Informed refusal and vaccine mandates
In the September issue of Nursing2022, the article, "Informed Refusal: A Patient's Right," highlighted the importance of informed consent and the competent patient's right to refuse care. When discussing vaccination in the article though, I was surprised when the author used the example of the PCV13 vaccine instead of the COVID-19 vaccine.
No one ever lost their job and livelihood for refusing to take a PCV13 vaccine. No one was ever banned from restaurants, college cafeterias, sports arenas, etc. for opting out of the PCV13 vaccine. I believe that tyrannical abuses have occurred with the absence of informed refusal and with the current blanket mandating of the COVID-19 vaccines in certain cities, states and institutions.
In my heart, I believe that if a 'vaccine' is not preventing a disease or its transmission, it should not be mandated-it should be a choice. I hope that the Advisory Committee on Immunization Practices does not dismiss what happened this past year with what I think are completely overreaching and unfair COVID-19 vaccine mandates as simply a 'change' in vaccine recommendations.
The lack of "shared clinical decision-making" over the past two years within the medical community has been very disillusioning for me. Informed refusal is a critical aspect of patient-centered care and patient autonomy. I hope that nurses everywhere will lead the way in ensuring that a patient's critical right to refuse is never lost.
Sincerely,
Kathleen Keane, RN
Garden City, NY
Author's response
COVID-19 restrictions were a result of the Public Health Service Act, a federal law enacted in 1944.1 Such law allows governments in different jurisdictions to declare states of emergencies and exercise powers under their public health emergency legislation to protect the health of our communities. In the case of a pandemic, public health laws are implemented.
The COVID-19 pandemic brought the complex relationship between individual rights and public health protection to the forefront.2 Yet, when the evidence is reviewed, nearly 700,000 Americans lost their lives to COVID-19 between January 2020 and July 2021, with over 100,000 in January 2021 alone.3 The first COVID-19 vaccine became available on December 11, 2020.4 The COVID-19 Bivalent Vaccine Booster was authorized for use on August 31, 2022.5 Clearly, the vaccine and boosters coupled with other protective measures have worked and continue to work to protect the health of our communities.
When the right to refuse also impacts the health and well-being of another person, without their consent, these rights must be balanced. Consideration of vulnerability must be taken into account.
Thank you,
Kathleen Peterson, PhD, RN, PPCNP-BC, CNE
Brockport, NY
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