Alabama doctor refuses to treat patients who reject Covid vaccine

Not really.

IANL, and certainly no US one but there must be precedents on how doctors deal with patients that refuse treatment. A doctor can’t be forced to treat a patient who refuses treatment, right?

A vaccine is treatment, one that this doctor advices before any other treatment(*). Any patient who refuses that refuses treatment. Simple.

There is also the obvious truth that a medical professional has no obligation, not even under any professional oath to assist a patients that threatens to kill them. Refusing a vaccine is maybe not the same as threatening to shoot any doctor that treats you, but the difference is in degree of the threat, not in the nature.

(*And that makes sense too. Whatever it is you see the doctor for(**) is NOT going to be helped with a COVID comorbidity.)

(**Possibly exception for really serious needle phobia.)

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It’s the CDC risk level. The overall message is “nowhere is safe”.

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When law enforcement gets involved, I wouldn’t bet on that:

ETA: I get that this is a different context, but given the vocal minority screaming about “their freedoms,” I can well imagine them wanting others to force doctors to give them care, even when their actions (or inaction) caused the problems.

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I wonder if contemporary versions of the oath say anything about having to accept any and all patients?

It wasn’t long ago that hospitals segregated patients by race. And that practice didn’t end because someone passed a law making racial discrimination in medical care illegal, it mostly ended because hospitals that discriminated by race weren’t eligible for Medicare money from the Federal government. If doctors could find room in their ethical codes to turn away Black people then surely there’s some room in there to turn away anti-vaxxers.

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Eh… I’m not in favor of moving Libertarian-anarchist-paranoics to an earlier time period, where they could engage in all kinds of hsitorical fuckery. Much better to take a page from Vernor Vinge’s Marooned in Realtime and displace them 10,000+ years into the future.

If humanity still exists, they’ll have 10,000+ years to prepare for their arrival.
If humanity doesn’t exist, welp, those Libertarian-anarchist-paranoics can do whatever they want, because their actions won’t affect society.

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17 posts were split to a new topic: Anarchism vs libertarianism vs anomie

Transportation in large part. The county seat was where a lot of things (notably courts) happened and you really didn’t want to be terribly far from it. Therefore, the county in most of the 19th century couldn’t realistically be more than a day or so by horseback from its center. Between rail in the 19th century and automobiles in the 20th, the trip to the county seat got shorter for long trips. Add that in the West people were just more used to spending time in the saddle. There’s a good account in No Land for a Lady of the author’s younger brother being sent on an errand from Datil to the county seat in Socorro (sixty-plus miles today by US 60). IIRC he wasn’t yet 10 years old.

In addition, the people moving west were less inclined to care about the county anyway. With the population density being as low as it was (and mostly still is) the post-Civil War States (check the map. Obvious break.) didn’t place that much emphasis on the county government. At a guess telegraphs played a big part in that.

That’s ‘not really’ my opinion?

Gee, thanks ever so much for letting me know.

Good question.

The thing is, rules and standards only matter if the majority actually upholds them.

I desperately need some major good news; this last few weeks has been thoroughly disheartening.

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You can only refuse to treat transgender patients.

And those without insurance.

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And pregnant women who want an abortion, in some states; if it violates the doc’s ‘religious beliefs.’

Weird how this seems to work, ain’t it?

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They’re not libertarian anarchists. They’re authoritarian cultists.

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So, the question here is the setting.

If the doctor is in a publicly funded hospital, it is unlikely they could refuse service to any patient who shows up. There are some carve-outs for religious exemptions (personally, not a fan of this), and certain diseases (think: Ebola) where the doctor doesn’t have the ability to safely treat the patient. The hospital gets around this by having more than one doctor on staff, and incentivizing volunteers to treat a patient.

If the doctor is in a private practice, they can choose whether to take a patient into their practice, and they can drop a patient from their practice with sufficient warning (such as saying: If you don’t take your blood pressure meds, I can’t be your doctor anymore).

This is of course generally speaking, and each jurisdiction may differ.

The second is what this doctor appears to be doing: He appears to be giving notice that he will drop patients who are not vaccinated from his practice. Unless he has a contract with the patient that says he has to treat the patient no matter what, he is well within his rights to tell them he can no longer in good conscious be their doctor.

And I say: good on him. Having a doctor threaten to eject them from their practice is often a wake up call to patients that they need to change their ways.

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Prior to vaccination, there were several primary care offices (including my own) that had a policy of refusing to treat healthcare providers due to the risk of covid, instead referring them all to the ED. Compared to that, refusing to see covid vaccine refuseniks seems positively rational.

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Thankfully this is not how most doctors feel or they would not treat anyone with any infectious disease.

It’s only a matter of time before this results in the usual hypocrisy from conservatives and Libertarians who’ll conveniently ignore the fact that choosing not to be vaccinated is also a personal choice that has consequences.

Before people start expressing grave concern about the hypocratic oath, I’m sure this doctor will treat any patient for any illness (including Covid) regardless of vaccination status when he’s working in whatever hospital he’s affiliated with. In his own clinic, however, he’s allowed to tell these science-denying morons to take a hike to reduce the odds of harm to himself, his staff, and his reality-based patients.

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I fully support this MD’s stance. But recent news tells us that vaccinated or not you are likely to be carrying the same viral load if you are infected with Delta.

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I desperately need some major good news…

It’s just a drop in the bucket, but this was nice to hear: U.S. Eliminates Student Loan Debt For Some Borrowers With Disabilities : NPR

The U.S. Education Department announced Thursday that it is discharging the outstanding student loans of more than 323,000 borrowers who have significant, permanent disabilities, and will remove barriers for borrowers who qualify for this relief in the future. The announcement will erase some $5.8 billion in debt and marks a significant step toward fixing a troubled debt relief program meant to help borrowers with disabilities.

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Medical Ethics is an important field because rarely are there easy answers to the questions posed throughout this thread. Discussions around ethics can be some of the most heated in medical training - there are only so many arguments to be made about reordering a differential diagnosis, but the who/when/why of treatment? - that shit can get personal, and everybody has an opinion.

Starting with the most straightforward - the Emergency Room.

He’s correct. The EMTALA law, passed in 1986 in response to for-profit hospitals in LA dumping indigent patients on skid row instead of treating them, ensures that anyone - regardless of the ability to pay - may be seen in an ER (if the hospital offers 24-hour emergency services and accepts federal payment, i.e. Medicare). No matter who you are, if you present to a qualifying ER (basically all of them), a provider there MUST perform a “Medical Screening Exam” to ensure no emergency exists. The providers have a lot of discretion as to the nature of the MSE, but usually it involves a pretty serious workup - defensive medicine and all that.

If an emergency does exist, the provider is obligated to stabilize the situation or to transfer you to a center that can. In fact, the hospital with more services MUST accept the patient referred as long as there is bed capacity. Tertiary care referral centers fill up fast in crises, which is exactly what’s happening now, with patients being stuck in the ER of hospitals that can’t provide all the services needed - no place to send anybody.

Primary care providers have a lot more discretion in treating, if they’re not employed by an outside hospital or larger healthcare organization (unfortunately, there are fewer and fewer independent practices - another discussion for another day). There may be a lot of different factors in the decision not to treat somebody. At least a couple of them have been mentioned already.

First, the willingness of a patient to follow the instructions given by the provider – you’re not gonna follow the advice I offer? Okay, maybe you get put at the bottom of the queue for additional advice & treatment. Of course, it’s rare to have a patient follow every detail of advice and prescribed treatment, so there’s something like a sliding scale here. Having trouble managing everything? Sure, let’s keep working on it - that’s more or less the bread and butter of primary care. But if you’re actively hostile to the doctors recommendations? Maybe you need to find another provider.

Second, the risk of harm to other patients from a potentially infected, non-vaccinated patient. Honestly, this may be a bit less of a concern at the moment. COVID is EVERYWHERE right now, and a medical practice trying to avoid infected patients is akin to visiting the beach and trying to keep sand out of the car on the way back - it might be possible, but it’s unlikely. To be sure, in a large patient population with unknown COVID status (infected vs not), the unvaccinated are more likely to be on the infected side of the fence; excluding them from your waiting room is one way to decrease the sand on the floor mat, but it doesn’t eliminate the risk altogether.

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Thank you. That was right in the era of the second KKK, although I was off on the exact years.

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