to underline a few points about #VaccineMandates for healthcare provides
🧵👇🏾

2-In bioethics, autonomy is no longer that centuries-old belief that the individual can or does somehow stand apart from their community, social circumstances & political environment. Also, autonomy has a different scope when intervention in question has implications beyond self.

3-Dr Nedelsky(osgoode.yorku.ca/faculty-and-st…) calls the belief that autonomy is isolated from outside influence a “pathology”: “If we ask ourselves what actually enables people to be autonomous, the answer is not isolation, but relationships—with parents,
teachers, friends, loved ones.”

4-I love this statement by Mildred Solomon & Bruce Jennings: “Independence relies on interdependence.”
This societal interdependence combined w/ the biological one (communicable disease) ➡️decision to receive/refuse the #CovidVaccine implicates societal autonomy not personal ones

5-Autonomy in a PH is about a structured environment that provides options, good information, & the
absence of manipulation of preferences
by self-interested outsiders (misinformation, grifters).

6- Misinformation & pseudoscience in general have long gone hand-in-hand w/ extreme epistemological
relativism, where people are encouraged to believe that they should decide not merely what they want to
do, but what the facts are about #ClimateChange, #vaccines, supplements, etc

7-This is indeed a clever marketing scheme‼️
e.g. in 2010, the 🇺🇸 Federal Trade Commission
charged Pom Wonderful with
false advertising b/c of its unsupported
claims that its pomegranate
juice prevents heart disease &
erectile dysfunction & can “cheat
death.”🤯

8-In response, Pom ran new ads, telling consumers when it comes to "FTC v. POM - You be the judge." Which is of course completely ludicrous b/c the average person does not have the skills or resources to run a randomized longitudinal trial & ascertain the truths of the claims.

9-Above is an example of false autonomy: illusion of individual
choice that in fact limits INFORMED
decision-making & hence autonomy.
You are made to believe you’re given the independence of choice, when in reality, you lack the devices to make informed choices.
#Ivermectin

10-Many healthcare providers that oppose #VaccineMandates do so on the basis of the assumption that it violates their autonomy.
But we just established that:
📌autonomy doesn’t exist in isolation
📌if one lacks devices to make informed decision, one lack true autonomy

11-HCW have a fiduciary responsibility to “do no harm”. Patients have an absolute right to non-maleficent care.

Autonomy of the patient & HCW are interdependent & any personal decisions that endangers the wellbeing of the other person is unethical & grounds for legal action.

12-So autonomy is NOT a valid argument.
What about other ethical considerations?
When mandating vaccines, 3 broad bioethical questions should be addressed:
Q1: Can the population be protected w/o the mandate?
Q2: Is the compound safe & effective?
Q3: Is equity met?

13- Q1:Vaccination rates have plateaued & some in allied health remain unvaccinated. Given their risk level (to themselves & others) & their responsibility to not cause harm, there is an overwhelming consensus (scientists, clinicians, bioethicist, etc.) that mandates are needed.

14- Q2: The approved vaccines are very safe & effective— this question is NOT up for debate.

The fact that disease risk from infection >>>>> any potential side effects from vaccines is an established scientific fact & you do NOT get to make your own version of it.

15- Q3: this is the most challenging & yet essential issue to address.
📌Offer exemptions for VALID medical reasons
📌Compensate anyone who might suffer vaccine injury
📌Ensure everyone in the mandated population has equitable access to vaccines (#PaidSickLeaves, etc.)

16- In conclusion & in my humble assessment, there aren’t any bioethical hinderances to #VaccineMandates as long as we ensure the #equity aspect is address properly, and that the mandate is enforced firmly but fairly.
#VaccinesSaveLives
#SayYesToVaccines