Pfizer vaccine approved

[Count Steer]

That was cleared up quietly, so much for the EU song and dance about suing them.
https://www.bbc.co.uk/news/world-europe-58426880

EU and AstraZeneca reach deal to end vaccine row

Brussels' tardiness has cost a lot of lives but hey, they're not elected so they can't be got rid of.

Not elected? Meh. The Australian government were elected, Trump was elected, the Polish government was elected, our spivs were elected.
The ballot box is no guarantee of competence or of the selection of those with generally beneficial intent. It's just, possibly, the least worst option which puts the choice of government in the hands of those with the fewest qualifications to actually choose one.

[irie]

That was cleared up quietly, so much for the EU song and dance about suing them.
https://www.bbc.co.uk/news/world-europe-58426880

Brussels' tardiness has cost a lot of lives but hey, they're not elected so they can't be got rid of.

Not elected? Meh. The Australian government were elected, Trump was elected, the Polish government was elected, our spivs were elected.
The ballot box is no guarantee of competence or of the selection of those with generally beneficial intent. It's just, possibly, the least worst option which puts the choice of government in the hands of those with the fewest qualifications to actually choose one.

No, they weren't elected.

Whether or not those who are elected are competent to do their jobs is another issue, as you say.

[wheelnut]

So do we think that the government will go against the JCVI advice and routinely vaccinate the under 16s?

If they do it will pretty much disregard medical ethical standards as they are currently understood.

[irie]

So do we think that the government will go against the JCVI advice and routinely vaccinate the under 16s?

If they do it will pretty much disregard medical ethical standards as they are currently understood.

Given that the decision to vaccinate on purely medical grounds appears to be marginal, it may be that vaccinating 12-16 year old in order to avoid the wider educational and social impact of school closures is justifiable. On balance, I think it probably is.

[wheelnut]

So do we think that the government will go against the JCVI advice and routinely vaccinate the under 16s?

If they do it will pretty much disregard medical ethical standards as they are currently understood.

Given that the decision to vaccinate on purely medical grounds appears to be marginal, it may be that vaccinating 12-16 year old in order to avoid the wider educational and social impact of school closures is justifiable. On balance, I think it is.

The problem with that approach, is that it goes against the good of the individual that’s been treated. If the net benefit to the patient is on the negative side of the scales (and it appears that it is) then the treatment shouldn’t be given. Doctors are obliged to give (or not give) a treatment that is best for that particular patient. That it may or may not be beneficial for the wider population cannot enter the reasoning.

I’m not sure how the government can swerve that without a major shift in the way the medical profession handles treatment.

[irie]

So do we think that the government will go against the JCVI advice and routinely vaccinate the under 16s?

If they do it will pretty much disregard medical ethical standards as they are currently understood.

Given that the decision to vaccinate on purely medical grounds appears to be marginal, it may be that vaccinating 12-16 year old in order to avoid the wider educational and social impact of school closures is justifiable. On balance, I think it is.

The problem with that approach, is that it goes against the good of the individual that’s been treated. If the net benefit to the patient is on the negative side of the scales (and it appears that it is) then the treatment shouldn’t be given. Doctors are obliged to give (or not give) a treatment that is best for that particular patient. That it may or may not be beneficial for the wider population cannot enter the reasoning.

I’m not sure how the government can swerve that without a major shift in the way the medical profession handles treatment.

No, as said above, it appears that the net medical benefit to the patient is marginal. That is to say, difficult to assess as being medically either advantageous or disadvantageous.

But

it may be that vaccinating 12-16 year old in order to avoid the wider educational and social impact of school closures is justifiable.

[wheelnut]

No, as said above, it appears that the net medical benefit to the patient is marginal. That is to say, difficult to assess as being medically either advantageous or disadvantageous.

I think you’ve answered your own question there. If the medical benefits of giving a drug to a patient can’t be quantified then it shouldn’t be given.

it may be that vaccinating 12-16 year old in order to avoid the wider educational and social impact of school closures is justifiable.

And that has to be totally irrelevant to the medic giving the jab. They have to believe that’s it’s of a medical benefit to that patient.

The government may decide that it’s the way forward. My point is that if they do then it will go against established medical ethics.

[Mussels]

Are doctor's really that blinkered that they only consider individual cases in isolation and ignore wider impacts?
I doubt it unless they are worried about being sued.

[wheelnut]

Are doctor's really that blinkered that they only consider individual cases in isolation and ignore wider impacts?
I doubt it unless they are worried about being sued.

It’s not blinkered at all. You cannot give one person a drug that may cause more harm than benefit to that patient for the benefit of someone else.

It’s nothing to do with being sued, it’s a case of following their own code of conduct.

[irie]

Are doctor's really that blinkered that they only consider individual cases in isolation and ignore wider impacts?
I doubt it unless they are worried about being sued.

Doctors are charged with the sole consideration being that of the patient.

Others must consider wider implications.

[Mussels]

Are doctor's really that blinkered that they only consider individual cases in isolation and ignore wider impacts?
I doubt it unless they are worried about being sued.

Doctors are charged with the sole consideration being that of the patient.

Others must consider wider implications.

I don't think that's true otherwise they wouldn't be able to refuse abortions.

[wheelnut]

I don't think that's true otherwise they wouldn't be able to refuse abortions.

You’re going to have to explain that one a bit further. Plus I’m not sure doctors do refuse abortions (where it’s legal).

What we’re talking about is using kids as a means to protect adults.

[Mussels]

I don't think that's true otherwise they wouldn't be able to refuse abortions.

You’re going to have to explain that one a bit further. Plus I’m not sure doctors do refuse abortions (where it’s legal).

What we’re talking about is using kids as a means to protect adults.

Doctors are allowed conscientious objection to ignore the best interests of their patient (the mother) and preserve the life of another (the foetus). They don't need to justify their actions to ignore the patient.
It's the other way round but shows that the rule is not black & white.
They could also decide it is in a child's best interest that its guardians don't catch covid, if they wanted children to have the vaccine they could have justified it.

[wheelnut]

Doctors are allowed conscientious objection to ignore the best interests of their patient (the mother) and preserve the life of another (the foetus). They don't need to justify their actions to ignore the patient.
It's the other way round but shows that the rule is not black & white.

You’re talking about a different thing. Yes a doctor can decline to treat a patient where they disagree with a procedure on moral grounds, effectively referring that patient to another doctor.

That is different from giving an individual patient a treatment that could cause a net harm

They could also decide it is in a child's best interest that its guardians don't catch covid, if they wanted children to have the vaccine they could have justified it.

That’s the crux, we can’t use kids as a means to protect adults. That’s where it goes against current medical ethics.

[Mussels]

The doctors didn't say vaccines caused net harm, they said the benefit was marginal.
I'd say on an individual level the benefit of the MMR vaccine is marginal, if a child doesn't have it they are still unlikely to suffer from the illnesses it protects against. That's because most others have had it.
I guess the question with the covid vaccine is whether it prevents anyone catching or spreading it, if all it does is reduce symptoms then I agree with the doctors but I don't know if there's enough evidence to support that.

[wheelnut]

The doctors didn't say vaccines caused net harm, they said the benefit was marginal.
I'd say on an individual level the benefit of the MMR vaccine is marginal, if a child doesn't have it they are still unlikely to suffer from the illnesses it protects against. That's because most others have had it.
I guess the question with the covid vaccine is whether it prevents anyone catching or spreading it, if all it does is reduce symptoms then I agree with the doctors but I don't know if there's enough evidence to support that.

They say;

As evidence shows that COVID-19 rarely causes severe disease in children without underlying health conditions, at this time the JCVI’s view is that the minimal health benefits of offering universal COVID-19 vaccination to children do not outweigh the potential risks.

https://www.gov.uk/government/news/jcvi ... ung-people

It does seem to help stop transmission, but not anywhere near as much as was hoped.

I reckon the government will give the go ahead for it, but my main point is that it will show a major shift in accepted ethics. The JCVI have recognised that but the government are looking to change the goalposts- which is quite a big deal.

I wonder if we will get any doctors refusing to jab kids?

[irie]

My guess is that by/during winter the goalposts will have been moved by a double whammy of Covid and 'flu.

[Count Steer]

I reckon the government will give the go ahead for it, but my main point is that it will show a major shift in accepted ethics. The JCVI have recognised that but the government are looking to change the goalposts- which is quite a big deal.

I wonder if we will get any doctors refusing to jab kids?

Governments (and advising scientists) will take more into account than the SAGE review did. They may consider longer term factors of disrupted education for example. eg obesity and wealth are linked, education and subsequent wealth are linked. Reducing disruption to education has many potential benefits for children that look beyond the '60 children per million may suffer side effects' analysis.

Economically, reducing disruption to education reduces disruption to the labour force and enables some families to keep earning which again can impact beneficially on a child's well-being.

It's not an a+b=c problem, which may explain why several major governments have gone ahead with vaccination.

[wheelnut]

I reckon the government will give the go ahead for it, but my main point is that it will show a major shift in accepted ethics. The JCVI have recognised that but the government are looking to change the goalposts- which is quite a big deal.

I wonder if we will get any doctors refusing to jab kids?

Governments (and advising scientists) will take more into account than the SAGE review did. They may consider longer term factors of disrupted education for example. eg obesity and wealth are linked, education and subsequent wealth are linked. Reducing disruption to education has many potential benefits for children that look beyond the '60 children per million may suffer side effects' analysis.

Economically, reducing disruption to education reduces disruption to the labour force and enables some families to keep earning which again can impact beneficially on a child's well-being.

It's not an a+b=c problem, which may explain why several major governments have gone ahead with vaccination.

All valid concerns, but not relevant to a doctor who is making a decision to give a treatment to a patient where the approving body have decided that the risks outweigh the benefits.

For other countries , I think, but could be wrong, that they have approved the use saying that the medical benefits outweigh the risks.

[irie]

For other countries , I think, but could be wrong, that they have approved the use saying that the medical benefits outweigh the risks.

As CS says, that probably depends upon how narrowly/widely "medical benefits" are considered.