Letters

Ethics of Mandatory Vaccination
I enjoyed Dr. Catherine A. Marco’s discussion in last month’s issue of ACEP News concerning the competing ethical principles involved with mandatory influenza vaccinations for health care workers. However, I believe the debate is not exactly between autonomy and beneficence, but rather between autonomy and perceived beneficence.

For, as she says herself, there is a “lack of scientific evidence of the public health benefits of mandatory vaccination.” Therefore, the conclusion that supporting mandatory vaccination is the beneficient position is itself unproven. What seems like a good idea, even what seems like common sense, is not always and necessarily the right thing to do. How many times in medicine have we seen promising, even simple, supposedly benign and common sense therapies fail to deliver on their early promises?

I receive the influenza vaccine every year and yet still oppose mandatory vaccination for my colleagues. I believe influenza vaccination is the right thing for me and my family, but apparently I am in the minority among health care workers. As for the 60% or more of health care workers who opt not to get vaccinated, I am unwilling to sacrifice their autonomy unless and until there is some proven beneficience.

Brian Zachariah, MD, MBA, FACEP Houston