4 ms·

That's different because there's no moral judgement in that position. If you refuse treatment for a condition, even a preventative one, then there's no moral im

That's different because there's no moral judgement in that position. If you refuse treatment for a condition, even a preventative one, then there's no moral imperative to offer a different treatment later. Doctors did their best to save you, but you didn't do your part. That's on you.

dijonman2 5y ago
I couldn’t disagree more. Everyone deserves the same level of care.
- deleted 5y ago
  [deleted]
- jagger27 5y ago
  Everyone deserves care. It’s unpleasant to think about giving emergency care to people who actively refuse preventative treatments at the cost of canceled appointments and surgeries for non-COVID patients. Triaging really sucks.
- onion2k 5y ago
  They're getting it. Everyone is offered the vaccine. If people choose not to accept that care then what happens afterwards has to be assessed and prioritized on a case by case basis. If there's an ICU bed and two patients, one who's a Covid patient who refused to protect themselves and the other someone who has something not preventable, the second one should get priority. Ideally there would be two beds, and everyone would get the care they need, but reality means choices have to be made. Refusing a vaccine should send you to the back of the queue.
jlawson 5y ago
Absolutely not, that's not how it works. You won't be denied tramua treatment for a gunshot because your doc told you to stop playing with guns. You won't be refused heart medicine because you didn't stop eating bacon when your doctor told you to 5 years earlier. You won't be denied ER treatment because you were drunk when you crashed your car. There is no rule where we have to treat all patients equally (including mass murderers) except those who didn't accept n earlier-offered treatment or who did something that caused their own medical condition (i.e which probably includes most medical conditions). Medical care is not an exploding offer. Honestly - shame on you for trying to sneak in an absurd exception just so you can abuse the medical system to hurt people you don't like. That's not what hospitals are for.
- mlyle 5y ago
  I think if we really ran out of health care capacity, it might make sense to prioritize people who took preventative measures over those who didn't. Especially with COVID: if you're at the point of triage and rationing resources, you need to consider likely outcomes, and people with the vaccine presenting at hospital are more likely to survive than those presenting without. It seems like we're not going to bump into those limits, though, so it's moot.
  - BjoernKW 5y ago
    > people with the vaccine presenting at hospital are more likely to survive than those presenting without In my opinion, that logic is flawed. The currently available COVID-19 vaccines vastly reduce the likelihood of developing severe symptoms from a SARS‑CoV‑2 infection. They also somewhat reduce the risk of getting infected in the first place. So, getting vaccinated against COVID-19 makes you far less likely to need to be hospitalized, should you contract the virus, which apart from of course being beneficial to yourself also helps with keeping the healthcare system from being overwhelmed. However, if you've already been hospitalized, it is because you've developed severe symptoms, which in turn means that, in that situation, for you, the vaccine has failed. At that point, all other factors being equal, your likely outcome is no different from that of a person who hasn't been vaccinated. Therefore, using vaccination as a criterion for triage (which - like you said - is all about rationing resources, not passing judgement) doesn't make sense. Now, it could very well be possible that being vaccinated improves your outcome even once you've already developed symptoms sufficiently severe to require hospitalization. However, I'm not sure there's conclusive evidence suggesting that is indeed the case.
    - mlyle 5y ago
      > Now, it could very well be possible that being vaccinated improves your outcome even once you've already developed symptoms sufficiently severe to require hospitalization. However, I'm not sure there's conclusive evidence suggesting that is indeed the case. Current data seems to show that fully vaccinated people who require hospitalization have hospital stays that are 33% shorter and are also about 33% less likely to die (despite having more comorbidities on average than unvaccinated hospitalizations). So, if you have one bed left, and can put either an unvaccinated or vaccinated person in it-- all else being equal-- the vaccinated person is less likely to die with hospital care, and is more likely to free up the bed for someone else soon. (We don't know, though, if you deny hospital care to both what the death rate for each would be-- here's where you have to guess. If you assume both die without hospital care, then you should give the bed to the vaccinated patient).

dijonman2 5y ago

I couldn’t disagree more. Everyone deserves the same level of care.

deleted 5y ago
[deleted]
jagger27 5y ago
Everyone deserves care. It’s unpleasant to think about giving emergency care to people who actively refuse preventative treatments at the cost of canceled appointments and surgeries for non-COVID patients. Triaging really sucks.
onion2k 5y ago
They're getting it. Everyone is offered the vaccine. If people choose not to accept that care then what happens afterwards has to be assessed and prioritized on a case by case basis. If there's an ICU bed and two patients, one who's a Covid patient who refused to protect themselves and the other someone who has something not preventable, the second one should get priority. Ideally there would be two beds, and everyone would get the care they need, but reality means choices have to be made. Refusing a vaccine should send you to the back of the queue.

jlawson 5y ago

Absolutely not, that's not how it works. You won't be denied tramua treatment for a gunshot because your doc told you to stop playing with guns. You won't be refused heart medicine because you didn't stop eating bacon when your doctor told you to 5 years earlier. You won't be denied ER treatment because you were drunk when you crashed your car. There is no rule where we have to treat all patients equally (including mass murderers) except those who didn't accept n earlier-offered treatment or who did something that caused their own medical condition (i.e which probably includes most medical conditions). Medical care is not an exploding offer. Honestly - shame on you for trying to sneak in an absurd exception just so you can abuse the medical system to hurt people you don't like. That's not what hospitals are for.

mlyle 5y ago
I think if we really ran out of health care capacity, it might make sense to prioritize people who took preventative measures over those who didn't. Especially with COVID: if you're at the point of triage and rationing resources, you need to consider likely outcomes, and people with the vaccine presenting at hospital are more likely to survive than those presenting without. It seems like we're not going to bump into those limits, though, so it's moot.
- BjoernKW 5y ago
  > people with the vaccine presenting at hospital are more likely to survive than those presenting without In my opinion, that logic is flawed. The currently available COVID-19 vaccines vastly reduce the likelihood of developing severe symptoms from a SARS‑CoV‑2 infection. They also somewhat reduce the risk of getting infected in the first place. So, getting vaccinated against COVID-19 makes you far less likely to need to be hospitalized, should you contract the virus, which apart from of course being beneficial to yourself also helps with keeping the healthcare system from being overwhelmed. However, if you've already been hospitalized, it is because you've developed severe symptoms, which in turn means that, in that situation, for you, the vaccine has failed. At that point, all other factors being equal, your likely outcome is no different from that of a person who hasn't been vaccinated. Therefore, using vaccination as a criterion for triage (which - like you said - is all about rationing resources, not passing judgement) doesn't make sense. Now, it could very well be possible that being vaccinated improves your outcome even once you've already developed symptoms sufficiently severe to require hospitalization. However, I'm not sure there's conclusive evidence suggesting that is indeed the case.
  - mlyle 5y ago
    > Now, it could very well be possible that being vaccinated improves your outcome even once you've already developed symptoms sufficiently severe to require hospitalization. However, I'm not sure there's conclusive evidence suggesting that is indeed the case. Current data seems to show that fully vaccinated people who require hospitalization have hospital stays that are 33% shorter and are also about 33% less likely to die (despite having more comorbidities on average than unvaccinated hospitalizations). So, if you have one bed left, and can put either an unvaccinated or vaccinated person in it-- all else being equal-- the vaccinated person is less likely to die with hospital care, and is more likely to free up the bed for someone else soon. (We don't know, though, if you deny hospital care to both what the death rate for each would be-- here's where you have to guess. If you assume both die without hospital care, then you should give the bed to the vaccinated patient).