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When Doctors Become 'Patients': Advocating a Patient-Centered Approach for Health Care Workers in the Context of Mandatory Influenza Vaccinations and Informed Consent


Christine Nero Coughlin


Wake Forest University - School of Law

Nancy M.P. King


Wake Forest School of Medicine

Kathi Kemper


Wake Forest University - Department of Family and Community Medicine

August 4, 2010

Wake Forest University Legal Studies Paper No. 1656648

Abstract:     
Today’s health care delivery has evolved from a physician-centered model into a more patient-centered model. Although the definition and boundaries of the patient-centered health care movement are still being developed and refined, patient-centered care is arguably distinguishable, both historically and conceptually, from public health.

Nonetheless, just as public health concerns and individual medical choices have come together in some health care decision-making contexts for centuries, contemporary questions such as whether hospitals should mandate annual influenza vaccinations for their health care workers involve legal and ethical principles underlying the patient-centered movement, most notably that of informed consent.

This article discusses some of the legal arguments addressing health care employers’ mandatory influenza vaccination policies in the United States. In particular, we examine the relationship between influenza vaccination mandates imposed on health care workers by private sector employers and informed consent to vaccination, in the absence of federal or state vaccination requirements. This article proposes that the practice of requiring employees to sign a consent form when they receive the influenza vaccination as a condition of continued employment conflicts with the ethical and legal doctrine of informed consent, and concludes that when an employer’s policy effectively removes an employee’s freedom to choose whether to become vaccinated, it is unethical to require that health care worker to sign a consent form. The article advocates that if, despite controversy over such policies, employers choose to mandate immunization, they provide an alternative form, so that health care workers who would not seek vaccination except to avoid termination of employment may acknowledge that acquiescence to vaccination is informed but not voluntary.

Number of Pages in PDF File: 12

Keywords: Mandatory Vaccinations, Informed Consent, Ethics, Patient-Centered Health

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Date posted: August 11, 2010 ; Last revised: November 24, 2010

Suggested Citation

Coughlin, Christine Nero and King, Nancy M.P. and Kemper, Kathi, When Doctors Become 'Patients': Advocating a Patient-Centered Approach for Health Care Workers in the Context of Mandatory Influenza Vaccinations and Informed Consent (August 4, 2010). Wake Forest University Legal Studies Paper No. 1656648. Available at SSRN: http://ssrn.com/abstract=1656648 or http://dx.doi.org/10.2139/ssrn.1656648

Contact Information

Christine Nero Coughlin (Contact Author)
Wake Forest University - School of Law ( email )
P.O. Box 7206
Winston-Salem, NC 27109
United States
Nancy M.P. King
Wake Forest School of Medicine ( email )
Wachovia Center
100 N. Main St, Ste. 1449
Winston-Salem, NC 27101
United States
336.716.4289 (Phone)
HOME PAGE: http://bioethics.wfu.edu/
Kathi Kemper
Wake Forest University - Department of Family and Community Medicine ( email )
Winston-Salem, NC 27157
United States
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