We shouldn’t deny healthcare to those unvaccinated against Covid-19
There is overwhelming evidence the Covid-19 vaccine is safe and effective. Despite this, some Kiwis have decided not to get vaccinated.
And with limited supplies of treatment for the virus in New Zealand, it is important to be clear about why these treatments should be available – for free – to the unvaccinated, regardless of public opinion among some quarters and regardless of approaches taken in other countries.
When asked, Health Minister Andrew Little has made it clear that unvaccinated people are eligible for Covid-19 medicines. The Ministry of Health and the Nursing Council have also issued statements saying that patients should be provided with care, regardless of vaccination status.
In Singapore, unvaccinated patients must now pay for their treatment (Singaporeans have compulsory medical savings accounts and most have private health insurance). A similar proposal was debated in New South Wales.
Wanting to de-prioritise or charge unvaccinated patients for care often stems from anger, frustration, and a sense of fairness. But a closer look at the reasons some people remain unvaccinated, as well as medical ethics, makes it clear it would be wrong to do so.
Overwhelming evidence shows that the risks of having Covid-19 far outweigh the risks of the vaccine. Despite this, people refuse the jab for complex emotional reasons, including the genuine belief it will cause them harm. Indigenous people, women, disabled people and members of the rainbow community have valid reasons for not trusting
medical systems that have not served them well.
Compounding this, relentless misinformation and disinformation has been targeted at vulnerable groups such as Māori and Pasifika. These groups are also more likely to distrust the vaccine because they have suffered abuse and systemic racism from the state and health authorities.
Research published in the Journal of the Royal Society Interface found conspiracy theories spread so quickly through groups already distrustful of authority that it made it harder to suppress major Covid19 outbreaks in those communities.
Health professionals have an ethical obligation to provide care for people regardless of their choices. This is why you can drink alcohol, smoke or climb mountains and still get treatment when you get sick or injured as a result of these behaviours.
The healthcare system is not there to provide justice – it is there to treat people, without judgment.
When resources are scarce, prioritisation is usually based on health outcomes. Smokers would not typically be allowed a lung transplant because they are less likely to benefit from it.
In the US, a 31-year-old man was denied a heart transplant, with one of the considerations being that he was not vaccinated against Covid-19.
Health authorities could be forced to make difficult choices if hospitals were completely overrun with another wave of Covid19. Experts have recommended that triage decisions are based on saving the most lives, minimising inequity and protecting the public’s trust.
Denying unvaccinated people treatment for the virus would not only lead to more hospitalisations and deaths, it would also be unethical, inconsistent and further marginalise already vulnerable groups.
Reporting disclosure statement: This post was written with expert advice from Otago University medical ethics associate professor Angela Ballantyne, and Te Pū naha Matatini disinformation project lead Kate Hannah.
This post was reviewed by The Whole Truth: Te Mā ramatanga expert panel member Dr Rawiri Jansen.