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> My biggest fear is an antivaxxer taking up an ER bed someone else might need for a real issue. There is a lot of fear to go around. Someone out there has as

> My biggest fear is an antivaxxer taking up an ER bed someone else might need for a real issue. There is a lot of fear to go around. Someone out there has as their biggest fear being forced to have a medical procedure that then gives them lifelong medical problems, problems that might be shrugged off by doctors/family/friends, and even if they can find someone to believe that their plight is real, they can't find anyone that can fix it. Is that a likely outcome? It doesn't look like it to me or you. But someone out there has that fear just like you have yours. You may believe your fear to be more justified, and it may even be so. But that doesn't change that other people have their fears that they can't get away from, and that no proclamations like yours will cure them of. Put aside for a second what all the talking heads and the bureaucrats and the internet commenters are saying, and remember that there are people, actual living and breathing people behind such a one dimensional label as "antivaxxer". Whatever cartoon character you dream up when you hear that word, you can bet that it misses more folks than it hits.

xvector 5y ago
Sure, I see what you mean. And a crippled alcoholic may truly and desperately believe that her alcoholism does not cause liver problems. Yet, she will still be deprioritized for a liver transplant when compared to a fit individual. We cannot take people's delusions into account when giving care. But what we can take into account is "will they make the most of this care?" And for both the alcoholic and antivaxxer, the answer is a resounding and objective "no."
- landemva 5y ago
  To the list of denying care to antivaxxer and alcoholic, would it be reasonable to add the obese? Being fat is a co-morbidity and often a lifestyle choice.
  - xvector 5y ago
    We do in fact deprioritize transplants to the obese. The average waiting time for a kidney transplant for an obese person is 5 years, as opposed to 3 years for a healthy person. And if curing your obesity was as easy as getting a shot, of course you should be deprioritized for related morbidities.
    - landemva 5y ago
      Not everyone is medically able to get a shot. It's not 'easy' for those people. For most people obesity can be resolved by putting down the fork and soda straws. It's a lifestyle choice.
      - xvector 5y ago
        > Not everyone is medically able to get a shot. It's not 'easy' for those people. A vanishingly small portion of people for which an exception would obviously be made. > For most people obesity can be resolved by putting down the fork and soda straws. It's a lifestyle choice. This is perhaps the most naive thing I've seen on HN. I hope you never have to deal with a serious addiction, where a simple act like "putting down the fork" evolves into requiring Herculean willpower. As someone that made the journey from morbidly obese to a normal BMI, losing 80lbs, I can assure you it was not "just a lifestyle choice" - it was, by a significant margin, the hardest thing I have ever done and ever will do. Absolutely not comparable to getting the jab.
- ifyoubuildit 5y ago
  > We cannot take people's delusions into account when giving care. But what we can take into account is "will they make the most of this care?" Who is this we? I'm not a doctor or nurse or any other kind of healthcare professional, so I (rightfully) have no input into decisions like this. Is it safe to assume the same is true for you? Who is to say some "antivaxxer" or alcoholic that you're ready to deprioritize wouldn't go on to accomplish great things? You may find that hard to imagine (which is a consequence of thinking in sloppy terms like "antivaxxer") but again, you have to remember that these are people from all walks of life, all different levels of education. To think that you are qualified to judge who will make the most of their lives seems delusional in itself to me.
  - xvector 5y ago
    > Who is to say some "antivaxxer" or alcoholic that you're ready to deprioritize wouldn't go on to accomplish great things? They might. But the question is not "whether they will accomplish great things," but rather, "whether they will make the best use of the limited care we can provide." And the answer to that is still "no." It's why obese people and alcoholics are turned away from transplants, and on average, wait years longer - often dying in the process. Could obese and alcoholics go on to do great things? Almost certainly! But, will they make the most use of the transplant? Given their choices so far - no. So, they are frequently turned away. It is the same situation here.
    - ifyoubuildit 5y ago
      > But the question is not "whether they will accomplish great things," but rather, "whether they will make the best use of the limited care we can provide." Maybe I'm being dense, but I don't see how these aren't the same thing. What does it mean to make the best use of medical care then? I was assuming best use meant something like return on investment of resources (which is certainly a cold way to look at human lives, but I don't know how else to read that). I can think of a couple potential metrics there - years lived after, "value" added to society - but I don't see how vaccine status could be reasonably expected to predict those metrics. I'm also taking your word that we choose transplant patients this way, since I have no knowledge there. Reading about it a little, it sounds like its not so cut and dry. Are we really disqualifying these people because they have specific conditions, or are we doing it because of some metric like years lived after or odds of the procedure working?
- timbo1642 5y ago

xvector 5y ago

Sure, I see what you mean. And a crippled alcoholic may truly and desperately believe that her alcoholism does not cause liver problems. Yet, she will still be deprioritized for a liver transplant when compared to a fit individual. We cannot take people's delusions into account when giving care. But what we can take into account is "will they make the most of this care?" And for both the alcoholic and antivaxxer, the answer is a resounding and objective "no."

landemva 5y ago
To the list of denying care to antivaxxer and alcoholic, would it be reasonable to add the obese? Being fat is a co-morbidity and often a lifestyle choice.
- xvector 5y ago
  We do in fact deprioritize transplants to the obese. The average waiting time for a kidney transplant for an obese person is 5 years, as opposed to 3 years for a healthy person. And if curing your obesity was as easy as getting a shot, of course you should be deprioritized for related morbidities.
  - landemva 5y ago
    Not everyone is medically able to get a shot. It's not 'easy' for those people. For most people obesity can be resolved by putting down the fork and soda straws. It's a lifestyle choice.
    - xvector 5y ago
      > Not everyone is medically able to get a shot. It's not 'easy' for those people. A vanishingly small portion of people for which an exception would obviously be made. > For most people obesity can be resolved by putting down the fork and soda straws. It's a lifestyle choice. This is perhaps the most naive thing I've seen on HN. I hope you never have to deal with a serious addiction, where a simple act like "putting down the fork" evolves into requiring Herculean willpower. As someone that made the journey from morbidly obese to a normal BMI, losing 80lbs, I can assure you it was not "just a lifestyle choice" - it was, by a significant margin, the hardest thing I have ever done and ever will do. Absolutely not comparable to getting the jab.
ifyoubuildit 5y ago
> We cannot take people's delusions into account when giving care. But what we can take into account is "will they make the most of this care?" Who is this we? I'm not a doctor or nurse or any other kind of healthcare professional, so I (rightfully) have no input into decisions like this. Is it safe to assume the same is true for you? Who is to say some "antivaxxer" or alcoholic that you're ready to deprioritize wouldn't go on to accomplish great things? You may find that hard to imagine (which is a consequence of thinking in sloppy terms like "antivaxxer") but again, you have to remember that these are people from all walks of life, all different levels of education. To think that you are qualified to judge who will make the most of their lives seems delusional in itself to me.
- xvector 5y ago
  > Who is to say some "antivaxxer" or alcoholic that you're ready to deprioritize wouldn't go on to accomplish great things? They might. But the question is not "whether they will accomplish great things," but rather, "whether they will make the best use of the limited care we can provide." And the answer to that is still "no." It's why obese people and alcoholics are turned away from transplants, and on average, wait years longer - often dying in the process. Could obese and alcoholics go on to do great things? Almost certainly! But, will they make the most use of the transplant? Given their choices so far - no. So, they are frequently turned away. It is the same situation here.
  - ifyoubuildit 5y ago
    > But the question is not "whether they will accomplish great things," but rather, "whether they will make the best use of the limited care we can provide." Maybe I'm being dense, but I don't see how these aren't the same thing. What does it mean to make the best use of medical care then? I was assuming best use meant something like return on investment of resources (which is certainly a cold way to look at human lives, but I don't know how else to read that). I can think of a couple potential metrics there - years lived after, "value" added to society - but I don't see how vaccine status could be reasonably expected to predict those metrics. I'm also taking your word that we choose transplant patients this way, since I have no knowledge there. Reading about it a little, it sounds like its not so cut and dry. Are we really disqualifying these people because they have specific conditions, or are we doing it because of some metric like years lived after or odds of the procedure working?
timbo1642 5y ago