To Mandate or Not to Mandate Vaccination? That is a Social Psychiatric Question


Getting vaccinated and wearing a mask: the ethical way.




Health care workers are at high risk for contacting or spreading contagious diseases. Even so, only half of health care workers have traditionally been vaccinated for the common seasonal flu. The percentage of psychiatric professionals who do so is unknown, as far as I can tell.

The only approach that seems to produce near-total compliance is mandatory vaccination. The power of the government to mandate vaccination “for the public good” has long been recognized by the Supreme Court.

Ethically, the Hippocratic oath conveys the need to try to “do no harm.” COVID-19 unvaccinated health care workers inevitably will do harm to colleagues, patients, the public, and loved ones.

Psychiatrically, we can help to find the appropriate amount of fear and understanding of reality in regards to the pandemic. We know how to positively reframe inappropriate negative thinking as we do in cognitive behavioral therapy. Given our experience with establishing therapeutic alliances with reluctant patients, it very well might help to establish a federal mental health team to guide reassuring messaging.

That takes us to a week ago, when the New York State deadline for health care workers getting vaccinated expired. Enough did get vaccinated to apparently avoid staffing shortages. There have been peaceful counter protests. I do not know if they got input from us, but I do hope we in mental health care become increasingly vaccinated one way or another, and wear our masks where we scientifically should. That is the ethical way.

Dr Moffic is an award-winning psychiatrist who has specialized in the cultural and ethical aspects of psychiatry. A prolific writer and speaker, he received the one-time designation of Hero of Public Psychiatry from the Assembly of the American Psychiatric Association in 2002. He is an advocate for mental health issues relate to climate instability, burnout, Islamophobia, and anti-Semitism for a better world. He serves on the Editorial Board of Psychiatric TimesTM.

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