Ipswich Hospital has had to place restrictions on the number of visitors patients can receive because of Covid-19. Other hospitals across the NHS have done the same.
An earlier outright ban on most visitors was designed to keep Covid out. Unfortunately, as again with other hospitals across the NHS, there is a fair amount of Covid inside already.
The vast majority of Covid patients requiring the most sophisticated care, such as mechanical help to breathe, are unvaccinated. This is causing growing anger among doctors and other healthcare professionals who are concerned that care is going to patients who would almost certainly not have been there had they chosen to have their jabs six months ago, instead of going to more “deserving” (my quotation marks) sufferers on the ever growing NHS waiting list.
The unvaccinated limit critical care of others
Healthcare professionals I have spoken to are particularly incensed that the unjabbed being admitted to hospital are putting in danger those already there being treated for diseases such as cancer whose immune systems may be compromised, perhaps because of chemotherapy.
This is becoming a serious issue and raises inevitable questions of medical ethics. I was speaking to an old friend over the weekend whose wife works at an NHS hospital. He was furious that the unjabbed were creating immense and entirely avoidable problems for his wife and her colleagues.
His solution was simple. Anyone unvaccinated who requires treatment for Covid should receive only palliative care. Relieve their symptoms, do not waste rare resources trying to cure them. They are there of their own choice.
This seems harsh and unethical to me, but I doubt he is the first to suggest such a course of action. People fail to be vaccinated for various reasons. Some may believe the conspiracy theories flourishing on the Internet – Covid doesn’t exist, the vaccines are a form of social control, it’s all something to do with Bill Gates… There is an interesting and inevitable overlap between such people and the anti-maskers. They both say, we are being told what to do, and as free individuals we should have a choice. Even if it puts other people at risk.
A second category of the unjabbed are simply too lazy or disorganised to get the vaccines. A third, generally young men, are convinced they are so fit that they have no chance of succumbing to the disease. None deserve much sympathy, in my view.
There has long been an argument in medical circles. If a patient’s lifestyle contributes to his or her condition, to what extent should rare NHS resources pay for their treatment. A heavy smoker with a lung disease, someone morbidly obese with type 2 diabetes? Even someone driving carelessly on the A12 who has an accident?
Most medical ethicists believe it is only right to treat those whose bad lifestyle choices have brought about their condition. I suspect most clinicians would not turn away unvaccinated people with Covid, no matter what their personal instincts might be.
Someone else in this debate with me over the weekend suggested a second solution. Where healthcare resources are limited, prioritise those “undeserving” sick people with cancer or whatever over those whose refusal to have the vaccines has contributed to their condition. Triage, then. I wonder if this is already happening, to some extent. We will probably never know.
Ethically, it is better than the “palliative care” route, though I am not sure myself how much better.
There is one further concern. The NHS is not going to “collapse” over the winter if that supply of voluntary Covid patients combines with the usual seasonal workload. But the NHS will find itself failing to treat, through no fault of those working for it, a higher proportion of patients who would otherwise be cured. People will die, deaths that will be on the consciences of those unvaccinated patients.
This is already happening, and has been for some time.
My worry is that the hard right ideologues on the Conservative benches will use this apparent “failure” of the NHS this winter as ammunition to press for further privatisation, a process some claim is already under way.
Sajid Javid, the health secretary, has made no secret of his admiration for the controversial American thinker and novelist Ayn Rand. Rand’s philosophy of Objectivism is centred around a very limited state and the importance of individuals taking control of their destinies.
Javid has indicated that this philosophy has occasionally guided his approach to healthcare.
The central character of Rand’s 1957 novel Atlas Shrugged is a brain surgeon who walked away from socialised healthcare because it was, as he described it, “the enslavement of medicine”. Another Rand protagonist, the “rugged individualist” Howard Roark in The Fountainhead, describes those who believe in state intervention for the public good as “parasites”. Javid has said he regularly rereads the courtroom scene from The Fountainhead to himself.
It would be unfortunate, to say the least, if the decision of a minority of selfish or deluded individuals not to accept a life-saving vaccine, thereby putting others at risk, were also to lead, ultimately, to a lessening of the protection provided free to all by the NHS. Unfortunate, to say the least.