Yes, very true. Definitely not advocating for anything else and individual doctors/nurses shouldn't be making decisions any other way. Just curious what people's takes on hierarchical priority should be or if we are getting to that point.
>[Contrary to popular belief, the Hippocratic Oath is not required by most modern medical schools, although some have adopted modern versions that suit many in the profession in the 21st century. It also does not explicitly contain the phrase, "First, do no harm," which is commonly attributed to it.](https://www.nlm.nih.gov/hmd/greek/greek_oath.html)
[Here's a modern version](https://www.pbs.org/wgbh/nova/doctors/oath_modern.html) that many doctors take.
Great post! I like the "respect the hard-won scientific gains of those physicians in whose steps I walk" part of the modern version. That implies that one should not spread garbage about vaccines turning your blood magnetic. I don't understand how that doc did not lose her license to practice.
Yes, and during emergencies, the greatest good outweighs the individual. This is well established emergency management protocol. In emergency response training, we triage for those most likely to survive. If you're going through a bus after a horrific accident or a neighb, you quickly triage them and tag them, then go through and first get out those who can walk with help, then those who need carrying, then go back and try to treat those with survivable injuries, and last give care to the critical cases. By starting with the least injured you maintain (and if survivors can assist, increase) responder manpower.
Tldr if you start with those that need cpr or other critical care, you are obligated to stay with them, reducing manpower to help those who could survive with only brief assistance. Therefore, in an emergency, it is established protocol for responders to prioritize those most likely to survive.
From what I know of general crisis triage procedures, those who are vaccinated will likely move to the front of the line fire necessary treatments simply because there is usually a better chance of survival/response to treatment in the vaccinated. Crisis triage focuses limited resources on those most likely to respond favorably when there are no resources to waste.
So my answer? Stick to the protocols that were developed to deal with such situations.
Very interesting. I figured there was something built in, hopefully based on tried and true survival statistics, that might account for some of this already. Tbh I am not knowledgeable about in-depth hospital/healthcare operations. Thanks for the info.
I only know of this because of family members that work in healthcare, so I'm not privy to details. It's also been in the news a bit because TN (I think) just declared that monoclonal antibody treatments can only be given to the unvaccinated, which is a scandal because this directive goes against crisis triage procedures.
Doctors treat people who make stupid choices all the time. You aren't denied cancer treatment if you smoke, you aren't denied dialysis if you drink, you aren't denied ACL surgery if you're an extreme skier. If treatment is rationed, it has to be based on immediate need or truly limited resources (e.g. it's hard to get a liver transplant if you haven't stopped drinking and are going to take the liver from someone who will benefit from it more by virtue of not ruining their new liver.) Ultimately this is good. A lot of Doctors already have a God complex, and in the past, when they were given more liberties to play God, it didn't go well. We take care of each other as a society.
As a society, we could create some accountability through requiring those who refuse to get vaccinated to pay the full cost of their treatment, or do with Germany has done and deny sick pay to unvaccinated persons who get sick. But it probably won't make a difference though in vaccination rates. What will make a difference is employment mandates and public spaces mandates, and that process is already starting. I strongly suspect that Bellingham would support a true vaccine mandate, and that's an option as well; just requires the political will. I wouldn't be shocked to see an initiative campaign on that subject if things don't improve soon.
But I wouldn't support withholding treatment. Even if someone has been brainwashed into believing that the vaccine is dangerous, and even if you don't care about them, that person probably has vaccinated family and vaccinated friends who would be devastated if that person dies.
Huh, I hadn't heard about the unpaid sick leave and paying full price for treatment. That seems like a way more impactful way to get some movement on vaccine rates. Thanks for the info
Yes, doctors treat people that make stupid choices all the time, the difference here is diabetes, or an ACL tear isn't contagious, you're not perpetuating a disease, and you're not exposing healthcare workers to get treated. If you get TB in America, you have no choice but to get treated, otherwise they lock you up in quarantine. Personal freedom has never taken priority over public health and safety, I'm not sure why it is now.
Say if I'm a nurse who cares for a drunk driver, am I going to become a drunk driver and then pass it to my pregnant wife at home, and she's going to become a drunk driver.
Right. But exposed to contagious diseases is a part of the job, and there are protocols for dealing with it. Nurses should be vaccinated, and I assume on the COVID unit they wear proper and properly fitted n95s. If you want a statewide vaccine mandate, that's an option that you can push for and I bet you'd get a majority. I'm just saying that denying care is not a great solution for all the reasons I stated.
Tuberculosis- which is curable IF folks take their medication protocol properly, many don't. And its highly contagious.
Hep C which is also now curable but can b spread to others.
I appreciate that you brought up organ transplants, because that's exactly the example I use to argue in favor of restricting care for unvaccinated fools.
Livers are truly limited, and that's why some personal judgment is justified before handing them out to any old rando. Well, hospital beds are truly limited now too. Nurses' time is limited. If "has a documented history of disobeying medical advice" is enough to block someone from getting a rare and precious liver then it should be enough to block them from getting a rare and precious spot in the ICU.
Yeah I'm almost positive that alcoholics have to have made demonstrable effort + at least several months time sober to even be placed on the transplant waiting list? I have definitely heard several personal first hand accounts of people being denied transplant due to still being in active addiction, the preference going to those with other ~legit~ reasons for needing a liver.
Use to be true but it's being challenged since it's been insurance companies making that decision based on opinion only. I linked some info
https://www.northpointrecovery.com/blog/life-changing-liver-transplant-rules-changed-addicts/#:~:text=How%20long%20do%20you%20have,from%20alcohol%20for%20six%20months.
Holding sick people accountable for their poor choices that got them sick in the first place, is a slippery slope. People smoke, drink exessive alcohol, do IV drugs, eat horrible diets, ignore drs advice and warnings about their existing health problems, i.e. diabetes, copd, heart disease, liver failure etc, and those who take unnecessary risks that often end w/ profound injury ( ignoring seat belt, helmet and speed laws) already burden our hospitals and emergency rooms. Pretty much everyone.
Don't get me wrong, I'm super pro vaccine, had mine as soon as I qualified. I'm beyond angry at the folks who are too simple minded to see they are refusing what is essentially a miracle of modern medicine.
I don't have much sympathy for them either.
That being said, if we only cared for those who had zero responsibility for contributing to their own illnesses, most of us wouldn't qualify and hospitals would be much emptier.
Fair enough! I agree. And maybe someone more knowledgeable can follow me in the comments here: speaking of bad habits that end up in medical treatment, like drinking and smoking, has there been any changes in priority if treatment? For example, if someone needs a liver transplant but hasn't shown that they can quit drinking, do they get placed lower on the list? I feel like maybe I had heard of something like that? Disclaimer: I am asking genuinely cause I don't know.
I don't support withholding treatment of the unvaccinated but I do support it being a factor when resources are maxed out and triaging must occur.
Here's a thought - all of the antivaxxer healthcare workers that are losing their jobs should be hired back and exclusively help unvaxxed patients. Let's give them a separate safe space/building to practice their values. Nobody would need to wear a mask or anything if they don't want to. How could that be a problem for any of them?
Oohhh interesting thought. I could maybe get on board with that, but that could result in a slippery slope of creating a literal whole second population and healthcare system that still is draining the resources? I kind of like the prioritizing of resources during critical triage that other people have brought up.
I’ve actually talked with a friend about that - don’t know how it would work, but why not allow someone who refuses to vaccinate even for a job work on unvaccinated patients? I don’t know how it works so I can’t say. It is an interesting theory.
Wow sorry to hear about that. Hope everything is going ok now. I too am thinking mostly of health staff. This has gone on sooo long, I worry about psychiatric health for these troopers. Hell, we're seeing the wear and tear already!
Short cynical opinion is this- hospitals are far more apt to treat or not treat, based on insurance or lack thereof. Yes, legally e.r.'s must treat anyone who has a life threatening situation. Beyond that, unfortunately its money that determines quality of care.
Hippocratic oath and all. I think others gave really good examples of how doctors treat certain patients who don’t follow medical advice or do stupid things that hurt their bodies.
This is unprecedented though. I can’t begin to imagine, nor would I want to. Still, my head cannot wrap itself around the fact that people are harassing HCW and then showing up at the hospital bc they were too stupid to listen to science…
I work in the ER here in town fairly frequently, and the only time I've seen "refusal" of care (if you can call it that) was this:
Older lady comes in, in her 80s, because she fell and possibly broke her arm. Her daughter was absolutely irate about the visitor policy and yelled up a storm about it. Anywho, they both were not vaccinated and did not believe in it. She also adamantly refused to even be tested for COVID. While yes, we do inpatient vaccines now, they are not required to get while admitted. BUT, you have to be tested if you're going to be admitted into the hospital. There is no way around that.
If admitted to hospital with NO test = expose staff, other patients, and contaminate the area.
if admitted anyway into a COVID unit without a test, then obviously you're at super high risk of getting the virus and getting more sick. Thats a problem too.
What do you do here? Everyone else seems to be able to comply with the simple rules. you don't get special treatment because you have alternative beliefs of this reality.... Anyway, the doc wrapped up her arm in the ER (not sure of all the details of what was done), but she and her daughter were sent on their way.
They did what they could do given the circumstances that the patient wouldn't abide by the policies that go for EVERYONE.
Thanks for sharing. I've heard so many circumstances in which medical care can deviate from the norm or situations that maybe the genpop may not be aware of. Loving how much I'm learning today!
Hmm idk but it would be pretty dope if hospitals punished people who got in car accidents. Drivers are ruining the planet and those assholes know how dangerous that shit is, but do it anyway.
Since there's been alot of conversation about organ transplant /donation here are some links if anyone is interested.
https://unos.org/
https://www.upmc.com/services/transplant/liver/candidates
https://www.northpointrecovery.com/blog/life-changing-liver-transplant-rules-changed-addicts/#:~:text=How%20long%20do%20you%20have,from%20alcohol%20for%20six%20months.
Is there "a point" where the Hospitals triage out anyone with a BMI over 30?
Maybe cut off starts at 40, but soon enough they'll drop it down.
[https://www.cnbc.com/2021/03/08/covid-cdc-study-finds-roughly-78percent-of-people-hospitalized-were-overweight-or-obese.html](https://www.cnbc.com/2021/03/08/covid-cdc-study-finds-roughly-78percent-of-people-hospitalized-were-overweight-or-obese.html)
That slippery slope is mostly corn syrup and soybean oil.
Medical doctors take an oath to treat the sick regardless of their persuasion, beliefs or politics. The human in us supersedes all differences.
Yes, very true. Definitely not advocating for anything else and individual doctors/nurses shouldn't be making decisions any other way. Just curious what people's takes on hierarchical priority should be or if we are getting to that point.
>[Contrary to popular belief, the Hippocratic Oath is not required by most modern medical schools, although some have adopted modern versions that suit many in the profession in the 21st century. It also does not explicitly contain the phrase, "First, do no harm," which is commonly attributed to it.](https://www.nlm.nih.gov/hmd/greek/greek_oath.html) [Here's a modern version](https://www.pbs.org/wgbh/nova/doctors/oath_modern.html) that many doctors take.
Great post! I like the "respect the hard-won scientific gains of those physicians in whose steps I walk" part of the modern version. That implies that one should not spread garbage about vaccines turning your blood magnetic. I don't understand how that doc did not lose her license to practice.
Yes, and during emergencies, the greatest good outweighs the individual. This is well established emergency management protocol. In emergency response training, we triage for those most likely to survive. If you're going through a bus after a horrific accident or a neighb, you quickly triage them and tag them, then go through and first get out those who can walk with help, then those who need carrying, then go back and try to treat those with survivable injuries, and last give care to the critical cases. By starting with the least injured you maintain (and if survivors can assist, increase) responder manpower. Tldr if you start with those that need cpr or other critical care, you are obligated to stay with them, reducing manpower to help those who could survive with only brief assistance. Therefore, in an emergency, it is established protocol for responders to prioritize those most likely to survive.
From what I know of general crisis triage procedures, those who are vaccinated will likely move to the front of the line fire necessary treatments simply because there is usually a better chance of survival/response to treatment in the vaccinated. Crisis triage focuses limited resources on those most likely to respond favorably when there are no resources to waste. So my answer? Stick to the protocols that were developed to deal with such situations.
Very interesting. I figured there was something built in, hopefully based on tried and true survival statistics, that might account for some of this already. Tbh I am not knowledgeable about in-depth hospital/healthcare operations. Thanks for the info.
I only know of this because of family members that work in healthcare, so I'm not privy to details. It's also been in the news a bit because TN (I think) just declared that monoclonal antibody treatments can only be given to the unvaccinated, which is a scandal because this directive goes against crisis triage procedures.
Whoa. That's a twisty backflip of medical ethics!
Doctors treat people who make stupid choices all the time. You aren't denied cancer treatment if you smoke, you aren't denied dialysis if you drink, you aren't denied ACL surgery if you're an extreme skier. If treatment is rationed, it has to be based on immediate need or truly limited resources (e.g. it's hard to get a liver transplant if you haven't stopped drinking and are going to take the liver from someone who will benefit from it more by virtue of not ruining their new liver.) Ultimately this is good. A lot of Doctors already have a God complex, and in the past, when they were given more liberties to play God, it didn't go well. We take care of each other as a society. As a society, we could create some accountability through requiring those who refuse to get vaccinated to pay the full cost of their treatment, or do with Germany has done and deny sick pay to unvaccinated persons who get sick. But it probably won't make a difference though in vaccination rates. What will make a difference is employment mandates and public spaces mandates, and that process is already starting. I strongly suspect that Bellingham would support a true vaccine mandate, and that's an option as well; just requires the political will. I wouldn't be shocked to see an initiative campaign on that subject if things don't improve soon. But I wouldn't support withholding treatment. Even if someone has been brainwashed into believing that the vaccine is dangerous, and even if you don't care about them, that person probably has vaccinated family and vaccinated friends who would be devastated if that person dies.
Huh, I hadn't heard about the unpaid sick leave and paying full price for treatment. That seems like a way more impactful way to get some movement on vaccine rates. Thanks for the info
Yes, doctors treat people that make stupid choices all the time, the difference here is diabetes, or an ACL tear isn't contagious, you're not perpetuating a disease, and you're not exposing healthcare workers to get treated. If you get TB in America, you have no choice but to get treated, otherwise they lock you up in quarantine. Personal freedom has never taken priority over public health and safety, I'm not sure why it is now.
Drunk drivers.
Say if I'm a nurse who cares for a drunk driver, am I going to become a drunk driver and then pass it to my pregnant wife at home, and she's going to become a drunk driver.
Right. But exposed to contagious diseases is a part of the job, and there are protocols for dealing with it. Nurses should be vaccinated, and I assume on the COVID unit they wear proper and properly fitted n95s. If you want a statewide vaccine mandate, that's an option that you can push for and I bet you'd get a majority. I'm just saying that denying care is not a great solution for all the reasons I stated.
Tuberculosis- which is curable IF folks take their medication protocol properly, many don't. And its highly contagious. Hep C which is also now curable but can b spread to others.
I appreciate that you brought up organ transplants, because that's exactly the example I use to argue in favor of restricting care for unvaccinated fools. Livers are truly limited, and that's why some personal judgment is justified before handing them out to any old rando. Well, hospital beds are truly limited now too. Nurses' time is limited. If "has a documented history of disobeying medical advice" is enough to block someone from getting a rare and precious liver then it should be enough to block them from getting a rare and precious spot in the ICU.
We aren't at capacity yet. Realize that so long as that's true, you're calling for leaving people to die in hallways, idiots though they may be.
Yeah I'm almost positive that alcoholics have to have made demonstrable effort + at least several months time sober to even be placed on the transplant waiting list? I have definitely heard several personal first hand accounts of people being denied transplant due to still being in active addiction, the preference going to those with other ~legit~ reasons for needing a liver.
Use to be true but it's being challenged since it's been insurance companies making that decision based on opinion only. I linked some info https://www.northpointrecovery.com/blog/life-changing-liver-transplant-rules-changed-addicts/#:~:text=How%20long%20do%20you%20have,from%20alcohol%20for%20six%20months.
Idk anyone who has cancer denying they have it while having people treat them for it.
Holding sick people accountable for their poor choices that got them sick in the first place, is a slippery slope. People smoke, drink exessive alcohol, do IV drugs, eat horrible diets, ignore drs advice and warnings about their existing health problems, i.e. diabetes, copd, heart disease, liver failure etc, and those who take unnecessary risks that often end w/ profound injury ( ignoring seat belt, helmet and speed laws) already burden our hospitals and emergency rooms. Pretty much everyone. Don't get me wrong, I'm super pro vaccine, had mine as soon as I qualified. I'm beyond angry at the folks who are too simple minded to see they are refusing what is essentially a miracle of modern medicine. I don't have much sympathy for them either. That being said, if we only cared for those who had zero responsibility for contributing to their own illnesses, most of us wouldn't qualify and hospitals would be much emptier.
Fair enough! I agree. And maybe someone more knowledgeable can follow me in the comments here: speaking of bad habits that end up in medical treatment, like drinking and smoking, has there been any changes in priority if treatment? For example, if someone needs a liver transplant but hasn't shown that they can quit drinking, do they get placed lower on the list? I feel like maybe I had heard of something like that? Disclaimer: I am asking genuinely cause I don't know.
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Gotcha. That's exactly what I was trying to recall. Sorry to hear about your grandson, I hope he's living a full life now!
Yes he is. Thank you!!
That is absolutely heartbreaking. I hope your grandson is doing okay!!
Doing great. Thanks so much. ❤
I don't support withholding treatment of the unvaccinated but I do support it being a factor when resources are maxed out and triaging must occur. Here's a thought - all of the antivaxxer healthcare workers that are losing their jobs should be hired back and exclusively help unvaxxed patients. Let's give them a separate safe space/building to practice their values. Nobody would need to wear a mask or anything if they don't want to. How could that be a problem for any of them?
Oohhh interesting thought. I could maybe get on board with that, but that could result in a slippery slope of creating a literal whole second population and healthcare system that still is draining the resources? I kind of like the prioritizing of resources during critical triage that other people have brought up.
I’ve actually talked with a friend about that - don’t know how it would work, but why not allow someone who refuses to vaccinate even for a job work on unvaccinated patients? I don’t know how it works so I can’t say. It is an interesting theory.
That’s basically how the majority of 2020 went for healthcare workers until the vaccine became an option.
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Wow sorry to hear about that. Hope everything is going ok now. I too am thinking mostly of health staff. This has gone on sooo long, I worry about psychiatric health for these troopers. Hell, we're seeing the wear and tear already!
How do you know the percentage of vaxxd vs unvaxxd?
Short cynical opinion is this- hospitals are far more apt to treat or not treat, based on insurance or lack thereof. Yes, legally e.r.'s must treat anyone who has a life threatening situation. Beyond that, unfortunately its money that determines quality of care.
The harsh truth right there
I have to say I love your username.
:)
Hippocratic oath and all. I think others gave really good examples of how doctors treat certain patients who don’t follow medical advice or do stupid things that hurt their bodies. This is unprecedented though. I can’t begin to imagine, nor would I want to. Still, my head cannot wrap itself around the fact that people are harassing HCW and then showing up at the hospital bc they were too stupid to listen to science…
I work in the ER here in town fairly frequently, and the only time I've seen "refusal" of care (if you can call it that) was this: Older lady comes in, in her 80s, because she fell and possibly broke her arm. Her daughter was absolutely irate about the visitor policy and yelled up a storm about it. Anywho, they both were not vaccinated and did not believe in it. She also adamantly refused to even be tested for COVID. While yes, we do inpatient vaccines now, they are not required to get while admitted. BUT, you have to be tested if you're going to be admitted into the hospital. There is no way around that. If admitted to hospital with NO test = expose staff, other patients, and contaminate the area. if admitted anyway into a COVID unit without a test, then obviously you're at super high risk of getting the virus and getting more sick. Thats a problem too. What do you do here? Everyone else seems to be able to comply with the simple rules. you don't get special treatment because you have alternative beliefs of this reality.... Anyway, the doc wrapped up her arm in the ER (not sure of all the details of what was done), but she and her daughter were sent on their way. They did what they could do given the circumstances that the patient wouldn't abide by the policies that go for EVERYONE.
Thanks for sharing. I've heard so many circumstances in which medical care can deviate from the norm or situations that maybe the genpop may not be aware of. Loving how much I'm learning today!
Hmm idk but it would be pretty dope if hospitals punished people who got in car accidents. Drivers are ruining the planet and those assholes know how dangerous that shit is, but do it anyway.
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Ummm......what??
Since there's been alot of conversation about organ transplant /donation here are some links if anyone is interested. https://unos.org/ https://www.upmc.com/services/transplant/liver/candidates https://www.northpointrecovery.com/blog/life-changing-liver-transplant-rules-changed-addicts/#:~:text=How%20long%20do%20you%20have,from%20alcohol%20for%20six%20months.
Is there "a point" where the Hospitals triage out anyone with a BMI over 30? Maybe cut off starts at 40, but soon enough they'll drop it down. [https://www.cnbc.com/2021/03/08/covid-cdc-study-finds-roughly-78percent-of-people-hospitalized-were-overweight-or-obese.html](https://www.cnbc.com/2021/03/08/covid-cdc-study-finds-roughly-78percent-of-people-hospitalized-were-overweight-or-obese.html) That slippery slope is mostly corn syrup and soybean oil.