THUNDER BAY, ONTARIO, /EDMONTON, AB/ Troy Media/ - A number of paediatricians in California have begun to refuse to see children whose parents will not get them vaccinated. Amid the biggest outbreak of measles in the United States in 15 years, they say, they cannot risk the health of their other patients in their practice being exposed to measles, pertussis, or other potentially fatal or permanently crippling childhood illnesses.
For the paediatricians this is a "tough love" approach, an attempt to convince those opposed to vaccines to rethink their position and look again at the evidence. Others, including the American Academy of Paediatricians, are worried they may be violating medical ethics in refusing treatments.
At first look such cases appear to be shocking breaches of ethics and of the trust society places in doctors. Surely it is the parents' fault and not the child's - why then should the child suffer and be refused access to other medical services? Every ethical code of every professional medical body in the world places the best interests of the patient first and foremost. Are the paediatricians right to refuse to see patients whose parents refuse to vaccinate them?
Patients have the right to refuse medical treatment but the situation here is complicated by the fact that the patients in question are minors and it is their legal guardians, their parents, who are refusing vaccination These are the "anti-vaxxers," the people who still believe in the criminally fraudulent research of the discredited British physician Andrew Wakefield, who claimed to have discovered a link between common vaccines and autism. Their refusal to vaccinate their children has been directly responsible for the re-emergence of childhood diseases like mumps, pertussis (whooping cough), and measles. These aren't parents who have asked for a second opinion about a recommended course of treatment: they hold mistaken and dangerous beliefs that endanger the health of their children.
Physicians are allowed to refuse patients when they believe there has been a breakdown of trust in their relationship - that the patient is regularly lying about their symptoms, refusing to follow the recommended course of treatment, or is selling their medication. The breakdown of trust here is that the physician feels that if the children's parents do not believe them about basic medical facts (such as, in this instance, the overwhelming evidence of the efficacy and safety of vaccinations), they are unlikely to trust them about anything else and the physician-patient relationship is thus rendered futile.
The doctors are doing more than asserting the efficacy of Western medicine: they are protecting the other patients in their practice. Many children are unable to receive vaccines because they have conditions or are taking medications that compromise or impair their immune systems. These children are in the offices of paediatricians every day and exposure to a child who is unimmunized but may unknowingly be carrying measles or rubella could be fatal for them.
I would be tempted to go even further than these physicians: I think governments should not allow parents to send their children to public schools if they will not vaccinate them (currently many states in the U.S. allow "conscience exemptions" from their vaccination requirements).
One of the only ways to reach people who hold to false beliefs is to show them that there are consequences for holding them. If it requires inconveniencing parents to make them take the health of their children more seriously, then so be it. It's unlikely to work - in fact it will probably deepen the persecution complex these parents already have - but it is worth a try.
Michael Flood is a marketing writer and communications consultant. He holds an MA in Philosophy from the University of Alberta.