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Should the H1N1 flu vaccine be required for doctors and nurses?

That's one of the questions Parkhurst Exchange will explore in a Q&A with chief public health officer Dr David Butler-Jones (right), set to be published in the September issue.

But in the meantime Canadian Medicine offers you this sneak preview of Dr Butler-Jones's comments on the matter:

"We’ve kind of gone around that a few times and generally courts have not supported compulsory immunization for healthcare workers. It is, at the end of the day, an issue of choice. It is prevention, not treatment. That being said, I think every professional body encourages its members to be immunized. The reality is, if I am not immunized and I get flu, I kill my patients. I mean, that’s the reality. We’re the ones -- doctors and nurses -- who take it, by and large, into the nursing home, and spread it around. The fact that we are lucky to get 50% of our colleagues who take actually take the vaccine is amazing, when you think of it. I mean, it’s different if you have a contraindication or whatever, but in so many other realms if you basically give a noxious agent to a patient and kill them, that’s malpractice. And yet a totally or largely preventable disease that we carry and then share with our patients, somehow that’s okay? I don’t think it’s okay. At the end of the day, it is a matter of choice but my hope is, unless there is a reason not to, basically why would we not protect, as physicians or nurses or healthcare workers, why would we not protect not only ourselves but our patients and families besides?... The ethical position would be: why not do anything reasonable? I don't go drunk into surgery, so why not be immunized?"
Doctors, nurses and patients: what do you think?

Is the refusal of so many thousands of healthcare workers to be immunized against the flu (a pattern all but certain to repeat itself this fall with the pandemic H1N1 flu) tantamount to operating under the influenza? Legal issues aside, should doctors and nurses be pushed harder by their workplaces or by their professional associations to receive the vaccine?

Photo: Public Health Agency of Canada

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4 comments:

  1. sharonAugust 5, 2009 at 10:22 AM

    RE: the decision-making process in:
    (a)Public Health,
    (b)Global Health,
    (c)International Health

    NOTE: these 3 have very different perspectives on what constitutes evidence.

    (a)Where do "public" health perspectives begin ?

    http://clinicalevidence.bmj.com/ceweb/SearchServlet?
    searchTerm=H1N1+immunization&x=10&y=8&_charset_=

    [After looking at this site and it's perspectives you will see there is still ambivalence in the " public" health perspective that vies "prevention" against " harm reduction" views .....and related actions

    Where do we go after we have ? clinical evidence ?

    For that answer we have to look at the impact of (b) and (c) ......... (but right now I am out the door for a " field trip" ....more later ) :)

    Delete
  2. sharonAugust 5, 2009 at 5:51 PM

    cont'd:

    (b) global health

    http://www.globalizationandhealth.com/content/4/1/6#B5

    Really acquaint yourself with what this "diagonal "approach means in terms of not just looking at the disease state...but also at the health "system" that delivers it.

    In many ways this " should we get the vaccine" debate belongs here. They are really asking for a "systems" change.

    (c) International health

    http://www.nytimes.com/2007/03/25/magazine/25wwlnidealab.t.html?pagewanted=1&_r=1

    "Reverse Subsidies" must be understood clearly as "epidemiologically" based needs assessment in this age involves the entire mobile planet.

    The movement of wealth will determine who survives.

    How does all this affect a simple " to do" decision?

    Note: In North America reverse subsidies must be factored into extra charges/demands made upon a tax-paid development.
    e.g. you cannot have a tax payer build a library and then charge admission fees ( but you can impose fines)

    Therefore...in essence, you cannot have a publicly paid health system " impose" more compliance [but they can penalize for non-compliance with some standard(key) you agree to]

    Summary

    To look at the macro/micro fit in the simplest of decisions follow McLuhans Tetrad:

    Here is an example of how it impacts your everyday by the " googlebot"

    http://www.anthonyhempell.com/papers/tetrad/ai.html

    Q- do we want to be " herded" into anything?

    Delete
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