Ethics (medical bioethics) is a strategy to apply clear thinking and frameworks to decision-making and implications of decisions. Testing ideas or programs against ethical principles can provide guidance – but is not the same as “legal finding” nor does such analysis have legal standing.

The pdf presentation link here [ PADOH_HCW Flu Vax Program_Ethics Module_June 2011] looks at ethical principles in the context of HCW flu vaccinations programs. Overall, we use the four thematic areas below, and define the “technical” bioethics language and how it applies.

The Center for Vaccine Ethics and Policy/Penn has been following this issue for several years, analyzing case around the country (and around the world) and we are not entirely neutral given the evidence!

Your programs WILL encounter ethical issues…even dilemmas!!

Our summary observations (also in the pdf link above):
– Vaccination requirements for HCWs against various diseases is well-established

– New requirements/mandates for any vaccination should meet critical tests against bioethics and other societal principles

– Responsibility for patient safety empowers health care providers to take prudent action: work rules, mandates, etc.

– Assuring HCW flu vaccination levels appropriate to patient safety falls within this empowerment

– Patient safety imperative implies that work rules, immunization requirements, etc. could and should apply to all who can compromise safety

– It is irresponsible to allow conditions which compromise patient safety to continue where corrective action is available, safe, affordable, effective

– No compelling argument encountered to date that mandated programs are “unethical” per se

– Does not mean that any given program (voluntary OR mandated) is free from  questionable or even unethical policies, practices…

– Each program and new program element should face the same tests…the patient safety imperative does not mean “no challenges allowed”

– Case studies in this overall training offer a range of options…no cookie cutter solutions but templates for effective action!  Real ethical problems were addressed in each case!



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