Wednesday, August 31, 2011

You still have the right to quit

Over at Fox News, Dr. Manny Alvarez supports the decision by a hospital organization in Michigan to mandate vaccination against seasonal flu by its staff on pain of termination.  The argument for this is that people who work at hospitals are at a greater risk for contracting and spreading the flu.  The counter-argument is that an employer should respect the rights of employees as to what they inject into their bodies.

Dr. Alvarez makes a good point when he says that a hospital can mandate that a worker must have certain education and credentialing qualifications before being allowed to work, so why shouldn't they mandate vaccination?

I agree with Dr. Alvarez on this.  The flu kills on average about 6000 people in the United States, with thousands more becoming sick.  These sick people are going to concentrate at doctor's offices, emergency rooms, and hospital wards.  People who work at these facilities, regardless of their job, are going to be exposed either to the patients or to the things they touch or cough and sneeze on.  For their own health, and the health of the people they will come into contact with, they should be immunized against this highly infectious illness.

Yes, the flu shot is not always effective, and yes there will be people who get sick from the shot itself.  But the risk of spreading flu in an environment where people are seeking health care is too high.  People who have a moral or medical reason to not get the flu shot can get out of it with a note from their doctor or pastor.

The other side of the coin is the rights of the employees.  I don't like it when my employer comes out with yet another mandatory briefing, background screening, training session, or whatever that I have to do in order to stay employed.  While my company encourages flu shots and immunization in general, they don't mandate it.  But I'm not working with or around sick people either.

My take on this particular situation is that employees who don't don't want to get the flu vaccine and don't have a religious or medical reason for doing so, can always quit.  When you accept employment, even if you have the strongest union contract in the world, you are agreeing to exchange your labor and adherence to policies set by your employer in exchange for money in one form or another.  If an aspect of the work or one of those policies offends you, leave.  Drop your two weeks notice, start calling business and family contacts looking for your next gig, and polish your resume a bit.  Cashing the paycheck means you agree to the employer's terms and conditions.


Jake (formerly Riposte3) said...

I have to disagree with you on this one. First, the comparison to training and certification fails, because, unlike training, the flu vaccine carries a not insignificant health risk - as you noted. Second, the benefits (the very existence of which is uncertain from year to year) are questionable.*

Third, while someone may have the right to quit, realistically they may not have the ability - especially given the current state of the economy. Quitting, or letting yourself get fired, right now, can leave you still unemployed six months from now, or more. The employer has a real position of power here, and this isn't a situation where someone can simply put up with what they view as an unacceptable situation long enough to look for another job.

So you have a situation where an employer is using its position of power to force employees to annually undergo a medical procedure with a small but not insignificant risk for a questionable and uncertain benefit.

I think the employees' Right to determine their own medical treatment trumps the employer's right to determine employment requirements in this particular case.

* Unlike many other vaccines, the effectiveness of the flu vaccine depends greatly on whether the makers guessed at the correct strain of flu to base it on the year before. There was a bit of a kerfluffle a couple of years ago when they picked the wrong virus strains and the resulting vaccine did not protect against one of the most common strains that year, while carrying the same risk as always.

Matt said...

Sorry, but I have to disagree as well.

What's next that they can demand you do to your body? Once it starts, where does it stop?

The Communist Government in China demands and enforces an unwanted medical procedure in China. It's called abortion.

DaddyBear said...

I do agree that the flu vaccine sometimes leaves a lot to be desired, both in effectiveness and potential side effects. Employees of this hospital will have to weigh that in their decision about whether or not to get the immunization. I suppose that someone could make the legal argument that since the hospital accepts Medicare and Medicaid funds, then it is acting as an de facto agent of the government in some way, and then the argument that the government does not have the power to force someone to take the flu shot could be made. But that would take some good lawyering to get that through the courts.

I will be the first one to decry an attempt by a de jeur government agency to force anyone to get a flu shot, whether it is the federal Department of Health and Human Services, the state credentialing authority for medical personnel and facilities, or a local health department.

But that's not what we have here. We have two private entities, a hospital and an employee, that are making a business transaction on an open market. The hospital, who is the consumer in this transaction, has told the producer, the employee, that if a flu vaccination is not obtained by a certain date, then the consumer will find another source for the labor and expertise supplied by the producer. The employee has a full quarter of a year to decide whether or not to get the shot, and if they decide that either the risk of getting the shot or the principle of the thing prevents them from getting vaccinated, then they have that time while still gainfully employed by the hospital to seek employment elsewhere.

And I can sympathize with how hard it is to find a job in this economy. I have close friends who have been looking for more than six months for a job that makes as much as the one they lost. If put in a similar position, it would have to think long and hard about whether or not the side effects of a mandatory flu shots outweigh my ability to put food on the table. I know that voluntarily leaving a job in this economy will be exceedingly difficult, but my point is that there is an alternative to getting the vaccination, however difficult and odious it may be.

No-one is being forced to get the shot under threat of imprisonment or worse, as the example of forced abortions in China suggests. The worst consequence for making the voluntary decision to remain unvaccinated is to stop working at one particular hospital system in one state. There are other hospitals in Michigan, and there are 49 other states that have hospitals to work in, assuming that working in a hospital is a mandatory solution to unemployment.

A mirror argument for this would be whether or not an employer has the right to demand that its employees refrain from taking intoxicants that could impair the health and safety of its other workers or customers, and enforces this with drug screens for all employees. Do the privacy rights of the employees in this situation trump the right of the private employer to know that their employees are safe to work in the environment of the business?

I would like to see statistics from this particular hospital system to show absentee rates for employees over the past few years that were attributed to seasonal flu, how many patients were treated for the flu after being in the hospital, and the cost to the hospital and ensurers for that care and loss of manpower. Numbers always make problems like this clearer.

DaddyBear said...

Wow, I haven't made that many grammatical and spelling errors in years. Sorry about doing such a poor job typing up the last comment, guys.

Spikessib said...

I disagree, too.

First, that is not the only hospital that plans to make getting a flu shot mandatory. So many hospital employees throughout the country are being forced to submit or be unemployed. And there is more risk to patients at an understaffed hospital than one where the employees have not had a flu shot.

Second, Universal Precautions, already mandated, are sufficient protection from exposure to the flu. Hospital employees are exposed to many more dangerous diseases every day with those exposures managed nicely by utilizing Universal Precautions. Masks, hand washing soap, alcohol hand cleaner, gloves and gowns are readily available and a more certain preventive that don't force the employee to undergo a not risk-free medical procedure.

Third, if risk of exposure is the criteria for the mandate than of all employers who should mandate flu shots for the "general welfare" WalMart and stores like it should be at the top of the list. And they should add the precaution of wiping down the carts with antiseptic between uses as part of their Universal Precautions. Flu is as likely to be passed there as at the hospital. Many more people run through there daily than the ED and lots of them are there for over the counter flu and cold remedies during the season.

Julie said...

Sorry DB I disagree too.

Basically this is a CHANGE in requirements for already employed staff.

If they mandated this for potential employees and advised them of this during the interview program I'ld have less of an issue.

I believe that a company can suggest / help / pay for / encourage etc behaviours that result in good health for their employees but mandating an injection (which may or may not be effective) is stepping over the mark.

LabRat said...

I suppose I'll be the lone agreeing voice, then.

It's a hospital. Some of its clients- that is, patients- are immunocompromised. Not only can't they themselves be vaccinated, they are the precise population for whom influenza represents a mortal threat rather than a terrible week off from work. The very old and the very young also fall into that overlapping pool of frequent hospital residents and the usual victims of actual mortality from the flu.

Yes, the flu shot is only sometimes effective, but that does not equate to ineffective. Hell, even Universal Precautions aren't 100% preventions of infections- but both of them are improvements.

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