The suggestion Covid deniers should stay out of Australian public hospitals is appalling | Stephen Parnis

I think I speak for almost every doctor when I say care is provided on the basis of medical need

I am responsible for the Covid zone in a major Melbourne emergency department.

To be a patient in here, you must be suffering from Covid-19.

In the middle of our third wave of the pandemic, this Covid zone is growing, as more and more patients fill the beds. They span the age spectrum from teenagers to the elderly, and the severity of their illness ranges from the mild (who will be able to be monitored at home) through to those whose life is in jeopardy, for whom intensive care must be considered.

After completing my shift and handing over to a senior colleague, I often reflect on the day, and carry home a heavy heart. Some of my patients are highly likely to deteriorate and may not survive. They remind me of members of my own family.

These patients come from all over Melbourne and their demographics could not be more diverse.

Across the state, many patients hospitalised with Covid have one thing in common, they are unvaccinated.

I hate the fact that so much of this death and disease is now preventable, and that a small but significant proportion of the community have not been vaccinated for reasons ranging from fear and complacency through to misguided refusal.

I have spent much of 2021 advocating for urgent, confident vaccination to anyone who would care to listen.

It comforted me to remember that while professional detachment is an essential part of being a good doctor, compassion and humanity are just as important. If you’re emotionally overwrought, your ability to make medical decisions is impaired, and the patient’s interests are jeopardised. By the same token, if you coldly follow some treatment algorithm without considering the human dignity of the person in front of you, you will never be the healer you aspire to be.

On Thursday, I was made aware of comments by the president of the Australian Medical Association’s Victoria branch. Reportedly, in discussing the enormous strain the pandemic is placing on medical resources, he suggests that those who deny the existence of Covid-19 “should update their advance care directives and inform their relatives that they do not wish to receive care in the public health system if diagnosed with the virus”. While noting that the unvaccinated would receive high-quality care in the state’s hospitals, McRae challenged Covid-deniers to commit to their beliefs and say “‘If I am diagnosed with this disease caused by a virus that I don’t believe exists, I will not disturb the public hospital system, and I’ll let nature run its course’.”

If the quote is faithfully conveyed, then it is in my view appalling, unethical, and an insult to the medical profession.

I think I speak for almost every doctor when I say care is provided on the basis of medical need, and the key principles of beneficence (doing all good for the patient) and non-maleficence (doing no harm) should always be applied.

However passionately I disagree with a patient’s views or actions – in this pandemic or any other context – I will never dispute their entitlement to public care on that basis. To do so would be reckless and undermine the confidence and trust placed in doctors by the community. It is no different to treating lung cancer or emphysema – smoking is only considered as a means to assess risk, not as a reason to judge their worthiness for public treatment.

This pandemic is presenting enormous challenges to our health system as we struggle to fight fatigue and resource constraints in the face of incredible demand. That’s why we always prefer prevention over cure.

But the decisions about treatment for Covid-19 (or any other illness, for that matter) will be based on offering the best available options for those who are most likely to benefit, and to avoid treatments where the risk of harm heavily outweighs the benefits.

Medical treatment should never be determined by populism but by evidence, and in a non-judgmental, compassionate manner. The Victorian community, who have already been through so much over the past 20 months, deserve better.

• Dr Stephen Parnis is an emergency physician and was the president of AMA Victoria from 2012 to 2014, and vice-president of the federal Australian Medical Association from 2014 to 2016

Contributor

Stephen Parnis

The GuardianTramp

Related Content

Article image
We healthcare workers steel ourselves for a battle we hope does not return to Victoria’s hospitals | Stephen Parnis
My medical colleagues and I have warned of the risks from a sense of complacency and a woeful public education effort

Stephen Parnis

01, Jun, 2021 @2:06 AM

Article image
As an Australian emergency doctor, I can’t wait to close the book on 2020 | Stephen Parnis
While this country has done well by world standards, healthcare workers have been on constant alert and a deep fatigue has set in

Stephen Parnis

28, Dec, 2020 @4:30 PM

Article image
As an emergency doctor in Melbourne, fatigue is settling in. The political blame game isn’t helping | Stephen Parnis
The question for us on the frontline, the unemployed and the distressed must be ‘What do you need?’ not ‘Who is to blame?’

Stephen Parnis

18, Aug, 2020 @3:04 AM

Article image
More than 700 Victorians have lost their lives in this pandemic. I have been with some of them | Stephen Parnis
The endless demands of emergency medicine in a pandemic have taken their toll on many of us

Stephen Parnis

14, Sep, 2020 @3:00 AM

Article image
Our vulnerable patients trust us but Victoria’s vaccination system is hard to navigate | Mariam Tokhi and Lester Mascarenhas
We must make vaccinations accessible to those from diverse backgrounds with poor English-language skills and limited health literacy

Mariam Tokhi and Lester Mascarenhas

01, Jun, 2021 @5:30 PM

Article image
I am a doctor. Here's what I know about communicating with reluctant patients | Ranjana Srivastava
Ridiculing the hesitant never works. Firmly but respectfully, I refuse to legitimise quackery

Ranjana Srivastava

09, Feb, 2021 @4:30 PM

Article image
The message to doctors has always been clear: if you get sick, do it on your own time | Ranjana Srivastava
A health minister ‘flabbergasted’ that a sick doctor went to work? That’s either naive, or dangerously misinformed

Ranjana Srivastava

09, Mar, 2020 @1:28 AM

Article image
Covid anxiety and intolerance rise together in Australia but the only way out is together | Ranjana Srivastava
Some Melbourne communities have been scapegoated during the pandemic, yet all our fates are intertwined

Ranjana Srivastava

29, Sep, 2020 @5:30 PM

Article image
In 28 years as an Australian emergency doctor, this is the most stressful period | Stephen Parnis
We dodged a bullet in March and April but any sense of relief has been wiped away in the last couple of weeks

Stephen Parnis

20, Jul, 2020 @3:01 AM

Article image
Experts chart a way out of Victoria’s world-record lockdown and rising Covid case numbers | Tony Blakely and Catherine Bennett
With soaring infections and compliance with restrictions wavering, academics say the key is to avoid red-line strain on hospitals

Tony Blakely and Catherine Bennett

05, Oct, 2021 @4:30 PM