Search

The ongoing COVID-19 pandemic has created unprecedented social, financial, and moral disruptions across the globe despite global efforts to reduce the transmission of the novel coronavirus. Currently, vaccinating populations against COVID-19 has emerged as the most sustainable strategy to help countries recover from the socioeconomic effects of COVID-19 while protecting public health. To meet vaccination targets, some countries have adopted policies that rely on varying levels of coercion. This paper analyses the ethical implications of coercive vaccination policies implemented in Singapore and Italy, which impose barriers to accessing healthcare on the unvaccinated. These two cases are compared to the vaccine mandate in New Zealand, which did not restrict access to healthcare for the unvaccinated. This analysis draws on key considerations from Kass' ethical framework for assessing public health intervention. This analysis is relevant to countries considering similar policies to increase vaccination uptake for infectious diseases. Since healthcare is a fundamental good, a critical question is whether imposing barriers to accessing healthcare services is an ethically justifiable consequence of the choice to remain unvaccinated. [ABSTRACT FROM AUTHOR]

Background: Māori have been found to experience marked health inequities compared to non-Māori, including for injury. Accessing healthcare services post-injury can improve outcomes; however, longer-term experiences of healthcare access for injured Māori are unknown. This paper reports on data from the longitudinal Prospective Outcomes of Injury Study – 10 year follow up (POIS-10) Māori study in Aotearoa/New Zealand (NZ), to qualitatively understand Māori experiences of accessing injury-related healthcare services long-term. Methods: Follow-up telephone interviews were conducted with 305 POIS-10 Māori participants, who were injured and recruited 12-years earlier, experiencing a range of injury types and severities. Free text responses about trouble accessing injury-related health services were thematically analysed. Results: Sixty-one participants (20%) reported trouble accessing injury-related health services and provided free text responses. Three related themes describing participants' experiences were connected by the overarching concept that participants were engaging with a system that was not operating in a way it was intended to work: 1) Competing responsibilities and commitments encapsulates practical barriers to accessing services, such as a lack of time and having to prioritise other responsibilities such as work or whānau (family); 2) Disrupted mana refers to the feelings of personal disempowerment through, for example, receiving limited support, care or information tailored to participants' circumstances and is a consequence of patients contending with the practical barriers to accessing services; and 3) Systemic abdication highlights systemic barriers including conflicting information regarding diagnoses and treatment plans, and healthcare provider distrust of participants. Conclusions: Twelve years post-injury, a considerable proportion of Māori reported experiencing barriers to accessing healthcare services. To restore a sense of manaakitanga and improve Māori access to healthcare, Māori-specific supports are required and systemic barriers must be addressed and removed. [ABSTRACT FROM AUTHOR]