Ethical dilemma - vaccinations?

[AuntyPonsonby]

We have an elderly relative with a variety of serious health problems, including dementia which is now tipping over to a point of significant confusion, including confusion about who people are. He also has cardio-vascular problems. He is in and out of hospital. We have already made a decision against resuscitation or ventilation. Essentially those decisions boil down to an acknowledgement that his quality of life is deteriorating to a point where a sooner "natural" death will be kinder to him than a later one. The question hasn't actually arisen yet, but it occurs to me that it might well be inconsistent for him to be vaccinated against covid, or indeed flu. I don't know what the right answer is, or whether the medical profession will formally acknowledge that this is a legitimate decision along with non-resuscitation. Any thoughts?

You should have a proper discussion with his GP to put together an advance care plan. Is he taking medication for his other health issues? Ethically I can’t see the sense in him taking non-palliative medication (eg for blood pressure) but then him not having the jabs.

I hope one of the GPs on here can help.

Covid jab is also to protect other people.

But you need to talk to his GP. A covid jab might be in his best interests if to save him from a worse death than he'd have otherwise, for example.

The vaccinations are suitably different as they protect others around them, not just themselves. Has implications for patient care in hospitals and care homes.

Talk to his doctors.

I suspect there is a side to this question that, while his quality of life isn't great, getting flu or covid - could be just horrible - and he might NOT die of it but just be even more unwell.

My Dad is 82 and has a DNR. He’s ECV but has had flu jab and will have COVID vaccine. I think there’s a big difference between having vaccines and having a DNR, resuscitation is brutal particularly at his age and is likely to cause massive damage if they resuscitated him

DMIL has very similar issues and also has a DNR. She's already had the 'flu vaccine and should be getting the Corona vaccine as it's as much about protecting her, the other residents and staff and the NHS staff. Plus if she did develop say pneumonia and get admitted to hospital it would be very distressing and upsetting fir her.

If he died of COVID would his relatives be able to say goodbye or would he be alone with masked strangers?

I'd give him the vaccine, OP. If he gets the virus and it turns really nasty, it's a horrible way to die.

Plus if she did develop say pneumonia and get admitted to hospital it would be very distressing and upsetting fir her. The DNR as it's been explained to me is strictly about resuscitation, not about being admitted to hospital. So someone with a DNR would still be given all treatment, including being admitted to hospital if necessary, just no attempt at resuscitation if their heart stopped.

The only time they wouldn't be admitted to hospital is if the admission were solely for resuscitation to be attempted.

Mere yes I understand perfectly the DNR, I was the one who put it in place.

The point I was trying to make is that with vascular dementia and delirium, any stay in hospital would be extremely upsetting for her, and us, especially one that we knew could be easily avoided.

@MereDintofPandiculation

Covid jab is also to protect other people.

But you need to talk to his GP. A covid jab might be in his best interests if to save him from a worse death than he'd have otherwise, for example.

*Covid jab is also to protect other people."

This. You may be at peace with your relative passing but, if he is in an out of hospital, he will risk passing it on to patients who haven't been vaccinated. (The caveat to that is that, at this stage, I don't think we know to what extent the vaccination stops or reduces transmission.)