Law and Ethics in Healthcare- Week 1 Discussion Response

Law and Ethics in Healthcare- Week 1 Discussion Response

Respond to  at least two of your colleagues’ postings in one or more of the following ways:

· Share an insight that you gained from having read your colleague’s initial post.

· Share advice that you would provide to the CEO in your colleague’s scenario regarding techniques used to increase voluntary immunization among their patient care staff. How can they help to ease tension between a healthcare professional’s personal autonomy and public safety?

Colleagues 1- Tia Sturdevant

Healthcare organizations continue to face complex decisions regarding COVID-19 vaccination policies for healthcare professionals. Although the federal mandate was rescinded in 2023, healthcare leaders must still determine how to balance employee autonomy, patient safety, workforce stability, and ethical responsibilities. As an advisor to the CEO of a healthcare organization, I would recommend maintaining a formal COVID-19 vaccination policy that strongly encourages vaccination for healthcare professionals while allowing limited medical and religious exemptions. This approach best supports patient safety, continuity of care, and organizational ethics while minimizing workforce disruption.

Implementing a vaccination policy has significant implications for healthcare service delivery and public safety. Healthcare professionals interact with vulnerable populations daily, including immuno-compromised patients, older adults, and individuals with chronic illness. Vaccination reduces the risk of severe illness, hospitalization, and transmission, which helps protect both patients and staff. The Centers for Disease Control and Prevention (CDC) estimated that COVID-19 vaccines prevented millions of hospitalizations and deaths, demonstrating their effectiveness in reducing healthcare system strain. Organizations that maintain vaccination policies may experience fewer staffing shortages due to illness-related absences and reduced risk of outbreaks within healthcare facilities. Infection prevention guidance from the CDC's Healthcare Infection Control Practices Advisory Committee (HICPAC) also supports vaccination as an important component of infection control practices (Centers for Disease Control and Prevention [CDC], n.d.).

Conversely, failing to implement a vaccination policy could negatively impact patient confidence and increase the likelihood of workplace outbreaks. Patients expect healthcare organizations to provide safe environments and to minimize preventable risks. Without vaccination policies, healthcare systems may experience increased transmission among staff and patients, potentially disrupting service delivery and reducing operational efficiency. However, organizations that enforce strict mandates may also face staffing challenges if employees resign or are terminated for noncompliance, as demonstrated in the care of Mayo Clinic employees who were terminated after refusing vaccination (Perus, 2022). Therefore, healthcare leaders must carefully balance safety priorities with workforce retention.

Several conflicts may arise regardless of whether a vaccination policy is implemented. One major conflict involves personal autonomy versus professional responsibility. Many healthcare workers argue that mandatory vaccination policies infringe upon individual freedoms and bodily autonomy. At the same time, healthcare organizations have an obligation to protect patients from preventable harm. This conflict became particularly visible during debates over vaccine mandates nationwide. Some healthcare systems continued enforcing vaccine requirements, while others relaxed or eliminated mandates after federal requirements were lifted (Gooch, 2023; Vannozzi, 2023). Tension may also develop between employees and leadership if staff perceive mandates as coercive or punitive. Additionally, organizations that do not implement policies may encounter conflict from patients or employees who believe leadership is failing to prioritize safety.

Ethical issues are also central to this discussion. Pozgar (2024) explains that ethical decision-making in healthcare often involves balancing competing principles such as autonomy, beneficence, nonmaleficence, and justice. Mandatory vaccination policies support beneficence and nonmaleficence because they aim to protect patients and reduce harm. However, they may conflict with respect for autonomy when employees object to vaccination. Utilitarian ethics further support vaccination policies because these policies promote the greatest good for the greatest number by reducing disease transmission and protecting public health (Vearrier & Henderson, 2021). Williams (2022) argues that selective mandatory vaccination policies can be ethically justified when healthcare professionals have direct contact with vulnerable populations. At the same time, ethical concerns arise if policies are applied inconsistently or fail to account for legitimate medical or religious exemptions. Organizations must therefore ensure policies are equitable, transparent, and legally compliant.

Based on these considerations, I would advise the CEO to implement a policy that strongly encourages COVID-19 vaccination for all healthcare professionals while permitting carefully reviewed exemptions and emphasizing education, infection control, and shared accountability. This strategy balances ethical obligations to protect patients with respect for employee rights. I would also recommend ongoing monitoring of CDC guidance. Local transmission rates, workforce impacts, and emerging scientific evidence to ensure the policy remains appropriate and adaptable. Sources used to make this recommendation would include the CDC, HICPAC guidance, peer-reviewed ethical analyses, organizational case studies, and professional ethics standards such as the American College of Healthcare Executives' Code of Ethics, which emphasizes patient welfare, professional integrity, and accountability (American College of Healthcare Executives, 2023).

American College of Healthcare Executives Code of Ethics Links to an external site.

American College of Healthcare Executives. (2023, December 5). Code of ethics.

CDC Healthcare Infection Control Practices Advisory Committee (HICPAC) Links to an external site.

Centers for Disease Control and Prevention. (n.d.). Healthcare infection control practices advisory committee (HICPAC).

Gooch, K. (2023, October 13). 5 health systems’ approach to COVID-19 vaccine rules. Becker’s Hospital Review. Becker’s Hospital Review article Links to an external site.

Petrus, C. (2022, January 23). Unvaccinated Mayo employees are officially being terminated: Lawmakers react. KTTC.com. KTTC Mayo Clinic article Links to an external site.

Pozgar, G. D. (2024). Legal and ethical issues for health professionals (6th ed.). Jones & Bartlett Learning.

Saunders, B. (2022). How mandatory can we make vaccination? Public Health Ethics, 15(3), 220–232.  https://doi.org/10.1093/phe/phac026 Links to an external site.

Vannozzi, B. (2023, June 13). NJ lifts COVID-19 vaccine mandate for health workers. NJ Spotlight News. NJ Spotlight News article Links to an external site.

Vearrier, L., & Henderson, C. M. (2021). Utilitarian principlism as a framework for crisis healthcare ethics. HEC Forum, 33(1–2), 45–60.  https://doi.org/10.1007/s10730-020-09431-7 Links to an external site.

Williams, B. M. (2022). The ethics of selective mandatory vaccination for COVID-19. Public Health Ethics, 15(1), 74–86.  https://doi.org/10.1093/phe/phab028

Colleague 2- Mike Hayes

When looking at the ethical implications of implementing a vaccination policy for a healthcare organization, there are a few issues. On the one hand, we want to provide a safe and secure environment for our patients, knowing some of them are immune compromised.  However, there are also issues relating to how we can ethically implement this policy with our staff.  Something that comes to mind is remembering the COVID-19 vaccine mandate at the healthcare organization I worked at previously.  The mandate was very heavily handed.  Where the policy was more favorable for staff who objected on religious grounds, and were granted an exemption, it was people with disabilities who struggled the most with exemptions, and many left the organization rather than have to jump through hoops to get an exemption from their doctors, who themselves worked for this organization and didn't want to sign something that could conflict with their employment.  I was one of the people with a disability who ended up leaving because of how difficult it was to get an appointment at the time in order to get a note exempting me.  

The ethical issues are, when implementing a vaccination, bodily autonomy should be respected, not ignored.  While I understand the need to protect our patients, we must also remember our staff tend to also be our patients and we must still protect their health too.  If staff have legitimate concerns over a vaccination potentially causing them further harm, we must respect their decision.  We must also recognize the ethical implications of forcing a vaccine without consent from the person receiving it.  There are also other ethical considerations we must look at when implementing a vaccination policy.  These are stigmatization from vaccinated staff against unvaccinated, impacts on individual team members trust of the system, and how this can impact team cohesion, and the distress among staff who feel pressured to seek an exemption for fear of losing their jobs or licensure. 

If I were to provide my opinion to the CEO, I would be against vaccination mandates.  I believe they impact the bodily autonomy and consent of the people who they are forced upon.  I believe, as individuals, it is our responsibility to look after our own health.  In the same vein of telling people to get vaccinated for the good of the people, an argument could also be made that those who are most at risk of contracting COVID-19 could also take proactive steps to avoid the public and possible exposure.  This is the route I went with, as someone with several autoimmune conditions.  Because I never expect others to do something that makes them feel violated for my own benefit, especially if it's something I myself wouldn't feel comfortable doing.  My argument against vaccine mandates is that vaccines aren't temporary, they are permanent.  using myself as an example, I developed Autoimmune Hepatitis in 2013 from the flu vaccine.  Something as simple as a shot has changed my entire life.  Looking at who I would use as a source for my recommendation, I would use the Journal of Medical Ethics, specifically the essay written by Professor Uwe Steinhoff.  I feel like he broke the argument against mandates down to the fundamentals and made several great points.

Sources:

The case against compulsory vaccination: the failed arguments from risk imposition, tax evasion, ‘social liberty’, and the priority of life. (2024). BMJ Journals. Retrieved May 27, 2026, from  https://jme.bmj.com/content/early/2024/10/28/jme-2024-110236Links to an external site.

Ethical challenges around mandatory vaccination among nurses: A systematic review of qualitative and quantitative evidence. (2026, March). Science Direct. Retrieved May 27, 2026, from  https://www.sciencedirect.com/science/article/abs/pii/S0020748925003232

2

Dear CEO,

I recommend continuing with a healthcare worker vaccine mandate, particularly for those directly managing patient care. This policy aims to promote safe provision of healthcare and enhance patient and public safety. Vaccination of employees will prevent sickness and provide consistency in service delivery. Moreover, there is less risk that the infected individual will get in contact with anyone who may be susceptible to the disease.

This vaccination policy may lead to conflict between the individual’s right to make personal decisions and the organizational role to safeguard the patients' health. Medical professionals might feel that such compulsory vaccinations restrict their ability to make decisions concerning their patients' medical care. Failure to have a policy in place, however, may contribute to anxiety about patient and provider safety in the workplace. As a result, public trust in the organization could be affected.

Several moral issues need to be addressed as well. Beneficence and nonmaleficence provide the ethical imperative to act in the best interests of the patient and to avoid causing patients harm, when possible (Pozgar, 2024). Vaccination is consistent with these principles as it helps to decrease the transmission of disease. In this light, consideration for individual autonomy implies that organizational decision-making should factor in personal convictions and concerns. As per Pozgar (2024), there is often the need to balance several considerations when making ethical decisions.

Healthcare administrators are required ethically to create an enabling environment for quality care, patients’ welfare, and the public’s confidence (American College of Healthcare Executives, 2023). With respect to such considerations, vaccination can contribute towards improving the health status of both patients and the employees. Therefore, I recommend requiring COVID-19 vaccination for healthcare professionals while allowing legitimate medical and religious exemptions. Employees granted an exemption to wear a respirator should follow additional infection-control measures. I would cite to support this recommendation the Centers for Disease Control and Prevention’s Healthcare Infection Control Practices Advisory Committee (HICPAC) guidance, ACHE ethical standards, and evidence-based research (CDC, n.d.).

References

American College of Healthcare Executives. (2023, December 5). Code of ethics. https://www.ache.org/about-ache/our-story/our-commitments/ethics/ache-code-of-ethics

Centers for Disease Control and Prevention. (n.d.). Healthcare infection control practices advisory committee (HICPAC). https://www.cdc.gov/hicpac/index.html

Pozgar, G. D. (2024). Legal and ethical issues for health professionals (6th ed.). Jones & Bartlett Learning.

2

Dear CEO,

I recommend continuing with a healthcare worker vaccine mandate, particularly for those directly managing patient care. This policy aims to promote safe provision of healthcare and enhance patient and public safety. Vaccination of employees will prevent sickness and provide consistency in service delivery. Moreover, there is less risk that the infected individual will get in contact with anyone who may be susceptible to the disease.

This vaccination policy may lead to conflict between the individual’s right to make personal decisions and the organizational role to safeguard the patients' health. Medical professionals might feel that such compulsory vaccinations restrict their ability to make decisions concerning their patients' medical care. Failure to have a policy in place, however, may contribute to anxiety about patient and provider safety in the workplace. As a result, public trust in the organization could be affected.

Several moral issues need to be addressed as well. Beneficence and nonmaleficence provide the ethical imperative to act in the best interests of the patient and to avoid causing patients harm, when possible (Pozgar, 2024). Vaccination is consistent with these principles as it helps to decrease the transmission of disease. In this light, consideration for individual autonomy implies that organizational decision-making should factor in personal convictions and concerns. As per Pozgar (2024), there is often the need to balance several considerations when making ethical decisions.

Healthcare administrators are required ethically to create an enabling environment for quality care, patients’ welfare, and the public’s confidence (American College of Healthcare Executives, 2023). With respect to such considerations, vaccination can contribute towards improving the health status of both patients and the employees. Therefore, I recommend requiring COVID-19 vaccination for healthcare professionals while allowing legitimate medical and religious exemptions. Employees granted an exemption to wear a respirator should follow additional infection-control measures. I would cite to support this recommendation the Centers for Disease Control and Prevention’s Healthcare Infection Control Practices Advisory Committee (HICPAC) guidance, ACHE ethical standards, and evidence-based research (CDC, n.d.).

References

American College of Healthcare Executives. (2023, December 5). Code of ethics. https://www.ache.org/about-ache/our-story/our-commitments/ethics/ache-code-of-ethics

Centers for Disease Control and Prevention. (n.d.). Healthcare infection control practices advisory committee (HICPAC). https://www.cdc.gov/hicpac/index.html

Pozgar, G. D. (2024). Legal and ethical issues for health professionals (6th ed.). Jones & Bartlett Learning.

Law and Ethics in Healthcare- Week 1 Discussion Response

Respond to  at least two of your colleagues’ postings in one or more of the following ways:

· Share an insight that you gained from having read your colleague’s initial post.

· Share advice that you would provide to the CEO in your colleague’s scenario regarding techniques used to increase voluntary immunization among their patient care staff. How can they help to ease tension between a healthcare professional’s personal autonomy and public safety?

Colleagues 1- Tia Sturdevant

Healthcare organizations continue to face complex decisions regarding COVID-19 vaccination policies for healthcare professionals. Although the federal mandate was rescinded in 2023, healthcare leaders must still determine how to balance employee autonomy, patient safety, workforce stability, and ethical responsibilities. As an advisor to the CEO of a healthcare organization, I would recommend maintaining a formal COVID-19 vaccination policy that strongly encourages vaccination for healthcare professionals while allowing limited medical and religious exemptions. This approach best supports patient safety, continuity of care, and organizational ethics while minimizing workforce disruption.

Implementing a vaccination policy has significant implications for healthcare service delivery and public safety. Healthcare professionals interact with vulnerable populations daily, including immuno-compromised patients, older adults, and individuals with chronic illness. Vaccination reduces the risk of severe illness, hospitalization, and transmission, which helps protect both patients and staff. The Centers for Disease Control and Prevention (CDC) estimated that COVID-19 vaccines prevented millions of hospitalizations and deaths, demonstrating their effectiveness in reducing healthcare system strain. Organizations that maintain vaccination policies may experience fewer staffing shortages due to illness-related absences and reduced risk of outbreaks within healthcare facilities. Infection prevention guidance from the CDC's Healthcare Infection Control Practices Advisory Committee (HICPAC) also supports vaccination as an important component of infection control practices (Centers for Disease Control and Prevention [CDC], n.d.).

Conversely, failing to implement a vaccination policy could negatively impact patient confidence and increase the likelihood of workplace outbreaks. Patients expect healthcare organizations to provide safe environments and to minimize preventable risks. Without vaccination policies, healthcare systems may experience increased transmission among staff and patients, potentially disrupting service delivery and reducing operational efficiency. However, organizations that enforce strict mandates may also face staffing challenges if employees resign or are terminated for noncompliance, as demonstrated in the care of Mayo Clinic employees who were terminated after refusing vaccination (Perus, 2022). Therefore, healthcare leaders must carefully balance safety priorities with workforce retention.

Several conflicts may arise regardless of whether a vaccination policy is implemented. One major conflict involves personal autonomy versus professional responsibility. Many healthcare workers argue that mandatory vaccination policies infringe upon individual freedoms and bodily autonomy. At the same time, healthcare organizations have an obligation to protect patients from preventable harm. This conflict became particularly visible during debates over vaccine mandates nationwide. Some healthcare systems continued enforcing vaccine requirements, while others relaxed or eliminated mandates after federal requirements were lifted (Gooch, 2023; Vannozzi, 2023). Tension may also develop between employees and leadership if staff perceive mandates as coercive or punitive. Additionally, organizations that do not implement policies may encounter conflict from patients or employees who believe leadership is failing to prioritize safety.

Ethical issues are also central to this discussion. Pozgar (2024) explains that ethical decision-making in healthcare often involves balancing competing principles such as autonomy, beneficence, nonmaleficence, and justice. Mandatory vaccination policies support beneficence and nonmaleficence because they aim to protect patients and reduce harm. However, they may conflict with respect for autonomy when employees object to vaccination. Utilitarian ethics further support vaccination policies because these policies promote the greatest good for the greatest number by reducing disease transmission and protecting public health (Vearrier & Henderson, 2021). Williams (2022) argues that selective mandatory vaccination policies can be ethically justified when healthcare professionals have direct contact with vulnerable populations. At the same time, ethical concerns arise if policies are applied inconsistently or fail to account for legitimate medical or religious exemptions. Organizations must therefore ensure policies are equitable, transparent, and legally compliant.

Based on these considerations, I would advise the CEO to implement a policy that strongly encourages COVID-19 vaccination for all healthcare professionals while permitting carefully reviewed exemptions and emphasizing education, infection control, and shared accountability. This strategy balances ethical obligations to protect patients with respect for employee rights. I would also recommend ongoing monitoring of CDC guidance. Local transmission rates, workforce impacts, and emerging scientific evidence to ensure the policy remains appropriate and adaptable. Sources used to make this recommendation would include the CDC, HICPAC guidance, peer-reviewed ethical analyses, organizational case studies, and professional ethics standards such as the American College of Healthcare Executives' Code of Ethics, which emphasizes patient welfare, professional integrity, and accountability (American College of Healthcare Executives, 2023).

American College of Healthcare Executives Code of Ethics Links to an external site.

American College of Healthcare Executives. (2023, December 5). Code of ethics.

CDC Healthcare Infection Control Practices Advisory Committee (HICPAC) Links to an external site.

Centers for Disease Control and Prevention. (n.d.). Healthcare infection control practices advisory committee (HICPAC).

Gooch, K. (2023, October 13). 5 health systems’ approach to COVID-19 vaccine rules. Becker’s Hospital Review. Becker’s Hospital Review article Links to an external site.

Petrus, C. (2022, January 23). Unvaccinated Mayo employees are officially being terminated: Lawmakers react. KTTC.com. KTTC Mayo Clinic article Links to an external site.

Pozgar, G. D. (2024). Legal and ethical issues for health professionals (6th ed.). Jones & Bartlett Learning.

Saunders, B. (2022). How mandatory can we make vaccination? Public Health Ethics, 15(3), 220–232.  https://doi.org/10.1093/phe/phac026 Links to an external site.

Vannozzi, B. (2023, June 13). NJ lifts COVID-19 vaccine mandate for health workers. NJ Spotlight News. NJ Spotlight News article Links to an external site.

Vearrier, L., & Henderson, C. M. (2021). Utilitarian principlism as a framework for crisis healthcare ethics. HEC Forum, 33(1–2), 45–60.  https://doi.org/10.1007/s10730-020-09431-7 Links to an external site.

Williams, B. M. (2022). The ethics of selective mandatory vaccination for COVID-19. Public Health Ethics, 15(1), 74–86.  https://doi.org/10.1093/phe/phab028

Colleague 2- Mike Hayes

When looking at the ethical implications of implementing a vaccination policy for a healthcare organization, there are a few issues. On the one hand, we want to provide a safe and secure environment for our patients, knowing some of them are immune compromised.  However, there are also issues relating to how we can ethically implement this policy with our staff.  Something that comes to mind is remembering the COVID-19 vaccine mandate at the healthcare organization I worked at previously.  The mandate was very heavily handed.  Where the policy was more favorable for staff who objected on religious grounds, and were granted an exemption, it was people with disabilities who struggled the most with exemptions, and many left the organization rather than have to jump through hoops to get an exemption from their doctors, who themselves worked for this organization and didn't want to sign something that could conflict with their employment.  I was one of the people with a disability who ended up leaving because of how difficult it was to get an appointment at the time in order to get a note exempting me.  

The ethical issues are, when implementing a vaccination, bodily autonomy should be respected, not ignored.  While I understand the need to protect our patients, we must also remember our staff tend to also be our patients and we must still protect their health too.  If staff have legitimate concerns over a vaccination potentially causing them further harm, we must respect their decision.  We must also recognize the ethical implications of forcing a vaccine without consent from the person receiving it.  There are also other ethical considerations we must look at when implementing a vaccination policy.  These are stigmatization from vaccinated staff against unvaccinated, impacts on individual team members trust of the system, and how this can impact team cohesion, and the distress among staff who feel pressured to seek an exemption for fear of losing their jobs or licensure. 

If I were to provide my opinion to the CEO, I would be against vaccination mandates.  I believe they impact the bodily autonomy and consent of the people who they are forced upon.  I believe, as individuals, it is our responsibility to look after our own health.  In the same vein of telling people to get vaccinated for the good of the people, an argument could also be made that those who are most at risk of contracting COVID-19 could also take proactive steps to avoid the public and possible exposure.  This is the route I went with, as someone with several autoimmune conditions.  Because I never expect others to do something that makes them feel violated for my own benefit, especially if it's something I myself wouldn't feel comfortable doing.  My argument against vaccine mandates is that vaccines aren't temporary, they are permanent.  using myself as an example, I developed Autoimmune Hepatitis in 2013 from the flu vaccine.  Something as simple as a shot has changed my entire life.  Looking at who I would use as a source for my recommendation, I would use the Journal of Medical Ethics, specifically the essay written by Professor Uwe Steinhoff.  I feel like he broke the argument against mandates down to the fundamentals and made several great points.

Sources:

The case against compulsory vaccination: the failed arguments from risk imposition, tax evasion, ‘social liberty’, and the priority of life. (2024). BMJ Journals. Retrieved May 27, 2026, from  https://jme.bmj.com/content/early/2024/10/28/jme-2024-110236Links to an external site.

Ethical challenges around mandatory vaccination among nurses: A systematic review of qualitative and quantitative evidence. (2026, March). Science Direct. Retrieved May 27, 2026, from  https://www.sciencedirect.com/science/article/abs/pii/S0020748925003232