Hörnle Tatjana
Humboldt-Universität zu Berlin und Max-Planck-Institut zur Erforschung von Kriminalität, Sicherheit und Recht, Günterstalstr. 73, 79100 Freiburg, Deutschland.
Ethik Med. 2022;34(4):481-495. doi: 10.1007/s00481-022-00716-8. Epub 2022 Aug 9.
The article asks whether vaccination status could become relevant if it is unavoidable to prioritize between patients in intensive care units during a pandemic. The aim is to analyze different approaches and arguments in favor of and against the inclusion of vaccination status.
The following arguments are assessed: First, it has been argued that it is unnecessary to open this discussion. Second, one could make the point that public debates about touchy subjects should be avoided. A third, frequently expressed opinion claims that physicians must never discriminate between vaccinated and unvaccinated patients, either because this is in conflict with human rights or because this is incompatible with the general principle that patients' prior conduct does not matter. Fourth, behavioral economists argue that intensive care medicine should take vaccination status into account with the goal to improve the overall numbers of vaccinations. A fifth line of thinking argues that it is more just to take vaccination into account.
The author concludes that the omission to get a necessary and recommended vaccination may be taken into account if patients' prospects to survive are similar. She points out that lotteries would be worse.
本文探讨在大流行期间，当重症监护病房的患者需要进行优先级排序而无法避免时，疫苗接种状况是否会变得重要。目的是分析支持和反对将疫苗接种状况纳入考量的不同方法和论点。
对以下论点进行了评估：第一，有人认为没有必要开启这个讨论。第二，有人指出应避免就敏感话题展开公开辩论。第三，一种经常表达的观点称，医生绝不能对接种疫苗和未接种疫苗的患者进行区分，要么是因为这与人权相冲突，要么是因为这与患者既往行为无关这一普遍原则不相容。第四，行为经济学家认为，重症医学应考虑疫苗接种状况，以提高总体疫苗接种数量。第五种思路认为，考虑疫苗接种情况更公平。
作者得出结论，如果患者的生存前景相似，那么可以考虑未接种必要且推荐疫苗的情况。她指出抽签会更糟糕。
