The pandemic has raised NEW ethical issues! Here are three valuable resources for dentists navigating ethical issues, primarily regarding vaccination, raised by patients and staff.
1) The Ethics of Vaccination ADA White Paper
The ADA's Council on Ethics, Bylaws and Judicial Affairs recently released an important white paper on The Ethics of Vaccination which we encourage all practitioners to read. The white paper addresses topics related to vaccination for which dentists must evaluate the ethics and their professional obligations, including the dentist’s ethical obligation if patients and/or staff members refuse vaccination.
2) NYSDA’s Ethics Specific Frequently Asked Questions
The New York State Dental Association (NYSDA) created a list of Frequently Asked Questions focus on Ethics issues to guide dentists during COVID.
3) Question posed to NYSDA’s General Counsel regarding a patient who only wants to be treated by vaccinated staff.
A patient just told me that he wants whoever is assisting me at his upcoming appointment to be vaccinated. We are under the impression we cannot ask staff if they have or have not been vaccinated due to privacy. How would you advise that I respond to this patient?
I would make it clear to the patient that the question is not relevant. There is no clear data yet that vaccination prevents a person from being a carrier of the disease, only that the person vaccinated is protected from getting the disease themself. Therefore, even if everyone in the office is vaccinated, it is no guarantee they might not transmit the disease to an unvaccinated patient. You would not want to give a false sense of safety that is not yet supported by science. And it isn’t even an absolute that a vaccinated person is necessarily 100% immune from the disease or its many variants. The patient’s question is premised on a fear/demand that you can never really satisfy 100%. You can ask employees the simple question of whether they have been vaccinated for COVID or not, under guidance from the United States Equal Employment Opportunity Commission (EEOC). No law prohibits asking that simple question according to the EEOC. But even if you do ask that question of employees, I would not use those answers to give a false sense of security to a patient.
I would convey the scientific, clinical truth of the current state of knowledge to the patient. An employer can also require COVID-19 vaccinations according to the EEOC, but some questions have arisen whether an employee has the right to refuse the vaccination under the United States Food, Drug and Cosmetic Act for an EUA vaccine as opposed to a fully approved vaccine (and whether the FDA Act has any effect on employers). There are warring legal opinions on that right now even among major law firms – one reason that NYSDA tells people to seek guidance from their personal attorney on the subject because, even without that latest debate, mandatory vaccinations are fraught with all kinds of other legal ramifications and considerations. I will not provide legal advice other than that for members seeking to do that. It is not a simple informational “yes” or “no” matter.