Opposing views from ethicists on health care worker flu vaccine mandates

Two bioethicists have weighed in via op-eds on the debate over mandating seasonal and swine flu vaccination for health care workers.

On the 'pro' side, our colleague Art Caplan minces no words in his column, "Health Workers: Get Flu Shots or Get a New Job," on MSNBC.com this morning. He writes:

"Look, there are legitimate issues that ought to be debated whenever someone says you must do something to benefit others ranging from taxation to restrictions on driving under the influence. But health care workers' own code of ethics dictates that they put the interests of others — their patients — first. Getting a flu shot is the least those who claim to be bound by professional ethics ought to do."

Taking the other side is George Annas, professor of health law at Boston University and a strong critic of mandates in medicine and public health. In an op-ed published in Newsday, "Don't Force Medical Pros to Get H1N1 Vaccine," Annas writes:

"The ultimate measure of success or failure of a swine flu vaccination program will be in lives saved and lives lost. The most effective way to maximize the numbers of the public being vaccinated is to send the message that physicians and nurses believe this is the most reasonable approach to take to prevent wide-scale death and disease from the swine flu. Legal threats and mandates undercut that public health message and will backfire."

Annas makes a strong point about the potentially troublesome message sent to the public about the importance of flu vaccination, if even health care professionals have to be compelled to receive it. Why enthusiasm for vaccination among health care workers is so low continues to puzzle public health experts. In the meantime, requiring vaccination in this community may be a necessary evil to prevent avoidable disease and death among patients.