Forced recruitment of medical personel
March 30, 2020 10:38 AM Subscribe
My wife is a medical doctor and immunocompromised. She is terrified that our government will pass legistlation that alows the forced recruitment of medical personel and she will be sent into a tent with 1000 Covid-19 patients without protection, which would be a likely death sentence for her. At the moment she is between jobs, so at least she has no employer that could force her to do that. Even if he did, she could simply quit.
But if the government takes her medical license and doctorate away unless she helps, or imprisons her or whatever this is another matter. We live in Germany and they almost passed legislation that allowed forced recruitment, it was taken out at the last minute. Although the passage was not very specific, there were no details about exemptions, implementation, sanctions, etc. it nonetheless rattled us. And now a state (NRW) is thinking about passing something similar, with other states surely thinking about it.
So far, did any other countries implement such a policy for the pandemic? Do you maybe know of examples prior to this where it happend and the specific implementation, besides in wartime?
But if the government takes her medical license and doctorate away unless she helps, or imprisons her or whatever this is another matter. We live in Germany and they almost passed legislation that allowed forced recruitment, it was taken out at the last minute. Although the passage was not very specific, there were no details about exemptions, implementation, sanctions, etc. it nonetheless rattled us. And now a state (NRW) is thinking about passing something similar, with other states surely thinking about it.
So far, did any other countries implement such a policy for the pandemic? Do you maybe know of examples prior to this where it happend and the specific implementation, besides in wartime?
Best answer: I'd look at past military drafts for an indication of how this might go. They will have an order of who gets called, based on various criteria, and they will work through those groups in order from most desirable to least until they fill the demand. At least at first they will be somewhat lenient in granting exemptions. My father got rejected for WWII service because of a heart murmur, which they had to strap him to a table and turn him upside-down to even detect. He lived to be 84. But that was when they had plenty of other healthy volunteers to choose from.
But if there is enough demand, even the least desirable group can be called.
A huge number of medical personnel who might be drafted for coronavirus service are retired from practice, and of advanced age—a COVID-19 risk group. The fact that they haven't already volunteered hints that they don't want to participate, quite likely for good reason. Many from this group who would be drafted would deserve an exemption as much as your wife does, but they certainly could be drafted anyway if things become desperate. And so could your wife. But I'd imagine she'd be way down the list.
posted by kindall at 11:01 AM on March 30, 2020
But if there is enough demand, even the least desirable group can be called.
A huge number of medical personnel who might be drafted for coronavirus service are retired from practice, and of advanced age—a COVID-19 risk group. The fact that they haven't already volunteered hints that they don't want to participate, quite likely for good reason. Many from this group who would be drafted would deserve an exemption as much as your wife does, but they certainly could be drafted anyway if things become desperate. And so could your wife. But I'd imagine she'd be way down the list.
posted by kindall at 11:01 AM on March 30, 2020
Best answer: I've been following the news fairly well through all of this. In China the army medical corps were drafted into civilian hospitals, but that was it. Both the U.S. and Britain (and apparently Germany) have made aborted moves in the direction of drafting non-working medical personnel. It has not been a popular option.
But the idea is in the air, so it could happen.
Even then: not that governments always act intelligently, but drafting people who are likely to fall ill makes no sense. It has a good chance of causing a bigger problem than it solves.
Hopefully it is documented in some way that your wife is immunocompromised.
posted by Tell Me No Lies at 11:13 AM on March 30, 2020 [1 favorite]
But the idea is in the air, so it could happen.
Even then: not that governments always act intelligently, but drafting people who are likely to fall ill makes no sense. It has a good chance of causing a bigger problem than it solves.
Hopefully it is documented in some way that your wife is immunocompromised.
posted by Tell Me No Lies at 11:13 AM on March 30, 2020 [1 favorite]
It is very worth contacting your elected representatives to let them know of this concern. The time to inject this into the conversation is now, when it is still in the early discussion phase.
As we saw with the recently passed U.S. legislation, they can move stuff fast when they need to, and it usually gets the big stuff fairly right. But when they're ramrodding things through at high speed is exactly when details like this get overlooked. So get the conversation & awareness started with your elected officials as soon as possible.
If you can get a few others to write/call/email, too, it makes a fair difference. Even 3, 5, or 10 people contacting an elected official with the same concern tends to raise its profile quite a bit, especially if it is clear they are regular citizens/voters raising a personal concern and not just part of a pre-fab astroturf campaign.
posted by flug at 11:15 AM on March 30, 2020 [1 favorite]
As we saw with the recently passed U.S. legislation, they can move stuff fast when they need to, and it usually gets the big stuff fairly right. But when they're ramrodding things through at high speed is exactly when details like this get overlooked. So get the conversation & awareness started with your elected officials as soon as possible.
If you can get a few others to write/call/email, too, it makes a fair difference. Even 3, 5, or 10 people contacting an elected official with the same concern tends to raise its profile quite a bit, especially if it is clear they are regular citizens/voters raising a personal concern and not just part of a pre-fab astroturf campaign.
posted by flug at 11:15 AM on March 30, 2020 [1 favorite]
Best answer: If it helps, here in the UK retired NHS staff were asked by letter whether they would be prepared to come back to help - to date about 20,000 have volunteered.
While I suppose there might have been something more stringent in the pipeline if people hadn't come forward, it would seem unnecessary and inappropriate to require people to work under potentially hazardous circumstances (especially people with underlying health conditions) when asking for volunteers hadn't been tried first.
posted by Martha My Dear Prudence at 12:01 PM on March 30, 2020 [2 favorites]
While I suppose there might have been something more stringent in the pipeline if people hadn't come forward, it would seem unnecessary and inappropriate to require people to work under potentially hazardous circumstances (especially people with underlying health conditions) when asking for volunteers hadn't been tried first.
posted by Martha My Dear Prudence at 12:01 PM on March 30, 2020 [2 favorites]
I understand the fear. She should call and email her representatives and ask them to leave provisions in any legislation for medical workers who are at higher risk. An additional concern seems to be that medical workers get exposed to a higher quantity of virus and may then be more likely to be more ill because of the viral load; not sure this is well documented for this virus yet.
posted by theora55 at 12:29 PM on March 30, 2020 [1 favorite]
posted by theora55 at 12:29 PM on March 30, 2020 [1 favorite]
People are still going to be getting sick with normal things that can be dealt with by telemedicine. If it gets to the point where we are drafting doctors by force - and I seriously doubt it's going to get to that point - then I think it's likely that she can do something remotely, thus freeing up a less vulnerable doctor to do more.
I'm a pharmacist and all of us midlevels (pharmacists, nurse practitioners, etc) are probably going to have to do more. Generally doing more means that we work under the supervision of an MD, based on state law. We'll need doctors to oversee that work and in the worst case scenario she can definitely do that without front line contact. Things are really scary now but nobody wants an immunocompromised doctor to get sick. She will do a lot more good working remotely. And again, I really doubt it's going to come to that (knock on wood).
posted by selfmedicating at 1:16 PM on March 30, 2020 [2 favorites]
I'm a pharmacist and all of us midlevels (pharmacists, nurse practitioners, etc) are probably going to have to do more. Generally doing more means that we work under the supervision of an MD, based on state law. We'll need doctors to oversee that work and in the worst case scenario she can definitely do that without front line contact. Things are really scary now but nobody wants an immunocompromised doctor to get sick. She will do a lot more good working remotely. And again, I really doubt it's going to come to that (knock on wood).
posted by selfmedicating at 1:16 PM on March 30, 2020 [2 favorites]
Apologies - I just realized you are in Germany and I answered assuming you were in the USA. But in general, I do think that telemedicine is the big thing that will help her stay safe, and she will help the cause out more if she's home safe than if she goes out and gets sick.
posted by selfmedicating at 1:22 PM on March 30, 2020
posted by selfmedicating at 1:22 PM on March 30, 2020
(As a long-term Berlin resident) I had not heard of that legislation, and am! surprised by it.
But there has been so much pushback and agonising from politicians and the opinionmakers about EVERY 'limitation' and 'restriction' on everyday life so far, there has been so much concern about individual freedoms and constitutionality and the role of the state, with the obvious historical baggage...
I am pretty convinced that even if such a thing were to pass it would be challenged and appealed on every level, would be opposed by every OTHER responsible legislative and civil body, would go to the constitutional court etc before it even got to the level of having to be challenged by individuals...
Added to that that your wife is immune compromised and currently w/o an employer...
And the personnel in such places would be sooooo unlikely to have no protection. With Germany's wealth and societal outlook and manufacturing resources, esp given time for factories to convert production?
Your anxiety is very understandable in such a rapidly shifting situation. But Zwangsarbeit - forced labour - of such a sort is just NOT gonna happen in this Germany.
posted by runincircles at 1:40 PM on March 30, 2020
But there has been so much pushback and agonising from politicians and the opinionmakers about EVERY 'limitation' and 'restriction' on everyday life so far, there has been so much concern about individual freedoms and constitutionality and the role of the state, with the obvious historical baggage...
I am pretty convinced that even if such a thing were to pass it would be challenged and appealed on every level, would be opposed by every OTHER responsible legislative and civil body, would go to the constitutional court etc before it even got to the level of having to be challenged by individuals...
Added to that that your wife is immune compromised and currently w/o an employer...
And the personnel in such places would be sooooo unlikely to have no protection. With Germany's wealth and societal outlook and manufacturing resources, esp given time for factories to convert production?
Your anxiety is very understandable in such a rapidly shifting situation. But Zwangsarbeit - forced labour - of such a sort is just NOT gonna happen in this Germany.
posted by runincircles at 1:40 PM on March 30, 2020
Best answer: I’m in the UK, and as Selfmedicating says it is much more likely she’ll be drafted in to do telephone clinics.
We have far more cases than Germany at the moment, with my local area being particularly badly affected, so we have cancelled literally all of our outpatient work and converted it to telephone/virtual reviews. So our self-isolating and vulnerable colleagues are doing that from home while we look after the wards and F2F stuff.
The virtual stuff is definitely more than 50% of the workload (all of our transplant patients, pre-dialysis and general Nephrology patients - literally thousands of patients). There’s just no need to put anybody at risk when we have plenty of stuff that they can safely do remotely. Might be different if she’s a surgeon, but physicians/family doctors/psychiatrists can do most stuff over the phone. Not quite as good as F2F, but much better than putting the patient at risk of infection.
posted by tinkletown at 2:48 PM on March 30, 2020 [2 favorites]
We have far more cases than Germany at the moment, with my local area being particularly badly affected, so we have cancelled literally all of our outpatient work and converted it to telephone/virtual reviews. So our self-isolating and vulnerable colleagues are doing that from home while we look after the wards and F2F stuff.
The virtual stuff is definitely more than 50% of the workload (all of our transplant patients, pre-dialysis and general Nephrology patients - literally thousands of patients). There’s just no need to put anybody at risk when we have plenty of stuff that they can safely do remotely. Might be different if she’s a surgeon, but physicians/family doctors/psychiatrists can do most stuff over the phone. Not quite as good as F2F, but much better than putting the patient at risk of infection.
posted by tinkletown at 2:48 PM on March 30, 2020 [2 favorites]
This thread is closed to new comments.
Consider that neither Italy nor Spain which have had much worse pandemics and who were not nearly so in control as Germany is have done such a thing. No country in Europe has done this. I cannot imagine that any country, let alone Germany in 2020, would require someone in a vulnerable category to take a front-line role.
posted by atrazine at 10:59 AM on March 30, 2020 [9 favorites]