[J] The Principle of Informed Consent.

Primum non nocere’ (First do no harm)

Medical practitioners have a professional and ethical obligation to draw attention to personal safety or risk as a consequence of a medical intervention, and doubt remains as to whether low-risk groups such as healthy children and young adults are more at risk from the mRNA vaccine.[i] While this may be at low levels, children and young people should not be put at risk. The claim that children and young people need the vaccine to stop the spread is ethically problematic, as it assumes that a degree of harm to this group is acceptable. Many doctors believe this claim is unacceptable, as society has a moral duty to protect the health of young people. Advice concerning potential risk is the foundation of informed consent and is a critical element of a medical doctors’ responsibilities when outlining to patients which potential pharmaceutical and nutritional protocols that are available, should patients become infected with Covid-19.

‘Ideally, the process is one that promotes the type of thoughtful and effective communication between a patient and her physician that ultimately allows the patient to realistically and objectively balance the risks and benefits of a proposed course of care.’[ii]

The scientific literature is replete with evidence of non-knowledge about the future risk of a drug, or non-disclosure of results in trials that are unhelpful to authorisation and marketing of a drug. The problem of not knowing, is why informed consent and public discussion is critical. Yet doctors attempting to raise these issues are ostracised as recalcitrant and non-compliant, their positions inconvenient to government policy. Scientists and doctors who have advocated and recommended the introduction of measures including rapid testing and relatively low-risk multi-target therapies which can be applied and used in the home, to reduce the risk of hospitalisation and death have faced public attack. Practical issues, such as the risk of thrombosis from either the virus or the vaccine remain out of scope for public debate.

Carrot and stick pressures for medical practitioners

There has been unprecedented pressure on general practitioners to downplay the potential for COVID-19 vaccines to present a risk to their patients. [iii] Early and mid-career practitioners have academic fees to pay for, clinic costs to manage, partnerships to pay for after 10 years plus of expensive medical education. The idea that they might risk their medical licence after such a long journey – is untenable. Serving their communities, building a successful clinic and protecting health is their passion, and stepping out of that and ensuring the shaming that we are seeing with late career scientists and medical practitioners is impossible for them financially, intellectually and practically. In addition, because the state has not sanctioned a treatment regime any treatment protocols also leave doctors at risk, as a failure to prevent hospitalisation and death may also result in complaints to the medical council. Finally, the payments to test and vaccinate ensure this work is highly profitable. Many good doctors, scientists and academics must justify their silence with the other good work they are doing. For many, there is no doubt that they must co-exist with at best an uncomfortable cognitive dissonance – at worst wilful blindness, in order to survive.

Therefore, with the emerging data that demonstrates that healthy adults, and particularly, young people and children are at low risk of harm from Sars-Cov-2, perhaps it is time that doctors with a long history of caring for patients, a long history of immunising patients with inoculants with years of safety data supporting general use - were permitted to incorporate the principle of informed consent in their medical practice, and discuss the risks and benefits of a novel mRNA vaccine which has not yet completed clinical safety trials, and for which the scientific literature illustrating the potential for adverse events are growing daily.

This role is made more difficult by a judiciary, executive branch, legislative branch and the fourth estate - who seem unwilling to deliberate, communicate and recognise the 5 absurd and plaguing incongruities of the states approach to narrow reliance on one medical treatment:

The risk-benefit profile of healthy populations;
The Human Right not to be subjected to medical or scientific experimentation, and the right to refuse medical treatment; and the troubling role of coercion in the current pandemic;
The potential population-level benefit of those who acquire natural immunity in achieving a level of resistance to unanticipated new variants (and respect for the individual see Health Act 1956 S.92 );
The persistent issue of waning and breakthrough after 6 months and the uncertain risk profile of a 3rd booster; and
The fact that without addressing these plaguing incongruities - while effectively impinging on human rights - trust in policy-makers and the rule of law will continue to erode.

NEXT: [K] Conclusion

REFERENCES

[i] Hansen et al 2021. First case of a postmortem study in a patient vaccinated against Sars-Cov-2. Int J Inf Dis. 107:172-175

[ii] Roe 2009. Not-So-Informed Consent: Using the DoctorPatient Relationship to Promote State-Supported Outcomes.

[iii] E.g. https://www.tga.gov.au/communicating-about-covid-19-vaccines

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