Tell Javid that – he has made it clear – Jag or risk lose your job
I don't work for Javid.
And yet no one seems to want to comment or discuss that post. Much better to instead focus on anger-fuelled vindictiveness. Apparently.
Ever considered a career as a tabloid headline writer? You've missed your calling.
Ever considered a career as a tabloid headline writer? You’ve missed your calling.
Interesting comment from someone who exudes so much anger and clearly relishes denigrating those with different opinions.
Anyway, putting personal attacks to one side ..... have you got any opinions concerning the strategy outlined by sparkymcguff cougar?
It sounds very much like the practical, sensible, and reasonable solution, to vaccine hesitancy within the NHS, without the need for interference from politicians and their arbitrary deadlines.
And yet no one seems to want to comment or discuss that post. Much better to instead focus on anger-fuelled vindictiveness. Apparently.
Umm no, I am fully aware of these efforts, thats why we are where we are now. People have had over a year to work this out. The last stragglers, have had all the efforts spent on them. If you put the line in the sand, see if they respond properly, if not, then they need to be redeployed or sacked.
EG look at this. 34 officers out of 10k unvaxxed refused in the end.
https://www.independent.co.uk/news/world/americas/new-york-police-vaccine-mandate-b1949518.html
To be fair another 1000 stayed off work than normal, but probably they were brought round, there are approx 100k employees so 1% refusal at worst.
you put the line in the sand
And yet a very major teaching hospital says that the April 1st deadline will have devastating consequences for them, and therefore presumably patients.
https://www.independent.co.uk/news/uk/covid-vaccine-nhs-hospital-staff-b1990111.html
Should we listen to them or the politicians?
Yes but thats the point, the NYC police union said the same thing, when in fact the deadline made little difference. Have you read the article?
On Monday, however, that chaos failed to materialise. Less than three dozen NYPD officers were put on unpaid leave, and the department reported no interruption in service.
“Members of the police department responded to this [vaccine mandate], they came to work as they always do, and there is literally no effect on service at this point,” Mr Shea said on Monday.
From the NYC article.
And in your own link, they expect less disrution than you headline.
Speaking on the BBC’s Sunday Morning show, Clive Kay, the chief executive of King’s College Hospital (KCH), said that 10 per cent of the 14,000 staff are still to receive their first dose of the jab. He added that, as a result, more than 1,000 KCH workers could be lost in an “extreme” scenario, unless vaccine uptake improves.
Have you read the article?
No I haven't. Presumably the hospital management at Kings haven't either.
Have you read this posted earlier by poly?
if people think that refusing will get them redeployed not sacked the motivation to get vaxxed may not be there (or worse – may be higher – if you are in a front line shitty job and there’s an option to refuse vaccination and get moved to a perceived less aggressive role you might even be encouraged to hold off vaccination to get the job move!)
Don't know how much evidence there is of that but an interesting angle when considering whether politicians know best.
Edit : Were NYPD officers offered redeployment? If you insist on making a direct comparison.
No I haven’t. Presumably the hospital management at Kings haven’t either.
I do not think you have read your own link either. The hospital management said 1000 in an extreme scenario, the NYC example shows that given the deadline most staff will comply. Anyone left can be suspended and resources can then be focussed on the alst few persuading them its better idea to take it. Bin the final refusers after a month or so of "duress".
At least the deadline will weed out the refusers.
Make it staged. Deadline = suspension on full pay. xx Days to comply, then suspension on no pay for a period, and then finally bin them.
Yes I read my own link. I very much doubt that Kings are creating a fuss about something which they don't perceive to be much of a problem.
And yes, I fully expect them to give the worse case scenario to make their point. It would be daft not to.
So, this below
And yes, I fully expect them to give the worse case scenario to make their point. It would be daft not to.
Kinda undermines this below right?
And yet a very major teaching hospital says that the April 1st deadline will have devastating consequences for them, and therefore presumably patients.
https://www.independent.co.uk/news/uk/covid-vaccine-nhs-hospital-staff-b1990111.html
Should we listen to them or the politicians?
I mean should we believe the Hospital either if they are going to inflate the emergency to make a point?
In fact I think the Hospital have been paraphrased to make a headline.
Worth a read.
Looks like the House of Lords submitted a report back in November 2021 suggesting that there isn't enough evidence to mandate vaccines for NHS workers.
Apologies if it's been posted before.
Kinda undermines this below right?
You obviously think it does. I obviously think it doesn't. I very much doubt that Kings would be concerned about the possible dire consequences of the deadline a few weeks away if there was no reason for them to be concerned, whatever happened with the NYPD.
What makes me particularly concerned is that the whole policy is dictated by politicians, which I remain unconvinced are the best placed to decide.
Especially as the policy was only successfully passed because one man made a U-turn.
https://uk.news.yahoo.com/labour-opposes-mandatory-jabs-nhs-084018989.html
I'm not sure how qualified Starmer is on these matters.
The policy is also opposed by all the royal colleges and all the unions and many senior managers
It also only applies to England not Scotland and wales.
its just a political stunt. The intent IMO is to try to create another "enemy within" to blame for the tories failures
What makes me particularly concerned is that the whole policy is dictated by politicians, which I remain unconvinced are the best placed to decide.
I can agree on this, I mean its a good way to speed up privatization, put even more stress on the system, however I am not convinced the lords numnbers are accurate, they think 61% of the current unvaxxed will remain refusers.
But I am also fed up with Govian anti science so to me mandatory vaxx are a great idea, **** the stupids. I am happy with your policy to persuade as many as possible, but in the end the diminishing returns should end up with sanctions on the refusers.
Anyway, putting personal attacks to one side ….. have you got any opinions concerning the strategy outlined by sparkymcguff
This is the strategy, but the strategy has a deadline that is approaching.
Think TJ is right on this, we have two opposing views - both with merit - and we're going round in circles. Time to close the thread maybe
"I would have thought that a concerted effort to inform and educate would leave such a small minority unvaccinated that compulsion might not be necessary, and the few remaining could be deployed where they pose no risk."
But Scientists are notoriously bad at explaining stuff to ordinary people. Who are they going to get to do that?
Look at all the self regarding clever clogs on here, including one mod, reduced to shouting at people who don't agree with them...
including one mod, reduced to shouting at people who don’t agree with them…
Errmm -if that is aimed at Drac he has been really quite gentle considering his very strong position and his irritation with me. cougar resigned his modship a while back
I think its been pretty well tempered even tho I have been on the wrong end of the popular vote
This is the strategy, but the strategy has a deadline that is approaching.
The deadline is arbitrary, politically motivated, won’t increase take up and the mandate is too broad. By all means have compulsory vaccination within a tightly defined area of health care. But anything else is over reach and won’t add any meaningful protection to the public. In short it’s not evidenced based.
FYI the apples and bananas comparisons to various occupations earlier in the thread are pointless and add nothing to the conversation. What do they call it around these parts “straw man” arguments?
No, not aimed at Drac, or Cougar...
The mod in question is now an ex mod and his very shiny badge is up for grabs...
I am happy with your policy to persuade as many as possible
Whoa, it's not my policy..... I'm not qualified to have an opinion on the matter. Nor are politicians of course, which is my only point.
It is obvious that there exists a conflict of opinion between the government and hospital/trust managements, otherwise there wouldn't be an issue and the government wouldn't have set the April 1st deadline.
The only opinion I have on the matter is that I don't have more faith in the opinion of the government than I do in the NHS.
It's interesting that on a forum which is so consistently critical of the government, especially of its handling of the current pandemic, and sometimes unfairly imo, so many should be backing the government on this matter.
have you got any opinions concerning the strategy outlined by sparkymcguff
Our trusts I know of have been taking the stance mentioned. After all we’re over a year in for NHS staff being vaccinated. The government have felt the need to step in. Out of those not vaccinated there will be those who are exempt, those who don’t work face to face and some ready to leave. There is going to be a bit of a wave of leavers following the latest pension changes.
It’s interesting that on a forum which is so consistently critical of the government, especially of its handling of the current pandemic, and sometimes unfairly imo, so many should be backing the government on this matter.
This is logically unsound, and a bit ridiculous. I agree with some stuff they do, I don't disagree just cos its the govt. Thats not scientific is it, its just dogma.
I mean Hitler liked dogs, should I hate dogs? if i like dogs does that mean I am a nazi.
It is obvious that there exists a conflict of opinion between the government and hospital/trust managements,
And all the professional bodies and the devolved governments. Its The tories that are the outliers
Interesting comment from someone who exudes so much anger and clearly relishes denigrating those with different opinions.
I was going to say "I'm not angry" but in this case I am. I'm angry with vaccine deniers and I'm getting increasingly cross with people who defend them. You can think the earth is flat or the moon landings were faked and that's (offensive but) harmless so fill your boots. But this shit is dangerous. I tested positive an hour after picking my mum up from hospital after surgery, almost certainly as a result of an interaction with a covid-denier.
Sure, I like a forum debate as much as the next argumentative shitbag who enters into this arena willingly. I've butted heads with you Ernie and with TJ and countless others and it's essentially sport. But please don't see fit to lecture me about "opinions" over what could have been a fatal outcome for the sole family member I still have left. That's too far.
Anyway, putting personal attacks to one side ….. have you got any opinions concerning the strategy outlined by sparkymcguff cougar?
Must've missed that, sorry.
No, not aimed at Drac, or Cougar…
The mod in question is now an ex mod and his very shiny badge is up for grabs…
Errrrr!
almost certainly as a result of an interaction with a covid-denier.
What absolute bollocks , you could have got it anywhere from anyone, jabbed or not
But this shit is dangerous. I tested positive an hour after picking my mum up from hospital after surgery
You expect to test positive an an hour after coming in contact with the virus? I can't think of any other reason for you making that comment.
I'm certainly no expert but I can't help thinking that you haven't fully understood the science behind the pandemic. Which under the circumstances is somewhat ironic.
It’s interesting that on a forum which is so consistently critical of the government, especially of its handling of the current pandemic, and sometimes unfairly imo, so many should be backing the government on this matter.
Even stopped clocks are right twice a day.
And also interesting that even those of us with a blind hatred of the Tories, especially their handling of the pandemic, don't see this as a party political issue.
You mean like this :
And all the professional bodies and the devolved governments. Its The tories that are the outliers
Even stopped clocks are right twice a day.
It's not simply whether the government is right that is the issue, it's whether senior healthcare professionals are wrong.
"It’s not simply whether the government is right that is the issue, it’s whether senior healthcare professionals are wrong."
It may depend on who pays them...
More cash - its very much a party political issue. its a purely political ploy. Starmer was trapped into voting for it
You expect to test positive an an hour after coming in contact with the virus?
They did not say that. Just that they (unknowingly) put their relative and others at the hospital at risk after being (unknowingly) infected themselves. Which must have felt horrible. And you can see why that would get them angry.
its a purely political ploy
Why? I get the feeling this government would run a mile from “mandating” anything if they thought they could. What “ploy” do they have when it comes to how they get the last vaccine hold outs in care and health services to get jabbed? What is in it for them politically?
No, being angry because you have tested covid positive seems like a strange emotion.
I didn't feel in the least angry about testing positive.
Edit : Obviously I wasn't too happy about it buggering up Christmas plans at the last minute. But I wasn't seeking revenge against the person who gave it to me.
Try some empathy.
Try some empathy.
Well yes. He should have done the test an hour before seeing a vulnerable person, not an hour afterwards, it's what the government advises.
"No, being angry because you have tested covid positive seems like a strange emotion."
Really? I'd be effin' fuming! Stuff to do... not just fill me face with turkey 'n pud!
Why?
Its about creating an "enemy within" to blame for their failures. I think they hoped that the royal colleges would be even stronger in their opposition so they could be labeled "part of the problem" and it lets folk think they are doing something significant whereas it will make very little difference across the english NHS part from making staff shortages worse
"look we are doing everything we can but these pesky doctors and nurse are stopping us doing this"
Its been one of their key tactics from the beginning - finding scapegoats to blame and creating diversions to avoid their actions being placed under scrutiny
“look we are doing everything we can but these pesky doctors and nurse are stopping us doing this”
Plausible. I don’t buy it yet, but it’s possible.
Friends and family I know (including pesky doctors and nurses) in the NHS are behind vaccinations being mandated. If it wasn’t for this thread, and one outspoken anaesthetist who won’t get off my radio, I wouldn’t be aware of any kick back.
Just as well yo have been enlightened then...
Friends and family I know (including pesky doctors and nurses) in the NHS are behind vaccinations being mandated. If it wasn’t for this thread, and one outspoken anaesthetist who won’t get off my radio, I wouldn’t be aware of any kick back.
I don't know ANYONE that supports mandatory vaccinations. Not one single person.
And the current situation with Omicron makes mandating even less credible
I was referring to NHS staff. Those I know support all NHS staff being vaccinated if dealing with patients. Do you know many who don’t? Not sure it’s really a necessary move myself, but they all seem to just want to crack on with everyone vaccinated. I wasn’t referring to the general population outside social care and health workers.
"I was referring to NHS staff. All those I know support all NHS staff being vaccinated if dealing with patients."
I don't! But then I'm not an NHS staff, just a possible patient, grateful to get fixed, maybe, but would like it if you were to wear a mask...
I couldn't give a 5hit if you're vaccinated or not! just don't breathe all over me...
TJ’s point was that the government were setting up a situation where they could benefit politically from NHS staff kicking back against vaccination rules for NHS staff. I was referring to that, and talking explicitly about the attitudes of NHS staff that I know (who aren’t against what the government are doing on this specific point). I wasn’t referring to the attitudes of patients or the wider public.
But our opinion is more important! we are the "customers"...
*backs slowly away*
I’m not trying to play devils advocate here (maybe it comes naturally 😂) but would you be happy to be treated by someone that is medically exempt from the vaccine? A lot of the arguments I have read in this thread are based around non vaccinated people being more of a risk to patients. Surely medically exempt or against the vaccine, outcome is the same? Unless we aren’t talking about safety and more about peoples own views?
Good question. I'd have to weigh up whether the exempt is likely to be more cautious about other means of protecting themselves, and whether vaccine avoider is indicative of 'don't care, won't affect me that badly'?
And then whether vaccine avoider is indicative of lower understanding of the science and consequently will the care given be the same.
@marksnook medically exempt, which is incredibly rare in reality, versus arses who don't want vaccination and claim exemption are poles apart.
Those who don't want it have no reason not to be able to have it beyond their own reasoning, the more who have vaccine means those few who can't actually have it are protected more by reduced chance of contact with the virus.
I would say if you are following the mandatory vaccination line then they should be sacked as well as if they have a medical exemption they are unfit medically to be a healthcare worker. Retired on medical grounds if you like.
There is no difference to the patient between someone who has a medical exemption, Someone who has a good reason for not wanting the vaccine and someone who is an anti vax loon. they all create the same risk to the patient
They may be poles apart but only in principal? If a medically exempt person doesn’t care and goes to clubs licking peoples faces and some one against the vaccine is super careful and doesn’t put themselves at risk then the medically exempt person is more of a risk but thats ok? Maybe medically expempt should be reassigned as well, risk is risk?
This is a very complicated and nuanced situation in my eyes
Yeah that was my thinking tj, i thought it crazy that one got a free pass even though the risk was the same
A point that occurred to me. many folk on here think being anti vax shows you are not competent to be a healthcare professional for being "anti science" ( a position I have some sympathy with)
So do we also need to route out those who believe in other nonsense. Homeopathy? Crystals? Religion ( yes I have met nurses who believe ill health is "gods will" ) I certainly do not trust fundamental religious healthcare workers because they may put their religious views first. ( I have seen this happen)
Do we have to root out every doctor / nurse that has non mainstream views?
Do we have to root out every doctor / nurse that has non mainstream views?
Only those whose views create additional unnecessary risk for the patient.
So those who prefer prayer to medicine or let their religious views interfere? Those who waste time faffing around with crystals and homeopathy?
Who decides if the additional risk is "unnecessary" surely any additional risk from non mainstream views should mean a sacking?
Does this mean an end to the religious exemption in healthcare ( people can refuse to do things that are against their religion even if those things are mainstream treatments)
It's not uncommon, pre pandemic, to redeploy staff due to medical reasons, or apply for ill health retirement.
I don't work nhs setting anymore but am aware of many at risk staff who have been moved or had restrictions on what and where can work temporarily for their protection. So it's not a new concept at all
northshoreniall
Thats for the staff members protection not the patients IME.
BTW - I do not believe the stuff I have outlined is right but its a corollary of wanting to sack anti vaxxers for their unscientic views that others with other unscientific views should also be sacked
I was referring to NHS staff. Those I know support all NHS staff being vaccinated if dealing with patients
NOBODY should be forced into having a vaccine.
And anyone that says 'just get another job', have a word. I actually agree with MOST of what tj has to say on the matter
@tjagain that is in response to the discussion about people unable to have vaccine due to medical exemption so still for their protection.
Fair enough
Yeah I guess that’s part of a wider conversation, arguably someone without a vaccine could still provide excellent levels of care putting perceived risk aside.
In my eyes the rules have to be absolute, if it’s no vax-no job that means all scenarios of people not just someone who believes something different. Where that would end is complicated, like tj said, if you think prayer or some kind of witch craft is the answer maybe you need rooting out too!
And anyone that says ‘just get another job’, have a word
Anyone who cannot do a job to the required standards of customer safety needs to find another one, doctors, nurses, gas engineers, electricians. Those standards change over time.
I would only agree to be seen by medical staff that have vaccinated in the last three months.
Last week the broadband engineer seemed surprised when I asked him for his vaccine status before letting him in. Can you imagine that? I said, "c'mon, I don't want to catch the virus".
Unfortunately he then asked me for my vaccine status before agreeing to come in. Took a while but luckily I managed to find proof.
It might be useful if people wore a badge type certificate, just to let other people know. You can't be too careful.
Anyone who cannot do a job to the required standards of customer safety needs to find another one, doctors, nurses, gas engineers, electricians. Those standards change over time.
Working to dynamic industry standards is not the same as being forced to have a vaccine, I'm sure you know that
NOBODY should be forced into having a vaccine.
And exactly how do you think Smallpox was eradicated?
I would only agree to be seen by medical staff that have vaccinated in the last three months.
This is me also.
Do we have to root out every doctor / nurse that has non mainstream views?
The comparison to believers in stuff like homeopathy is an unhelpful one I think. The point of mandating vaccines like HepB for clinicians is that it offers protection for both pat and clinician (as does the COVID vaccine) whereas belief in the healing power of crystals while unhelpful is unlikely to actively do harm.
I think this problem has only really arisen because who'd have thought that so many clinicians would be vaccine hesitant? It would be an interesting experiment to see how many of them would now refuse the childhood vaccines they received that have undoubtedly saved lives. Perhaps we'll see the return of iron lungs?
I have no problem with politicians deciding this, it may involve a change in law (to mandate vaccines) and that's literally their job, it shouldn't be the role of the NHS or clinicians. There has to be a deadline once that's been decided. If anything, I'm somewhat embarrassed by my fellow healthcare workers that this is even "a thing"
EDIT. I'm posting this, as a reminder; plus ca change, plus c'est la meme chose (apologies for lack of diacritics)
Hep B is only mandated in a small number of areas
The comparison to believers in stuff like homeopathy is an unhelpful one I think.
I have seen nurses waste time on prayer to the extent of delaying badly needed end of life care. I have seen nurses use religious exemptions to refuse to participate in treatments, I have seen nurses waste valuable time with all sorts of non scientific mumbo jumbo that compromises care
Its not just a change in the law - its a massive change to the whole ethical basis of modern medicine. Its a question of whether yo think this is worth that and also if you are prepared to accept the effects from that massive change
the whole medical ethic on consent and autonomy now needs to be rewritten
Nickc - not meaning to be derogatory but you are a practice manager IIRC - not having any actual medical qualifications nor are you bound by the various codes?
whereas belief in the healing power of crystals while unhelpful is unlikely to actively do harm.
You may not be aware, but as TJ says there are countless examples of people refusing proper care in lieu of ALT medicines and then suffering/dying because of it.
What is even worse is that you can get a "degree2 in homeopathy and holisitc medicine etc, which fools the unwary in to thinking these people have any idea about how to help the sick.
So I am hugely against it, especially int he medical profession.
There is a great blog here from a leviathan of debunking. https://edzardernst.com/
Its not just a change in the law – its a massive change to the whole ethical basis of modern medicine
Yes, that's why it should be decided in parliament. That's the proper place.
not meaning to be derogatory
TJ, I'll say this but once, although others have said it already. I think you have to allow that others may disagree with you for perfectly valid reasons. I think everyone here understands and allows that you have strong feelings, but the opinion that certain treatments shouldn't be mandated is just that - an opinion, and the opposite view - that certain treatments should be required under law for the overall good health of a nation, is a valid argument, and has merit, whether you agree or not. Medical ethics change over time. (consent being the very obvious one being discussed here) Go back less than hundred years and the medical establishment would've been arguing very strongly that patients shouldn't be consulted at all. Would that been your position if you were a recently retired nurse at the time? (the answer is that it very likely would've)
Argue the rights and wrongs by all means, but have some respect for the opposing view at least. Up until this point we haven't had to mandate vaccine, the uptake is so broad, the benefits so obvious that the outliers pose little to no risk to society. But the counter argument that induvial rights shouldn't be allowed to be the cause of widespread societal ill-health is a valid one. You may personally disagree with it, but it has merit
Oh I do Nickc - sorry if it comes over that way I agree it has some validity I just think its less than the need to follow established medical ethics
I totally understand the desire to get rid of anti vax idiots. I agree they are a huge problem. I just disagree that this is the right way to go about it because of the huge shift in medical ethics this means. Personally I would put anti vaxers in the same category as religious fundamentalists and homeopaths etc- damaging to healthcare. so if we get rid of the anti vaxers can we also get rid of the fundamentalist religious and the alternative medicine bampots? I have seen both cause sub optimal care.
the answer is that it very likely would’ve
that is outrageously offensive and 100% wrong Ethics and morals are something I have a huge interest in, have studied at a high level to the extent I struggled thru "critique of pure reason" which is a basis of much modern thinking about ethics and morals and is far more than 100 yr old as well as various works by John Stuart Mill and iother thinkers in the area. Apply the categorical imperative to mandatory vaccinations and see what comes out
i was reading about ethics andmorals before I left school. I actually had uni places to study philosophy
Jeepers - why did I come back to this thread
All of us have grown up in a world where previously endemic diseases have all but been eradicated, so that treatment didn't need to be mandated because the benefits were clear to everyone. No more polio, no more smallpox. Miracles! Society has changed, there's no one alive that can really remember a time when children died of preventable disease, and where there was once a queue out the door, there's now disinformation and distrust. It may happen that now to make sure those diseases don't return, we may have make it law, like wearing seatbelt, or no cycling on a motorway.
It's not so unimaginable
Oh I do Nickc – sorry if it comes over that way I agree it has some validity I just think its less than the need to follow established medical ethics
But you're claiming that medical ethics has only one facet - consent / autonomy. Even me, with my relatively superficial (ha!) knowledge of ethics knows that there are three other pillars to consider.
So it's not black and white, and barking on about one pillar when there are so many perspectives to consider is just wrong. You are wrong. Not about everything, but about this one thing. Bodily autonomy is not the only thing to consider, it is not sacrosanct. To give an example that should be blindingly obvious for you: when someone is detained under the mental health act ('sectioned'), their autonomy is usually removed.
that is outrageously offensive and 100% wrong
I didn't say it to be offensive, I said it to highlight the fact that ethics change over time. It was a perfectly normal belief and reasonable behaviour in the medical establishment that pts didn't need to be consulted. You know this. Had both of us been in either primary or secondary care even just 50 years ago it's likely our opinions regarding treatment would've been shaped by the colleagues around us.
To give an example that should be blindingly obvious for you: when someone is detained under the mental health act (‘sectioned’), their autonomy is usually removed.
yes - and a court supervises treatment. ( mental health tribunal if you prefer) Its seen as a very strong step to take and can only be taken if there is clear danger to themselves and / or others. there are a lot more safeguards over it which are completely absent in this case. Where is the right of appeal? Where is the right have recourse to courts> Where is the legal oversight? Even if someone has been sectioned they still have the right to refuse some treatments - they donot lose their entire autonomy - one of the cases that is a basis for our law around consent demonstrates this clearly Bolam v >Friern Hospital Management Committee is an absolute cornerstone of law
yes there are other aspects to ethics - "first do no harm being one" for example 🙂
I am not wrong - I have a different opinion to most of you that comes from what I know. I put more emphasis on autonomy and consent than many of you - thats a product of who I am
its very clear that this step means a large rewrite of medical ethics - i agree its a balanced judgement and others may judge it differently. Politicians are NOT the people to do this tho. No training in ethics, no medical background, driven by short term political aims.
How do you square the need for consent to be given freely without pressure with this policy? that part of the NMC code now needs to be rewritten
There is also "the doctrine of necessity" which allows procedures without consent. however to proceed under that it has to be in the individuals best interests not societies
Final point - if the entire medical establishment agreed with the policy then I would clearly be in the minority. But the medical establishment is highly divided with senior managers, the royal colleges being against it and averyu vigorous debate in the BMJ that I have been following
perhaps some greater safeguards could be introduced? that would go a long way to assuage my concerns
finally - if this policy is so critical why is it not happening in wales and Scotland?
We cannot give informed consent when we are very young or very ill, mentally impaired, demented or unconscious, or merely frail or confused. Often people cannot give informed consent to emergency treatment. we may even find it quite taxing to give informed consent to complex medical treatment when feeling crappy (with COVID perhaps).
Then there's the obvious limitation of informed consent procedures in medicine; that they are useless for selecting public health policies. Public health policies, have to be uniform for populations. We cannot adjust water purity levels or food safety requirements to individual choice, or seek informed consent for health and safety legislation or quarantine restrictions.
and another limitation of informed consent is that medical treatment of individuals uses personal information about third parties that is disclosed without their consent. For example, family history information, genetic information and information about exposure to infections are often disclosed to clinicians without the consent of all to whom the information pertains. We do not expect patients to obtain prior consent to disclosure of such information from their relatives and contacts, and this would often be impractical or impossible. This fact about the way medical information is sought and used cannot be reconciled with the claim that informed consent is necessary for all ethically acceptable medical practice
Autonomy and consent should not be and cannot be the limit to treatment. Vaccination polices are an interesting and possibly hybrid case: in so far as we think of them as a matter of public health policy they cannot be based on individual choice, or on informed consent. But however, thus far we have treated vaccination only partly as a public health matter. We allow parents to refuse to have their children vaccinated without medical reason. Some have done so at little or no cost or risk to their children by sheltering behind protection provided by others' vaccinated children. The proportion of children vaccinated with measles, mumps, and rubella (MMR) has fallen, and free riders now face a problem. They still do not want to expose their children to the risk of measles, but can no longer do so by refusing vaccination. Public health policies can be undermined if their implementation depends on individual informed or uniformed (currently the likes of TJ make no distinction) consent. Should medical ethics allow that to happen?
