WaPo's Ruth Marcus doesn't think her argument that 'the irresponsibly unvaccinated should go to the back of the health care line' makes the slope 'unduly slippery'

Washington Post deputy editorial page editor Ruth Marcus isn’t afraid of a slippery slope. In fact, she’s prepared to jump onto her sled and slide down headfirst:

The irresponsibly unvaccinated should go to the back of the health care line. https://t.co/2bedgL2NHy

— Ruth Marcus (@RuthMarcus) September 4, 2021

This sounds promising, doesn’t it? Here’s how it starts out:

I’m going to come right out and say it: In situations where hospitals are overwhelmed and resources such as intensive care beds or ventilators are scarce, vaccinated patients should be given priority over those who have refused vaccination without a legitimate medical or religious reason.

This conflicts radically with accepted medical ethics, I recognize. And under ordinary circumstances, I agree with those rules. The lung cancer patient who’s been smoking two packs a day for decades is entitled to the same treatment as the one who never took a puff. The drunk driver who kills a family gets a team doing its utmost to save him — although, not perhaps, a liver transplant if he needs one. Doctors are healers, not judges.

But the coronavirus pandemic, the development of a highly effective vaccine, and the emergence of a core of vaccine resisters along with an infectious new variant have combined to change the ethical calculus. Those who insist on refusing the vaccine for no reason are not in the same moral position of the smoker with lung cancer or the drunk driver. In situations where resources are scarce and hard choices must be made, they are not entitled to the same no-questions-asked, no-holds-barred medical care as others who behaved more responsibly.

We all want more people to be vaccinated but discriminatory care violates medical ethics, degrades trust in medicine, and is counterproductive for public health.

It is essential for triage to be based on who would benefit most, not who supposedly deserves it.

— Andrew Goldstein #EndVaccineApartheid (@AndrewMakeTweet) September 4, 2021

"Deservedness" policies require human beings to be perfect, and keep people from care they need and deserve.

This approach has a deep history in racist, eugenicist, and classist projects.

We must not tolerate this logic anywhere in medicine.

— Andrew Goldstein #EndVaccineApartheid (@AndrewMakeTweet) September 4, 2021

What's next?

No access to ICU if you're a person with diabetes who eats ice cream?

Fired by your doctor because you missed a refill?

Is the author perfect? Are any of us?

— Andrew Goldstein #EndVaccineApartheid (@AndrewMakeTweet) September 4, 2021

Blaming unvaccinated people is unconscionably being used to shift blame away from the powerful for their policy failures:
– vaccine-only approach is failing to control spread
– vaccine programs focused only on availability (not accessibility/acceptability) fail to reach many

— Andrew Goldstein #EndVaccineApartheid (@AndrewMakeTweet) September 4, 2021

Despite any efforts to convince us otherwise, Ruth Marcus’ argument is not in good faith. It’s actually pretty terrifying.

In which an actual editor @washingtonpost argues that allowing docs to discriminate based on vaxx status is *not* a slippery slope because, basically, 'Hey, it's only this one time.'

Wonder how she'll feel when the pts who die are majority Black/brown?https://t.co/MzdZQyulBu

— Ann Bauer (@annbauerwriter) September 6, 2021

No, really. She said that:

One argument against this position is that it puts health-care providers on a slippery slope toward becoming free-ranging moral arbiters. Nope, I don’t think the slope is unduly slippery. This is a unique setting that combines the availability of lifesaving treatment, the imperative of individual responsibility and the attendant, pandemic-created shortage of resources. Carving out a justifiable exception from ethical rules doesn’t mean risking that they will be routinely ignored.

What could possibly go wrong?

Awkward pic.twitter.com/tFCgpQG6bc

— Daniel Miller (@WallStreetBean) September 6, 2021

Like we said: Ruth Marcus is not arguing in good faith.

Wow.

"Those who insist on refusing the vaccine… are not in the same moral position of the smoker with lung cancer or the drunk driver.. they are not entitled to the same… medical care as others who behaved more responsibly."

WORSE than drunk driving? What a crazy statement

— Matt, Pre-school Diploma 😀 (@statomattic) September 6, 2021

As a physician, I call bull💩 on this Grade-A nonsense. Husband is an ER doc, and when there’s a bad accident, the drunk driver gets the same care as the victims. It’s this thing called *medical ethics.* And you can hardly compare driving drunk to deciding not to get a vaccine.

— elizabeth bennett (@ebennett74) September 6, 2021

Well, Marcus did just that. So.

That’s not what I was taught to do during the AIDS epidemic. Are you saying my medical ethics training back then was wrong?

— Joe Pilot, MD (@JoeSilverman7) September 4, 2021

Ruth apparently thinks that medical ethics aren’t all they’re cracked up to be and need to catch up with the times.

"This conflicts radically with accepted medical ethics, I recognize."

Marcus's conscience tries in vain to get a word in edgewise.

— AGoodQuestion (@Benjones2Jones) September 6, 2021

My take?

Rhetorically, that's how you disarm the argument against you. You state it ('this conflicts with medical ethics') then provide the evidence that you've developed an unbeatable counter argument or solution. She forgot that last part.

— Ann Bauer (@annbauerwriter) September 6, 2021

Maybe people like Ruth Marcus whose consciences are already on life support should also be refused medical treatment.

Whenever they try to tell you healthcare is a human right laugh in their faces. https://t.co/ZLSAVdcU9O

— Stacey – FEMA Camp Region 4 (@ScotsFyre) September 5, 2021

We absolutely will.

Note to everyone: Please consider getting vaccinated if you have not. These shots have been used for 9 months now; data for effectiveness (still high) and adverse effects is available. It may save your life.

If you do not, you still deserve health care. This is America.

— Ann Bauer (@annbauerwriter) September 6, 2021