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Dr Debra Wilson is double-vaccinated and encourages patients to have the Covid-19 vaccination.
However, she is personally opposed to the vaccination being mandatory, and this week wrote in an individual capacity to her local MP, the Otago Daily Times and the Royal New Zealand College of General Practitioners (RNZCGP) to say so.
‘‘Vaccine mandates undermine the principle of voluntary consent as they unduly pressure individuals to receive the vaccine or risk losing their job, creating financial stress,’’ she said.
‘‘In any other circumstance this would amount to coercion.’’
Dr Wilson told the ODT she had been torn by the issue as she was pro-vaccination but did not think it was right that people’s employment could suffer because of their individual views.
‘‘I do think it is an ethical responsibility not to go to work if you have got symptoms and to go and get checked, whether you are vaccinated or unvaccinated.’’
Dr Wilson said getting vaccinated would help prevent overloading of the health system and it did initially help reduce transmission.
‘‘There are greater good arguments, but I want to see people get it on a voluntary basis... This vaccine has saved millions worldwide and I have encouraged my patients to get it.’’
RNZCGP president Dr Samantha Murton said she would reply to Dr Wilson's letter, and that she was entitled to her opinion.
‘‘There should be choice for any healthcare service that is provided, but then there is the potential they could have an impact on other people and that is the issue that we are facing,’’ Dr Murton said.
‘‘Our role could have a significant detrimental impact on someone else if we are not protecting harm by protecting ourselves.’’
Dr Murton said she understood Dr Wilson's view, and that it was a debate the medical profession should have.
‘‘But I don’t think there will be much of an appetite for not having healthcare workers vaccinated.’’
Asked about the letter, outgoing Children’s Commissioner Judge Andrew Becroft said children under 12 were unable to be vaccinated and medical professionals owed those people a duty of care to try to keep them free from possibly contracting Covid-19.
‘‘When children get sick, if they have a pre-existing medical condition, they can get very, very sick, which is a real worry,’’ he said.
‘‘Children have the right to have the highest standard of health possible... That will be compromised if people who refuse to be vaccinated maintain the stance they are taking.
‘‘I would have thought, frankly, shame on us if we are not prepared to put children’s rights ahead of our own.’’
GP's letter to the Editor
To: Otago Daily Times
I write to express my concern about the vaccine mandate for all health care workers and selected education workers announced by the Government on the 11th of October. This is my own individual opinion and does not represent that of any other organisation or person. I am a pro-vaccination General Practitioner practising in Gore. I am fully vaccinated against COVID. I hold open and honest vaccine discussions with my patients in regard to the Comirnaty (Pfizer) vaccine and have encouraged
many to have the vaccine. However, I am not in favour of the vaccine mandate for the reasons set out below.
1. There must be voluntary consent to any medical procedure. Cole’s Medical Practise in New Zealand 2017 states as follows in regard to voluntary consent:
- ‘Consent must be given freely without undue pressure or coercion. It is common for patients to receive information and advice from others and even for the patient to be influenced by the opinions of others and to make their decisions as a result. This is acceptable as long as the other person does not overbear the patient’s decision.
- Sometimes, after considering all the information, patients can still be unsure about what to do. They may ask their doctor what they would do if they were the patient. It is reasonable in this circumstance to give an honest answer to the question, but doctors must avoid dictating to the patient what to do. Patients should be given sufficient time and space to make an informed choice. (1)
Vaccine mandates undermine the principle of voluntary consent as they unduly pressure individuals to receive the vaccine or risk losing their job, creating financial stress. In any other circumstance this would amount to coercion. I am passionate about upholding the principle of voluntary consent in my profession.
2. I do not think there is an ethical justification to mandate vaccination so broadly on individuals to maintain their employment. The Comirnaty vaccine provides excellent protection against serious illness and death due to COVID-19. It is on this basis I have encouraged many patients to receive the vaccination, particularly those at high risk of serious COVID. I can see the vaccine is beneficial in avoiding overwhelming the healthcare system. However, with waning immunity over time breakthrough infections are increasingly seen in Israel where the majority of the population are vaccinated with the Pfizer vaccine. A recent study from Southern California published by The Lancet showed ‘vaccine effectiveness against infections of the delta variant was high during the first month after full vaccination (93% (95% CI 85-96)) but declined to 53% (39-65) after 4 months’. (2)
If vaccinated individuals experience increasing risk of breakthrough infection over time it would be important for both the vaccinated and unvaccinated to take the same precautions to prevent transmitting COVID-19 to the vulnerable or contracting it (staying home when sick and wearing personal protective equipment).
I have personally decided to be vaccinated. This is a decision I made without coercion and I would like all other health care workers/teachers to have the freedom to decide if they choose to be vaccinated. Some individuals ‘may have a set of values, views and beliefs that may lead to a decision that does not fit neatly with medical advice. A competent patient’s right to refuse treatment is recognised by Right 7(7) of the Code of Rights, the common law to self-determination and section 11 of the New Zealand Bill of Rights Act, which provides that everyone has the right to refuse to undergo any medical treatment.’3 I would like to see more public debate on vaccine mandates in New Zealand.
Dr Debra Wilson (MBCHB, DipCH, CertWH, FRNZCGP)
(1) Cole’s Medical Practice in New Zealand, 13th edition. Medical Council of New Zealand, 2017: Edited by Kevin A Morris, 216. mcnz.org.nz
(2) Tartof S.Y., Slezak J.M. (2021), Effectiveness of mRNA BNT162b2 COVID-19 vaccine up to 6 months in a large integrated health system in the USA: a retrospective cohort study. The Lancet, https://doi.org/10.1016/S0140-6736(21)02183-8