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Patients denied transplantation because not covid vaccinated
In Boston a hospital took a 31 year old man off the transplantation list for a heart transplant, mainly because he refused to get a covid vaccination. The patient objected to vaccination prior to transplant because he was afraid to get cardiac inflammation, a known side effect of the vaccination.
Earlier, a woman in Colorado was refused a kidney transplant because she did not want to be vaccinated against covid for religious reasons. Her Christian faith prohibited her to get a vaccine, because in the development of some of these vaccines tissue from cell lines was used from fetal origin, coming from abortions.
The hospitals have defended their decision by stating, that transplant recipients have a higher risk of dying from covid (about 20% higher), and they want to do everything to prevent scarce donor organs to be used in patients with non-optimal survival rates. Furthermore, they stated that vaccination before the operation was much more effective to induce a strong immune response against covid than after, again because of the medication to suppress the immune system after transplant.
I can see many good reasons to advise patients to take care of their body in the most optimal way if they are going to have a transplant. After all indeed, we wish these people the best possible chances to have a long and healthy life with these new organs. We should advise people to stop smoking if they get a lung transplant, or to stop drinking in case of a liver transplant. Or to get all sorts of common vaccinations to prevent other diseases, including covid. This is common practice and I see no harm in that. Because we should advise anybody to stop smoking and drinking and take care of their health well. There is nothing special in the situation of being a patient in need of medical assistance, that would allow us to do more than advise them. Perhaps even we should be more careful to putting these patients under the duress of extra advise, because they are in a dependent position and we should handle them with more regards and care.
But in none of these cases patients are obliged to follow these advises. And there is no way – fortunately – to force them to. Medical procedures under duress or force are only allowed in the rarest of cases, if people are not compos mentis, or if they are a clear and present danger to themselves, or if they have been acting in a criminal way (for instance a blood test for alcohol after causing a car accident). There always needs to be a legal basis for this. Because this would otherwise violate their constitutional rights. And I think that denying medical procedures should only be possible under the same, severe and extreme conditions and under the same protection of the law.
Denying people who are otherwise eligible for transplant surgery this option, if they chose not to be vaccinated, comes down to violating their freedom to decide how they chose to handle their health and bodily integrity in the way they see fit. It is very close to applying bodily force to them, and I don’t think there is a base for this in the law in cases like these so far. I urge those patients to take their case to the court and for patient organisations to pay for their expenses. I expect clear and prohibitive decisions from judges about this.
These people are not criminals. They pose no risk for themselves or others that is greater than other people are free to do in other situations. They are consenting adults that make an informed decision about their own body. That should be respected at all times, even in times of covid.
And it makes no sense practically speaking either. Even if these patients would, for the sake of being transplanted, agree to a vaccination, there is no way to force them to repeat vaccinations after the surgery either. Like there is no way to prevent a liver transplant recipient to start or keep drinking. Or a lung transplant patient from smoking.
We don’t force other patients to change their lifestyles, including habits in eating and drinking, moving, dangerous or unhealthy hobbies or occupations etcetera if they apply for a medical procedure. We can advise them and educate them. But in the end, there it stops. And rightly so. The mere fact that their behavior might increase the risk after the medical procedure that they might die earlier than other patients that follow a “perfect” lifestyle, was never a valid reason to withhold medical assistance to those who are in need of that. Who is to determine what this “perfect” lifestyle or behavior looks like anyway? Where are the objective criteria for that? Where are the laws that describe these and provide for a careful balance of interest, and for the rights to appeal to decisions that are taken that way? And when did the medical authorities get the right to enforce those self-made criteria by withholding urgent medical assistance?
And in a few years covid is like the flu, vaccines will only be 40% effective like flu vaccines are currently. There will not be just one prevailing mutation but a cocktail of different variants of different strains whose emergence has to be predicted quite unreliably, just like we do nowadays with the flues that go around each season. And no one in their right mind would deny patients any medical procedure for the mere reason that they didn’t get a flu vaccine. Already now it is becoming more clear every day that vaccination is not the solution.
Only a year ago science told us that vaccines would give 95% protection and would end the pandemic. And politicians worldwide followed this prediction. And now, after delta and omicron and omicron+ , after two base shots and one or two booster shots, infections are soaring higher than ever and we are waiting again for the newest vaccines to solve this? If we don’t change our ways of living we will lose more ground to the virus every day and medical solutions will disappear on the horizon soon. Should we then discriminate these poor patients that are in need for a transplant right now, in stead of in a couple of years? I call this diachrone discrimination.This is the thin end of the wedge in my opinion. Are we creating a society where only patients that follow a perfect lifestyle are eligible for medical care or protection under the law? Is this what we really want? I think this policy is both unethical and unlawful. And even if in future, governments would create a legal basis for this, it would still be unethical lawmaking. There are some precedents of this in human history and they are very ugly indeed. We still remember the victims of these mistakes.
We are entering a situation where those who do nothing to prevent infection except getting a vaccination are getting a free pass, whilst those doing everything to prevent infection (eating and living healthy, wearing masks, social distancing) except getting a vaccination are more and more pushed out of their civil rights and freedoms. This is indeed very sad.
What are your thoughts?
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