Centre for Medical Ethics and Law

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Browsing Centre for Medical Ethics and Law by Author "Botman, Karl Peter Maurice"

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    Should South African healthcare workers be mandated to receive the covid-19 vaccine
    (Stellenbosch : Stellenbosch University, 2023-12) Botman, Karl Peter Maurice; Van Niekerk, A. A.; Stellenbosch University. Faculty of Medicine and Health Sciences. Centre for Medical Ethics and Law.
    ENGLISH SUMMARY: The Covid 19 pandemic caused global multifaceted devastation. The world was thrown into unprecedented territory. Not since the Spanish Flu has a viral pandemic had such a remarkably negative impact on society and life in such a short period of time. This virus did not only cause destruction on a global scale, but also far-reaching harm at an individual level. The socioeconomic devastation and governments’ responses to mitigate the unknown, will be felt across the globe for many years. Even in many developed countries, healthcare infrastructure was unable to manage the large number of patients during the several waves of the pandemic. One can only speculate the impact that it has had on developing, under-resourced countries. Whether one lived in a developed or developing country, the impact was felt both directly and indirectly. The devastation caused could only be labelled a public health emergency. The life-saving role that healthcare workers played was unquestionably highlighted during this pandemic. Without these skilled and dedicated individuals, the health system and its resources would definitely not have survived the pandemic. The physical and mental well-being of not only patients were affected, but also that of the healthcare workers (HCW) managing these patients. Healthcare workers have played a crucial role specifically in the prevention, education and management relating to the disease process. These persons, whom many regard as the cornerstone of healthcare, have not been spared the wrath of this disease either. The infectious nature of this virus and its various presentations, especially the asymptomatic cases, made diagnoses difficult, unless persons subjected themselves to microbiological and immunological testing. The virus which caused this devastation was named Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) with its associated disease referred to as COVID-19. In many aspects, COVID-19 caused a public health crisis across the globe. COVID-19 brought the world to its knees. Governments, scientists and HCWs across the globe were forced to collaborate with each other regarding different healthcare-related fields, including public health, virology, immunology, epidemiology, and intensive care. The objective was to save lives by means of containment measures, finding a treatment for the infection and, ultimately, a vaccine to prevent the spread of the virus. The legal and ethical considerations in mandating COVID-19 vaccination in resource constrained countries like South Africa needed to be approached judiciously. On the one hand, there was the right to autonomy and thus, by implication, liberty, which the South African Constitution supports. Equally important were the legal and ethical implications in exposing innocent persons, whether it be patients or close contacts of the HCW, to a potential vector (the HCW) for the transmission of the virus. Governments and employers across the world, specifically during times of pandemics, have both ethical and legal obligations to protect their citizens and employees, which may give rise to ethical conflicts. Should South African healthcare workers be mandated to receive the COVID-19 vaccine? This question was approached from several perspectives: I discuss the science behind the effectiveness of a vaccine and the history of vaccination. This is followed by the relevant aspects of the Constitution of South Africa and the various legislated Acts applicable to the implementation of mandatory vaccination. Given this background, I focus on the ethics of mandatory vaccination applicable to HCWs. The familiar principles and general acceptance of bioethics as the protection of individual rights in the medical setting, however, must be considered together with public health ethics in the COVID-19 pandemic context. I argue that these two principles cannot be considered independently regarding HCWs. There is no doubt that a conflict exists between autonomy and the promotion and protection of public health through vaccination. This study highlights the importance of a balance between individual rights and the common good – not only during times of pandemics.