Hospitals are refusing transplants for unvaccinated patients. Is that ethical?

Credit: Science Photo Library
Credit: Science Photo Library

A Boston hospital’s denial of a heart transplant to a man who is unvaccinated for Covid-19 has generated national attention, but experts say mandating vaccines is in keeping with other long-standing requirements that patients have to meet to receive an organ — including getting other shots.

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Perhaps because of the politicization of Covid-19 vaccines more broadly, the reaction to such decisions is sometimes greeted with outrage. But ethicists and transplant physicians stress that organ allocation has to be partially determined by who can survive and thrive with a scarce resource. With so many people waiting for an organ, clinicians try to maximize the chances of a successful transplant. Hospitals don’t want to allocate an organ to people who are putting themselves at higher risk of dying after a transplant — especially since that organ can’t then go to someone else.

“The entire transplant evaluation process, which can be very long and very demanding, is about making sure patients are in the best physical, mental, and social condition to endure a transplant, and then all the downstream effects of transplantation,” said Olivia Kates, a Johns Hopkins infectious diseases physician who specializes in transplant patients.

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