AMA Amends Ethical Guidance on Physician Immunizations

Outlines precautions for non-immunized physicians to protect patients and colleagues

CHICAGO - Physicians who are not immunized from a vaccine-preventable disease have an ethical responsibility to take appropriate actions to protect patients and colleagues, according to amended ethical guidance adopted by physicians at today's Special Meeting of the American Medical Association (AMA) House of Delegates.

The AMA Code of Medical Ethics has long maintained that physicians have a strong ethical duty to accept immunizations when a safe, effective vaccine is available. This is especially true when a highly transmissible disease poses significant risks to patients and colleagues.

However, it is not ethically problematic to exempt individuals when a specific vaccine poses a risk due to underlying medical conditions. Ethical concerns arise when individuals are allowed to decline vaccinations for non-medical reasons, according to a report presented to the House of Delegates by the AMA Council on Ethical and Judicial Affairs.

"Physicians and other health care workers who decline to be immunized with a safe and effective vaccine, without a compelling medical reason, can pose an unnecessary medical risk to vulnerable patients or colleagues, said AMA Board Member Michael Suk, M.D., J.D., M.P.H., M.B.A. "Physicians must strike an ethical balance between their personal commitments as moral individuals and their obligations as medical professionals."

According to the newly amended AMA ethical guidance, "physicians who are not or cannot be immunized have a responsibility to voluntarily take appropriate actions to protect patients, fellow health care workers and others." This includes refraining from direct patient contact.

Delegates also approved guidance asserting the responsibility of physicians practices and health care institutions to proactively develop policies and procedures for responding to epidemic or pandemic disease with input from practicing physicians, institutional leadership and appropriate specialists. Such policies and procedures should outline appropriate protective equipment allocation, staff immunization programs and infection control practices, including those that limit patient and staff exposure to individuals who are not immunized.