Opinion/Heren: When is a right no longer a right?

Kathleen Heren is the lead ombudsman for the Rhode Island State Long Term Care Ombudsman Program in Warwick.

Hopefully, you have been following the story of Gov. Dan McKee mandating all health-care workers be fully vaccinated before Oct. 1.

I have given this important topic a great deal of thought for some time. First, health-care workers can carry COVID to their patients and potentially infect them. Second, many vaccinations are given to people who choose to work in health care. Why is this different?

One of the opposition’s arguments is, “I have the right to refuse what I put into my body.” Our office lives and breathes standing up for residents receiving long-term care services and their rights. I even teach resident rights to employees of long-term care facilities. The Bill of Rights is a mandated class that all long-term care workers, which includes all departments, are obligated to attend. One of the questions I start my lecture with is asking, “Do you all know what a right is?”  The employees who have attended this class each year all respond with, “It’s a resident’s right to do anything they want.” When I tell them they are incorrect, they look at me dumbfounded.

My definition of a right depends on two very important factors. First, does a person understand the consequences of exercising their right? Second, will their decision affect other people’s rights? A person’s ability to make decisions is not an either/or answer. Rather, it rests on the two conditions I just outlined.

To get into the weeds a little more, here are some examples.  I spoke with many residents who tell the staff they no longer wish to receive dialysis (a life-sustaining treatment). The staff panics and asks for an ombudsman to speak with the resident. Our role is listening to the resident then explaining the consequences of their choice. If they respond by telling me they do not wish to continue living like they are, then I will support them in carrying out their wishes.

As you can imagine, many families become very upset and tell us, “they are the power of attorney for health care.” We then remind them they only have the right to make decisions when the resident can no longer make them. If I have doubts, then I will ask the physician to order an evaluation with a mental-health worker. I don’t want our office to be a party to a suicide wish.

Let me now apply the second part of a right definition. Will this resident’s decision affect other people in a negative way?  The short answer is no.  It is critical now to compare this definition to the mandatory vaccination rule. The first definition applies to the health-care worker who has certainly received enough written material and counseling on the consequences of not being vaccinated. They tell you, “I am willing to take the risk.”  Does the risk they are taking have the potential to harm others? Absolutely. The veiled threat of “the employee resigning” cannot be ignored.  Do the homes want to lose these employees? Of course not.

It is also unfair to allow families to again experience the terrible loss of loved ones and not being able to visit. Could it be time to resort to the Family Care Act passed in Rhode Island? This article, I am certain, will make some people angry. I expect that, and I refuse to approve of any dangers to the frail elders that cannot speak for themselves.

Please contact either myself or a member of my staff at (401) 785-3340 with any questions or concerns you may have. They can be general inquiries or specific to your situation. I can answer any questions you may have. If I can’t, then I will direct you to someone who can.   

“Get vaccinated.”