As the U.S. grapples with a deadly fourth wave of the pandemic, many providers in hotspots and overwhelmed areas have expressed frustration that more people didn’t get vaccinated when they had the chance. One doctor has even stated that he will no longer treat unvaccinated individuals.
That begs the question: Can doctors refuse treatment to people who haven’t gotten their shots? Legal experts say it depends on the situation.
Alabama remains one of the lowest vaccinated states in the country. The state recently ran out of ICU beds, with several hospitals saying they were at or over capacity. Dr. Jason Valentine, a family physician at the Diagnostic and Medical Clinic Infirmary Health in Mobile, Alabama, made headlines when he announced on Facebook his practice would no longer treat unvaccinated individuals, effective October 1st.
Around the same time, a memo leaked from the North Texas Mass Critical Care Guideline Task Force that said the group was considering incorporating a patient’s vaccination status when determining eligibility for ICU beds.
Is any of this legal?
Experts say it all depends on the motivation of the person that decides whether a patient gets turned away. Providers must abide by professional norms and practices when making these decisions. That means a doctor can’t turn a patient away because they resent the person’s decision not to get vaccinated.
Doctors and nurses are morally bound to care for patients, regardless of how they feel about the person or their beliefs.
If a doctor feels their resentment is interfering with their ability to perform on the job, it may be ethical to step down or refuse service out of concern for the patient.
When it comes to prioritizing ICU beds for vaccinated patients, it may be ethical for doctors and nurses to select patients with the best chances of survival, which may mean turning unvaccinated patients away.
Refusing unvaccinated patients may also be necessary to protect the health and safety of the staff members, especially if the facility is short-staffed or losing a provider would endanger the surrounding community.
In his post, Valentine explained his motivation for turning unvaccinated patients away, writing, “COVID is a miserable way to die and I can’t watch them die like that.”
The memo from the North Texas Mass Critical Care Guideline Task Force says the expectation of better outcomes in vaccinated patients is a reason to consider vaccination status in allocating ICU beds, but this only applies when ICU beds are scarce.
The hospital also implored its staff not to let their anger or resentment affect their decisions.
However, once the memo leaked to the public, the author quickly reversed course by saying vaccination status shouldn’t be a factor when assigning ICU beds.
Can You Dismiss Unvaccinated Patients to Encourage Them to Get Vaccinated?
Legal experts say that refusing treatment to unvaccinated patients as a way of encouraging them to get vaccinated may be interpreted as coercive. However, this may be acceptable if the provider encourages others to get vaccinated as a way of preventing illness in the community, which is a part of their ethical requirements.
The bottom line is that providers can’t refuse unvaccinated patients if they have the resources to protect their staff and patients while creating a safe environment for the treatment process to occur.
While there are no laws that prevent providers from turning patients away, it’s their moral obligation to communicate their expectations clearly to the community, so patients don’t wind up stranded without care when they need it most.
The American Academy of Family Physicians offers communication procedure templates to providers thinking of dismissing patients or implementing vaccination requirements. A 2016 study of 794 physicians showed that around half have dismissed a patient for not following their treatment plan.
Pediatricians regularly deal with the issue of vaccination when dealing with their patients. A 2019 survey of 303 pediatric practices showed that over half of all practices have implemented policies that allow providers to dismiss patients that refuse routine childhood vaccinations.
However, the decision often comes down to the parent. The same survey showed that 18% of parents who refused vaccinations often or always changed their minds and agreed to be vaccinated.
Many people will likely remain unvaccinated, but some of them may have trouble finding medical care if the current wave continues.