From PBS: Next Health Care Mandate: Flu Shots for Medical Workers?
Brandon Hostler’s arm is usually among the first extended for the annual flu shot at Ruby Memorial Hospital in Morgantown, W.Va. He is, after all, a registered nurse — he knows it can do some good.
But if that shot ever becomes mandatory, he will balk.
“I wouldn’t quit or switch jobs,” he said. “But we are health care professionals. We know the risks and the benefits, and to force us to do something like that and not have a say in it, I think it would be offensive and unwanted.”
This story nicely points out two different facets of one of the most important values in the world of healthcare, namely autonomy.
Why is autonomy important? On one hand, it is important for its own sake. We simply value the ability to choose for ourselves. On the other hand, we value autonomy because we generally believe that when people choose for themselves, they will choose better than when others choose for them. Both of those facets of autonomy appear in the story above. Some nurses are hesitant about the flu shot because they’re uncertain about whether the risks are worth the benefits; others think the benefits are there, but still want the freedom, for its own sake, to say “no thanks.”
But there are also limits on autonomy. And in particular, membership in a profession brings a whole bunch of such limits. The benefits of professionalism involve a kind of quid pro quo — society asks things in return. The hard question, of course, is whether any particular limit on autonomy — such as mandatory flu shots — is or should be part of that bargain.
The Nursing Ethics Blog 
Requiring immunization against influenza for healthcare workers is an ethical question that must be considered carefully. While it is desirable for employees to be protected for their own health benefit, for the employer’s benefit in that the employee more likely to report for work, the real benefit is to the patients they serve. For vulnerable patients or clients to be infected with influenza by a healthcare worker is unacceptable. If this were the only consideration, the answer would be quite simple. The other side of the story, however, is that requiring healthcare workers to provide proof of annual immunization violates their autonomy and does put them at some risk The pressure of occupational requirements erodes the concept of informed consent. No immunization comes without the risk of side effects or the possibility of adverse outcomes. An employee must feel free to choose influenza immunization based on an informed assessment of benefits and risks. As fellow healthcare providers our role is to provide a fair assessment of benefit and risk in the context of their health history and health beliefs. I will be the first to say we need to do a better job of this, as well as portraying the reality that choosing not to be immunized affects the welfare of their patients.
Karen:
Your points are well taken, but I think we need to be cautious about letting autonomy trump all other considerations. After all, no one says health professionals “must feel free to choose” whether to have sex with patients. It is simply forbidden, as it should be. With professionalism comes a range of responsibilities, many of which limit professionals’ freedoms. So it’s at least not obvious that health professionals *must* feel free to choose.
Chris.