Abstract
This paper discusses the feasibility of enacting H.R. 5860 in America and explores the issues surrounding this bill. Furthermore, the paper explores the issue of individual liberty and autonomy compared to advancing the social good as purported by mandatory vaccines. It explores the significance of H.R. 5860 to the nursing profession by stating that it would exempt essential workers from mandatory Covid-19 vaccinations. Correspondingly, the paper looks into the importance of the legislation by ascertaining that its enactment might infringe on individual liberty and autonomy and enhance the need for transparency in decision-making and ethical analysis of mandatory vaccination. This paper also explores the need to find a balance between protecting public health and autonomy and individual liberty. It also described the stages in ensuring that a bill becomes law at the state or federal levels. Similarly, the paper utilized government websites to track the progress of the H.R. 5860 bill, which is still under consideration by the Health subcommittee of the House Energy and Commerce and the House Oversight and Reform. This paper also offered an opinion on the legislation’s merit, justifying the need for mandatory vaccinations to lower transmissions, mortality, and morbidity and safeguard the healthcare system’s capacity. Finally, the paper described the impact of H.R. 5860 on individuals, communities, and the nursing profession by stating that the lack of a mandate would result in health, public, and social disruptions.
Introduction
H.R. 5860 was introduced in the House of Representatives by Burchett Tim. The primary purpose of this bill is to exempt essential workers from mandatory Covid-19 vaccinations enforced by the federal government, contractors, private entities that got federal funds, and public institutions that got federal Covid-19 funds (Congress, 2022). Furthermore, H.R.5860 regards essential workers as individuals that ought to be exempted from Covid-19 response measures enacted by a territory, tribe, or state. The H.R.5860 bill is primarily related to health; however, mandatory vaccinations breach people’s right to choose what is good for their health. Cosponsors of the bill claim that when enacted, it will shield essential and frontline employees from forced vaccine regulations, allowing them to stay on the job and support our economic recovery. Although these vaccines are safe and effective, people should be encouraged to consult their physicians before getting them (Bardosh et al., 2022). Hence, supporters of this bill claimed that the President had overstepped by imposing vaccines on American citizens.
Issue Rectified by the Bill
Reports have proven that people can work, live, and perform their businesses safely during the pandemic without forcing hardworking citizens who support the healthcare industry, national security, and critical government functions from getting vaccines (Bardosh et al., 2022). Consequently, the government and various institutions have been known to enforce vaccination as a prerequisite for working in specific settings/roles (WHO, 2022). This enforcement breach people’s autonomy and liberty in deciding what is good for their health. Therefore, the H.R.5860 bill strives to uphold essential workers’ autonomy and liberty concerning their health while ensuring they are not laid off due to failure to get vaccines. However, some enforced policies are ethically justified as crucial laws aimed at protecting the wellbeing and the health of the public, contenders for the H.R. 5860 bill claim that policymakers need to consider the impact of mandating vaccinations on public trust and confidence.
Significance of H.R. 5860 to the Nursing Profession
Forced vaccination is most frequently debated in the health and social care context. The main concern is that health professionals have direct contact with populations at high risk of Covid-19, severe illness, or death due to COVID-19. Hence, the government tried to ethically justify enforced vaccination by quoting the ethical obligation of not harming patients as espoused in many health clauses. Mandatory COVID-19 vaccination may appear especially realistic for health professionals because vaccination of this population may be viewed as important to safeguard the health system’s capacity (Bardosh et al., 2022). The significance of the H.R 5860 is to ensure that unvaccinated health professionals are not forced to stay at home during health pandemics by protecting them from policies that require vaccination as a prerequisite for employment or risk being transferred to departments below their expertise.
Based on the current worries and concerns about health professional “burn-out” due to the pandemic and the potential impact of an under-resourced health workforce, mandatory vaccination laws that mandate vaccination as a prerequisite for employment or access to hospitals may have serious adverse effects on already overburdened health systems (WHO, 2022). Hence, this bill strives to ensure that nurses in the healthcare system are not overburdened when some of their colleagues do not get vaccinations. Similar effects could result from policies requiring the transfer of unvaccinated health workers to locations where the risk is lower, such as crowded living facilities where senior care is provided. Consequently, these policies could also transfer vital health workers from locations that urgently require personnel, especially in widespread community transmission of Covid-19 (Bardosh et al., 2022). Mandatory vaccinations that guarantee high vaccination coverage rates in healthcare contexts lead to more hospitalization, infections, and illness among nurses, negatively impacting the overburdened healthcare system.
For instance, twenty-one states and the District of Columbia already enforced vaccines for health care workers; however, Texas, Arkansas, Tennessee, Montana, Indiana, and Georgia have prohibited some employers from getting vaccines (Burch & Abelson, 2022). Similarly, eighteen states had no healthcare professional vaccine requirements; however, five states, including Michigan, Utah, and Arizona, absolved healthcare organizations from vaccine ban requirements. Early this year, the Supreme Court’s ruling impacted twenty states covered by federal mandates barring Medicare and Medicaid Service Centers from issuing orders. The vaccine regulation affects approximately 10 million workers in over seventy-thousand health facilities, such as long-term care facilities and hospitals (Burch & Abelson, 2022). Consequently, the Supreme Court ruled, at least implicitly, to invalidate state laws that prohibit vaccination requirements at facilities participating in Medicaid and Medicare programs. The enforcement of these vaccinations has led to nurses’ resignation, while reports show that of ten thousand employees, approximately ten nurses were laid off for rejecting vaccinations (Burch & Abelson, 2022). Hence, the H.R 5860 is significant in nursing to help nurses maintain their jobs because losing one nurse could negatively impact the overburdened healthcare system.
Importance of Legislation
This legislation is important because it addresses the need to respect individual liberty and autonomy. Furthermore, it enhances the need for transparency during decision-making which is a fundamental fact in the ethical analysis of mandatory vaccination. Hindering access to work, social life, public transport, and education based on mandatory vaccines breaches human rights and promotes social polarization and stigma, negatively affecting wellbeing and health (WHO, 2022). Mandatory policies may exacerbate economic and health inequalities, lower trust in scientific institutions and government, and reduce compliance with future health measures.
Investigation of the Legislative Process
How Legislation Related to Health Care Comes into Being at either the State or Federal level
In America, legislators introduce legislation in either the Senate or the House of Representatives. Healthcare legislation usually starts from either chamber; furthermore, the House has more responsibility to promote healthcare legislation since it is the direct representative of the citizens than the Senate.
Describe How a Bill Becomes a Law at the State Or Federal Level
First, a representative or senator proposes legislation to either chamber. Second, when the bill is introduced, a committee is assigned to research, discuss and make feasible changes to the bill (Keating, 2022). The proposed bill undergoes public hearings where proponents and opponents testify on the legislation and offer expert opinions and advice. Third, the committee releases the bill, which is taken to the House of Representatives to be debated, amended, and voted on by chamber members. Fourth, if the proposed bill passes by a simple majority of 218 of 435 votes, the bill is taken to the Senate (Keating, 2022). Fifth, the proposed bill is assigned to another committee for discussion, research, amendments, and voting in the Senate.
Sixth, when the Senate changes the bill, it is returned to the House for further discussion. Consequently, a conference committee consisting of House and Senate members meet to negotiate the bill specifics and arrive at a compromise that addresses the needs of all parties (Keating, 2022). Seventh, the bill returns to the Senate and the House for final approval, where both parties vote to accept a bill or reject it. Eighth, when the bill passes, the President is given ten days to sign the bill into law or veto it. However, if the President decides to veto a bill, Congress can override the veto with two-thirds of the votes in the House and the Senate (Keating, 2022). Finally, federal courts interpret federal and state laws based on the Constitution to protect individual rights; hence, they review laws to ensure they abide by the Constitution; if a law is unconstitutional, they strike it down.
Progress of H.R. 5860 in Becoming Law
H.R. 5860 was introduced in Congress on November 4th, 2021, which the committee will consider before sending it to the Senate and the House. Currently, the bill has sixteen Republican cosponsors with a 4% chance of enactment (GovTrack, 2022). The committees charged with overseeing the bill are the Health subcommittee of the House Energy and Commerce and the House Oversight and Reform. Finally, the bill does not have roll call votes.
Opinion on Legislation’s Merit
Governments have a history of mandating compulsory vaccinations to protect the wellbeing and health of the public. Although mandatory vaccinations interfere with individual liberty, they are necessary for advancing public health as a social goal. Vaccination mandates should wholly consider economic, social, and public health objectives. Vaccination mandates are justifiable as they are vital in interrupting viral transmission chains, protecting at-risk populations, preventing mortality and morbidity, and preserving the capacity of healthcare systems. Consequently, failing to mandate vaccinations where the danger of severe outcomes is threatening to disrupt public health may lead to significant harm that might have been avoided. Therefore, the absence of compulsory vaccinations during pandemics violates the duty to protect the public from harm (WHO, 2022). Although an obligation exists to center vaccination mandates on evidence-based research, the lack of comprehensive certainty on health measures should not prevent the utilization of mandates if there are reasons to believe they can avert significant harm.
Additionally, failing to use vaccination mandates represents a less favorable balance between safeguarding autonomy, individual liberty, and public health. Evidence from real-world use and clinical trials has shown that Covid-19 vaccines have met the safety condition of lowering mortality rate and preventing viral transmissions (WHO, 2022). Hence, the government should consider the harm that might emanate from failing to mandate vaccinations, which undermines public trust, confidence, and other freedoms. Moreover, public trust and confidence may be undermined if the steps to protect the public from Covid-19 are not implemented as a health response, increasing the risk among at-risk populations. Based on a cost-benefit analysis, compulsory vaccinations are vital for promoting the public, economic, and social good. Policymakers should consider the number of multiple doses proven effective to ensure whole participation and acceptance of vaccinations (WHO, 2022). Finally, authorities should use deliberative and transparent processes that consider the ethical issues and explicit analysis of vaccine safety by engaging key stakeholders.
The Impact of H.R. 5860 on the Health of Individuals, Communities, the Profession of Nursing, or the Health Care Community at Large.
The H.R 5860 may put individual and community health at risk. Covid-19 vaccines have proven safe and effective in preventing transmissions and mortality; furthermore, the efficacy continues to evolve through boosters, protection durability, and new vaccine authorization (WHO, 2022). H.R.586 will alter public trust and confidence, which might lower vaccination acceptance, leading to more Covid-19 cases. Furthermore, this bill will increase the disease burden among communities, especially in crowded adult care homes and hospitals, leading to high transmissions and disruption of economic, social, and public life. Consequently, H.R. 5860 may lower the plausibility of vaccines in the Healthcare community and the nursing profession as it strives to limit compulsory vaccinations. H. R. 5860 will put nursing professionals at high risk from infected patients, which harms the health system’s capacity.
Conclusion
In conclusion, the main purpose of H.R. 5860 is to exempt essential workers from mandatory Covid-19 vaccinations enforced by the federal government, contractors, private entities that got federal funds, and public institutions that got federal Covid-19 funds. Although proponents of this bill claim that mandatory vaccinations infringe upon individual liberty and autonomy, its enactment might increase Covid-19 transmissions, mortality, and morbidity and stifle healthcare capacity. The enforcement of mandatory vaccinations has led to nurses’ resignation; among ten thousand employees, approximately ten nurses were laid off for rejecting vaccinations. Nonetheless, policymakers need to consider the health repercussions of enacting H.R. 5860. Mandatory vaccinations are plausible for nursing professionals since they are a priority vaccination group to prevent transmissions and safeguard the health system’s capacity.
References
Bardosh et al. (2022). The unintended consequences of COVID-19 vaccine policy: why mandates, passports, and restrictions may cause more harm than good. BMJ Global Health, 7(5). Retrieved from https://gh.bmj.com/content/7/5/e008684
Burch, A & Abelson, R. (2022). Hospitals Confront the Fallout From Supreme Court Ruling on Vaccine Mandate. Retrieved from www.nytimes.com: https://www.nytimes.com/2022/01/15/us/healthcare-workers-vaccine-mandate.html
Congress. (2022). H.R.5860 – Keeping Our COVID–19 Heroes Employed Act. Retrieved from www.congress.gov: https://www.congress.gov/bill/117th-congress/house-bill/5860/text
GovTrack. (2022). H.R. 5860: Keeping Our COVID–19 Heroes Employed Act. Retrieved from www.govtrack.us: https://www.govtrack.us/congress/bills/117/hr5860
Keating, B. (2022). The Legislative Process. Retrieved from keating.house.gov: https://keating.house.gov/policy-work/legislative-process
WHO. (2022). Covid-19 and mandatory vaccination: Ethical considerations. Retrieved from apps.who.int: https://apps.who.int/iris/rest/bitstreams/1425927/retrieve
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