A medical ethicist weighs in on how to approach treating unvaccinated people

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Sarah McCammon speaks with doctor and ethicist Carla Keirns of the University of Kansas Medical Center about how best to treat unvaccinated people who fall ill with COVID-19.

Transcript

SARAH MCCAMMON, HOST:

About 64% percent of the American population has been fully vaccinated now, and many are feeling anger at the remaining 36%. There have been calls for hospitals to refrain from treating unvaccinated people, including from radio host Howard Stern last week.

(SOUNDBITE OF RADIO SHOW, "THE HOWARD STERN SHOW")

HOWARD STERN: Now, if it was up to me, anyone unvaccinated would not be admitted to a hospital. At this point, they've been given plenty of opportunity to get the vaccine.

MCCAMMON: And last year, late night host Jimmy Kimmel joked about it, too.

(SOUNDBITE OF TV SHOW, "JIMMY KIMMEL LIVE!")

JIMMY KIMMEL: Dr. Fauci said that if hospitals get any more overcrowded, they're going to have to make some very tough choices about who gets an ICU bed. I don't know. That choice doesn't seem so tough to me. Vaccinated person having a heart attack? Yes, come right on in. We'll take care of you. Unvaccinated guy who gobbled horse goo - rest in peace, wheezy. You're...

MCCAMMON: But medical ethicists say that is not the right approach. Dr. Carla Keirns is an associate professor of medical ethics and palliative care at the University of Kansas Medical Center in Kansas City, Kan. And she joins us now. Welcome.

CARLA KEIRNS: Thank you.

MCCAMMON: What is your reaction to people who say hospitals should turn away unvaccinated people?

KEIRNS: It makes me sad, first of all, because I have seen and treated a lot of folks who haven't been vaccinated throughout the pandemic. And these are our neighbors. The folks who remain unvaccinated, while there's a fraction who are resistant and aren't going to get vaccinated, a large fraction of the rest of them are folks who have poor access to health care or poor access to information. It's rural folks. It's folks from poor communities. It's folks who don't have insurance or who have jobs where they can't get away to get a shot in the middle of the day.

And the second thing is we don't do that. In health care, we treat people based on their need. And everyone could find themselves in need of health care. And just because you eat at McDonald's yesterday or you were driving a little too fast or you decided to go bungee jumping doesn't mean that we don't treat you for what happens.

MCCAMMON: An article in The Atlantic last week, which you may have seen, detailed another similar trend, which is people, particularly on social media, scorning those who are mourning their loved ones who've died from COVID and weren't vaccinated. And I just wonder how that strikes you.

KEIRNS: It's really a sign of the stress and tragedy of our times. You know, why would people be so angry or so mean? And I think the answer to that is that we are all tired, and we're angry, and our lives have been disrupted for two years now. And some folks are facing things like having surgeries delayed, and they're looking for someone to blame. But they're also looking for a sense of control. And the idea that I got vaccinated, so I'm going to be safe and it's their fault that they got sick helps almost as a psychological coping mechanism. It helps us think, well, this wouldn't happen to me.

MCCAMMON: Is that an appropriate question to ask, do you think? When someone has lost a loved one to COVID, is it OK to ask them if the person was vaccinated?

KEIRNS: Well, it doesn't matter now, does it? It's not going to change the outcome. The only circumstance in which I think it makes sense is some physicians and nurses and others have been saying, please get vaccinated yourself. We don't want this to happen to you. I think that the proper response to someone who's in mourning is to say I'm sorry and to offer support.

MCCAMMON: As you talk this through, you sound so calm and compassionate and reasoned. But as a health care worker, you must be frustrated sometimes. How do you deal with your anger?

KEIRNS: I had somebody I was caring for a few months ago who he and his family did not believe in COVID, whatever that means. And he was dying of it. And at first, I was angry at them, and then I was sad for them because they were lied to. They were fed misinformation by people who know better. And so I decided to be angry at them because the patient in front of me is already suffering more than anything that I could possibly want for anyone. The punishment for making a bad choice isn't death. I feel like we really need to look at the humanity of our neighbors and our patients and give them some grace and some respect and some recognition that we are all human and we're all mostly doing the best we can under tough circumstances.

MCCAMMON: Dr. Carla Keirns is an associate professor of medical ethics and palliative care at the University of Kansas Medical Center in Kansas City. Thanks so much for talking with us.

KEIRNS: Thank you. Transcript provided by NPR, Copyright NPR.