What would Hippocrates say?


Here’s an interesting ethical dilemma for you. Doctors in Greece (it’s not at all clear how many doctors are doing this) have a way of dealing with anti-vaxxers.

Mass fake vaccinations have been taking place in dozens of vaccination centers throughout Greece, media reported on Sunday. The bribe fee for doctors and nurses is apparently 400 euros. the fee is paid is by those who do not want to receive the vaccines against Covid-19 but want to gain access to several activities or simply avoid the twice per week Rapid tests for professional and other reasons.

But then a hilarious thing happened: Doctors pocketed the bribe but administered real vaccine and not “water” in order to avoid getting into trouble should the fake vaccination come out, according to a report by Mega TV.

On the one hand, this is just wrong. Doctors are bound to respect the wishes of their patients, and pocketing the 400 euros compounds the wrongness. Of course, it would also be unethical in this case to do as the patient desires.

On the other hand, this is great from a societal point of view. I want to say “keep it up!”…that is, until I meet a doctor who does the reverse, and out of misplaced, wacky ideas decides to give me a homeopathic dose of a vaccine.

Comments

  1. birgerjohansson says

    Seconded!
    (Personally, I would have told Prince I was giving him theologically neutral, synthetic blood transfusions to make it possible for him to have his necessary surgery for his pain, And then given him real blood once he was under anesthesia.)
    .
    OT Study pinpoints molecular targets of transplant rejection
    https://medicalxpress.com/news/2021-11-molecular-transplant.html
    Oh shit. I think Larry Niven wrote an SF story about the consequences of better transplantation science.

  2. says

    As long as the doctors don’t actually keep the money (i.e. hold it, then turn it over to the medical board when it investigates), why would or should they face any consequences?

    Those who do keep and spend it would be at risk, but I’d love to see them argue “I was doing what the patients asked, vaccinating them. I thought the money was a gift. They never said it was a bribe.”

  3. davidc1 says

    Talking of the covid vaccine ,,talking to my older brother yesterday ,he told me his daughter won’t let her two daughters get the vaccine .They have both had mild cases of covid ,also her husband .
    Sad to said she believes all the antivax bollox .

  4. kome says

    I want to say “keep it up!”…that is, until I meet a doctor who does the reverse, and out of misplaced, wacky ideas decides to give me a homeopathic dose of a vaccine.

    We’ve already met those kinds of doctors. Like the Arkansas prison doctor who lied to patients about giving them vitamins but gave them ivermectin. Or the ICE facility doctors who lied to asylum seekers about what they were doing in order to sterilize asylum seekers. Those doctors have been around far longer than the doctors who are doing the socially good thing despite undermining the sacrosanct trust between doctors and patients. Maybe I’d feel more strongly against what those Greek doctors are doing if any of the kinds of doctors like are employed by prisons and immigration enforcement ever got in any trouble. Don’t get me wrong, there is still a dimension on which I feel what the Greek doctors are doing is wrong… but I just can’t get that worked up about it because so many other doctors doing far worse things for far worse reasons go unpunished all the time.

  5. PaulBC says

    It’s clearly unethical. Also, I don’t see how you get away with it. The side effects of the second dose are hard to ignore, or at least they were for me. I wish people would just stop being assholes and voluntarily get vaccinated. Nobody should be tricked into it.

  6. gijoel says

    It’s wrong. They should be telling the free loaders to get lost, and not taking bribes.

    Still it gave me a good chuckle.

  7. cartomancer says

    I think there is a fairly strong argument to be made that the consent of the patient can be trumped by the importance of widespread vaccination as a public health measure.

    Were the only effects of a medical intervention personal in nature, with no effect on other people, then I would say it is acceptable to permit people to turn it down for whatever screwy reasons they come up with. This is different – not getting vaccinated causes measurable harms to others. Personally, I believe vaccination against this and other pandemic diseases should be mandatory and enforced (excepting only those who are medically unable to have the vaccine, i.e. those to whom the vaccine presents personal risks).

    So, to my mind, vaccinating the unwilling is a moral act in and of itself. The moral grey area is whether the doctors should have pocketed the bribes. But I’m not losing too much sleep over that.

  8. Rich Woods says

    @PaulBC #6:

    Also, I don’t see how you get away with it. The side effects of the second dose are hard to ignore, or at least they were for me.

    The placebo effect. If they think they’ve just had a saline injection they’ll put any side effects down to the physical intervention itself and minimise its importance in their heads, because of course anything that happens will be much less impactful than the 5G-phone-home-nanobots-turning-Nicki-Minaj’s-balls-magnetic mark-of-the-beast toxic shock that they were trying to avoid. At least it’ll keep them off the Greek equivalent of VAERS.

  9. whheydt says

    How many wrongs does it take to make a right? Bribing the doctors…wrong. Not doing what the patient requests…wrong. Asking the doctor to create fake records…wrong and probably illegal (it would be in the US…misuse of an official seal on the forms). Actually getting more people vaccinated…right.

    So…the doctors are taking the money. Can’t really blame them for that. When they file the paperwork, it reflects the true and honest state of affairs, the patient has received the vaccine, so the doctor has covered his ass from the state. So the only actual lie involved is giving the patient a vaccine he doesn’t want. But it’s done in accordance with what the public health officials want.

    Kind of hard to be very rough on the doctors, I think. Give ’em slap on the wrist and fine them about 30% of what they got in “bribes” because they did do a public service in spite of the effort the screw up the official records on the part of the patients.

  10. blf says

    Also, I don’t see how you get away with it. The side effects of the second dose are hard to ignore, or at least they were for me.

    I barely noticed either shot. Certainly nothing dramatic, nor more than a day or so (just a bit of soreness is all I can now recall).

    At least it’ll keep them off the Greek equivalent of VAERS.

    Which is potentially a problem if they are one of the rare few who really do have an adverse reaction.

    Kind of hard to be very rough on the doctors, I think. Give ’em slap on the wrist and fine them about 30% of what they got in “bribes” because they did do a public service

    That’s almost my initial thoughts too… If the doctor has not been or is not already “of concern” for other reasons, ask them to donate that 30% or whatever to a responsible health-related entity (e.g., an NGO such as ICRC or MSF; the local hospital or teaching medical University; etc.), with nothing on their records, provided that they did check beforehand for possible counterindications, and also did the 15m-or-so monitoring afterwards.

  11. John Morales says

    cartomancer:

    This is different – not getting vaccinated causes measurable harms to others.

    Potentially.

    I think there is a fairly strong argument to be made that the consent of the patient can be trumped by the importance of widespread vaccination as a public health measure.

    Surely ditching the precept of informed consent is worthwhile, after all what possible harms could accrue?

  12. mathscatherine says

    Thinking about homeopathic doses of vaccines… apparently the Pfizer vaccine at least is diluted with water before being used, and there have been two incidences in Queensland, Australia of someone accidentally thinking diluted vaccine was undiluted vaccine and diluting again. Luckily, both were identified and everyone concerned got another shot.

  13. dianne says

    All involved were in the wrong: the patients for trying to get a fake vaccine, the doctors for taking the bribe, and the doctors for injecting a substance into their patients against their will. I doubt that any actual harm was done and there may have been a good deal of harm prevention done, but if the doctors involved are willing to do that, what else might they be doing or be willing to do?

  14. says

    Either way, seems like the doctors are hosed if their involvement gets out. Either for assisting patients in falsifying government documents (saying they had a vaccine when they didn’t) OR in providing unauthorized medical treatment. (Plus, how to hide vaccine response effects that many people get.) And what happens in the rare case that someone suffers a traumatic impact from the vaccine – or even dies. I’m not actually against enforced vaccination of the entire population for the good of the world – it worked for smallpox and polio – but it’s still being done with a person’s knowledge, if not necessarily their consent.

  15. cartomancer says

    John Morales, #16,

    I didn’t say we should ditch the concept altogether. I said there are certain cases where it may not be absolute, and this is one of them.

    It seems to me that we already allow a lot of things to be done to people without their consent, in the interest of protecting others from harm. We allow the police to detain and restrain violent offenders for example, even though it is without the consent of the offender. I don’t see how this case is materially different – the unvaccinated pose a health risk, possibly a deadly one, to others just like the violent offender does.

    Sure, not all of the unvaccinated will contract the disease, and not all who have it will spread it to someone who will suffer death or permanent harm, but some inevitably will. Would we allow people to wander round public places with a device that spews random mystery gasses into the air just because they haven’t filled it with deadly cyanide 100% of the time? Doesn’t that degree of negligence equate to reckless manslaughter?

  16. John Morales says

    cartomancer,

    I didn’t say we should ditch the concept altogether. I said there are certain cases where it may not be absolute, and this is one of them.

    That’s the thing about principles; if you reduce them to a cost-benefit analysis, they’re no longer principles, they’re aspirational guidelines.

    We allow the police to detain and restrain violent offenders for example, even though it is without the consent of the offender. I don’t see how this case is materially different – the unvaccinated pose a health risk, possibly a deadly one, to others just like the violent offender does.

    Mmm. Sins of omission vs. sins of commission. Not materially different, right?

    Sure, not all of the unvaccinated will contract the disease, and not all who have it will spread it to someone who will suffer death or permanent harm, but some inevitably will.

    Ah yes, the principle of collective coercion. Very pragmatic.

    Anyway, it’s a matter of degree, no? Because it’s a pandemic, you advocate for this.
    But do you similarly advocate for, say, flu vaccines being mandatory?

  17. Daniel Holland says

    The doctors will be fine in terms of medical ethics. The patients have probably given their consent in writing, though with a wink, but the writing is what counts. The 400 Euro was just a “thank you” for the service, quite common in Greece anyway, but is the only thing the doctors may be worried about.

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