Yes, I'm a vaccine freak - 07/01/2022 - Hélio Schwartsman

I hope we don’t get to that point, but we can’t rule out the possibility that the micron will put so much pressure on the health system that, in some places, doctors are once again forced to decide which patients will go on the ventilator (or have access to other lifesaving and scarce treatment) and which will receive palliative care.

In order to reduce the anguish of health professionals in these situations, medical societies and even governments have published guidelines on how to proceed in these cases. They could be more or less explicit, but they revolved around classic bioethical principles, which dictate giving preference to patients who are more likely to survive and who have more years of healthy life ahead of them.

We are now living in a phase of the pandemic in which another criterion can be introduced: vaccine status.

Contrary to what happened in the other peaks, the supply of vaccines in Brazil is now abundant. Only the adult who did not want to be immunized was not immunized. But is this a valid criterion? It is more or less pacific in bioethics that a doctor is not a judge. The patient’s record, moral life, beliefs and preferences are not items that can be taken into account when deciding who will receive which resource.

But what about the patient’s actions that may have taken him to the hospital? Imagine two people arriving at the same time needing the only available ICU bed. They are equal in everything but the cause of the accident. The first was injured when diving without a cage with hungry white sharks and the second was the victim of a stray bullet. I think that, in this case, we can give preference to those who have not voluntarily submitted themselves to risk.

Something similar, I believe, is true for Covid. Vaccination status is an item to consider, but at the end of the list, just as a tiebreaker. If not, the way is open to deny treatment to smokers, sedentary, obese, etc.

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