Should doctors be expressing their concerns about Australia’s COVID-19 policies out loud?

In Both Sides Now, author and ethicist Leslie Cannold presents two sides of an argument. Then it’s over to you: what do you think is true, and what do you think Cannold really believes?

Today: should doctors speak out about the government’s COVID-19 policies and handling of the pandemic?

No: doctors have an important job of carrying Australia through the pandemic — they should put their heads down and finish the job. Yes: if doctors are going to carry Australia, they need to be able to contribute to informed debate around the pandemic.

No

The Australian Medical Board has had enough. Earlier this week, it felt impelled to remind the doctors it regulates that not only are they expected to be vaccinated themselves, but that “any promotion of anti-vaccination statements or health advice which contradicts the best available scientific evidence or seeks to actively undermine the national immunisation campaign (including via social media) may … result in regulatory action”.

The Therapeutic Goods Administration also stepped in to remind health practitioners how the agency’s longstanding prohibitions on advertising impact on what can and can’t be said about COVID-19 vaccines.

This comes in the wake of declining vaccination rates in Australia that in 2019 saw five-year high rates of measles and an historically severe early flu season, alongside surprisingly high rates of vaccine refusal by health care workers in the UK and United States and the dizzying growth of the online anti-vaccination movement since the start of the pandemic.

Not surprisingly, doctors have been the ones to squawk about what many health practitioners consider a long-overdue shot across the bows of people without specialist expertise offering us the benefit of their opinion on TV and radio about the vaccine. On the ABC’s Health Report this week, for instance, GP and emergency physician Dr David Berger complained that the timing of such warnings was “sinister” and would cause doctors like him to “self-censor” to avoid “offending” the regulator.

Too bad. As universities have discovered, the willingness of some academics to comment on issues outside their expertise can cause public confusion and alarm, casting doubt on the credibility of the university and the profession overall.

This is the last fate we need to befall health practitioners in our anti-science age as public health officials work arm-in-arm with actual infectious diseases and public health experts to protect the populace against COVID-19.

What does this mean for health practitioners without relevant expertise when it comes to COVID-19? That their job in helping Australia return to more normal levels of economic activity and mental health is the same as the one assigned to the rest us: to stay up to date with the latest evidence so we can help educate those around us about the importance and safety of COVID-19 vaccines — and to keep our mouths shut and arm out when our chance to be vaccinated comes.

Yes

Well, that was scary. Since when did squelching informed debate at a time of medical crisis become a smart thing to do? Especially when that debate is taking place between experts about matters on which reasonable people can — and do — disagree.

Let’s be clear. The problem with the official “reminders” to medical professionals was not their content but the timing, and the way responses from both agencies to subsequent questions suggested a use of existing rules designed to manage one problem ––anti-vax health professionals — to shut down legitimate public debate.

The slow response of the regulator to anti-vax health professionals is a matter of public record.

But doctors like Berger, or the still-registered host of the Health Report Norman Swann, were never the target of the regulator’s evidence-based approach to vaccines. Far from being aligned with long-discredited theories about the connection between the MMR vaccine and autism, or the QAnon 5G tower please-don’t-make-me-understand-it-any-more-than-this crap, these doctors seek to air and contribute to discussions about legitimately contested areas of vaccine science and public policy.

What are the risks of blood clots from the AstraZeneca jab for women under 55? Why spend the time and money rolling out a vaccine that may not protect much, if at all, against variants of concern? Why did we use our limited supply of Pfizer vaccines in aged care facilities instead of on hotel quarantine and returning Australians, given that our non-existent level of community transmission makes them our only risk? Given the problem with supplies from overseas, and the rapid vaccination process taking place in many COVID-infested nations, shouldn’t we be setting up more plants at home to manufacture an updated vaccine effective against all variants, in the hope that this might allow us to open up?

If I were a were a more useful kind of doctor instead of a PhD, such questions could be risky for me to ask and verboten for me to answer if I didn’t want to risk — as most health professionals don’t — any interaction with the regulator.

No one is obliged to stick out their arm and accept medication into their body without asking questions. While health regulators have a responsibility to stop charlatans from making unfounded (and often conclusively disproven) claims about established vaccines because of the way such behaviour undermines trust in the profession, it is something else entirely to stop some doctors from providing public comment on new vaccines and immunisation policy that are uncertain and a legitimate source of public interest and debate.

This is even the case when a government may find it convenient to suggest there is no disagreement about its decisions and plans because criticism is annoying, and they want us all to be vaccinated.

Which side do you think Cannold sits on? And what do you believe? Send your thoughts to letters@crikey.com.au with Both Sides Now in the subject line.