BARCELONA, Spain (AP) – A judge in northwestern Spain has dismissed a family’s objections and decided to allow health authorities to administer a coronavirus vaccine to an incapacitated woman in a nursing home.
The case appears to be the first known instance of a court in Europe to require someone to receive a COVID-19 vaccine. The Spanish government has repeatedly emphasized that shots are voluntary, as are the authorities in other European countries.
In a ruling by The Associated Press on Wednesday, a court judge in the Autonomous Northwestern Community of Galicia recently ruled in favor of a request from a nursing home to lift the refusal of the elderly resident’s family and proceed giving her the vaccine.
The resident was deemed by the nursing home’s medical staff to have suffered a cognitive loss to the extent that she was “unable to provide valid consent,” the ruling said.
Judge Javier Fraga Mandián said the court is legally obliged to intervene to protect the health of the woman. He said his decision was not based on the welfare of other residents, but that the “existence of tens of thousands of deaths” by the virus in Spain provided what he saw as irrefutable evidence that not taking the vaccine was more risky than the virus. possible side effects. .
The company that runs the nursing home, DomusVi, told the AP through its PR agency that of all the homes it manages across Spain, this was the only case of a family not wanting to vaccinate a resident who was deemed incapable of making personal health decisions. .
DomusVi said 98% of the 15,000 residents of the country’s nursing homes agreed to receive the vaccine. It said the remaining 2% refused to be vaccinated, but unlike the woman, are considered fit to make their own health decisions.
DomusVi said it sought court intervention in the interests of the health of all workers and residents of the nursing home residents and workers of the facility in Galicia.
Spain has administered more than 581,000 doses of the Pfizer-BioNTech vaccine since it was approved by the European Union in late December. Spain also plans to roll out its first batches of the Moderna vaccine.
Health Minister Salvador Illa said on Thursday that Spain “sees very low rejection of the vaccine, almost anecdotally.”
Nursing homes in Spain and across Europe have been devastated by the coronavirus, which is spreading rapidly to the elderly and those weakened by pre-existing medical conditions. Since the start of the pandemic, more than 25,000 people with COVID-19 are estimated to have died in Spanish nursing homes.
Other lawsuits over involuntary vaccine administration may lie ahead.
In southern Spain, a prosecutor recently said that family members acting as legal guardians for incapacitated nursing home residents could lose custody if they refused to consent to vaccination of their family members.
The Italian government last week passed a decree explicitly authorizing hospital chiefs and individual doctors to consent to vaccinations on behalf of patients who cannot do so themselves, including nursing home residents who are incapacitated for work and without a guardian to consent to them.
The procedure requires physicians to submit written documentation to a judge, who has 48 hours to approve or deny the request.
Although nearly a dozen European countries have mandatory vaccination laws for diseases such as polio, measles and diphtheria. The laws are rarely enforced by the courts, although in 2008 a Belgian court fined two sets of parents and sentenced them to five months in prison for failing to vaccinate their children against polio.
Unlike the COVID-19 vaccines, which are still technically considered experimental, the vaccines required by law are European-based vaccines that have been used for decades.
The World Health Organization has previously said it does not recommend making vaccination against the coronavirus mandatory, for fear it could undermine public confidence in the vaccines available.
At a press conference last month, Dr. Kate O’Brien, head of the WHO’s vaccination department, said she thought it would be better for countries to create a “positive environment” for immunization rather than mandates. But O’Brien acknowledged that in some high-risk settings, such as hospitals, it could make sense to require staff and patients to receive vaccines.
Some ethicists said the court’s decision to mandate the woman’s vaccination was likely justified by her high risk of COVID-19 as she lives in a retirement home.
“The court needs to look at the probability balance, and if the woman is older she is at a much higher risk of dying from COVID than from an unlikely side effect,” said Julian Savulescu, director of the Oxford Uehiro Center for Practical Ethics at the University of Technology. University of Oxford.
He said that even in countries that don’t have mandatory vaccination laws, the state is obliged to protect people when those who make decisions on their behalf may not be acting in their best interest.
“If you don’t vaccinate this woman and she dies from COVID, people will say, ‘Why didn’t you protect her?'” Savulescu said.
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Maria Cheng reported from Toronto. Nicole Winfield from Rome and Aritz Parra from Madrid contributed to this story.
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