Vaccinate-or-mask: Ethical duties and rights of health care providers in obtaining or refusing the influenza vaccination

There is much controversy over the effectiveness of the influenza vaccination; yet, globally, many health institutions are implementing policies that require health providers to either receive the influenza vaccination or wear a surgical mask. This vaccinate-or-mask policy has caused great hullabaloo among health care providers and the institutions wherein they work. In light of the limitations to best practice evidence, we conducted an analysis of the policy and its implications based first on the bioethical principles of beneficence, nonmaleficience, respect for autonomy, and justice and then on the ethical theories of Immanuel Kant and John Stuart Mill. The most important ethical issue was threat to patient safety and welfare in the event of receiving care from a health provider who chose to forego the influenza vaccination and surgical mask requirement. We concluded that policies requiring health care providers to receive the influenza vaccination or wear a surgical mask are only partially supported by the bioethical principle approach; however, they are clearly justified from a deontological standpoint. That is, Kant would argue the rightness of the policy as a moral imperative for health care providers to not impose a health risk to those they serve and for health care institutions to ensure professional care giver vaccination. In further considering the vaccinate-or-mask policy in terms of the utilitarian "greatest good for the greatest number", we determined that Mill would argue that this type of policy is ethically right and just, but also that policies solely requiring immunization would be ethical as public well-being is promoted.

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