by Richard Glickman-Simon, MD
Q: Many pediatric practices refuse to see patients whose parents choose not to immunize. How do you feel about this practice? How would you recommend we handle dealing with these patients?
A: The majority of doctors are zealous advocates of universal immunizations. They are understandably baffled, therefore, when a parent refuses to immunize a child. After all, immunizations were responsible for eradicating two of the most feared diseases of the twentieth century "small pox polio" and have reduced the incidence of seven other major infectious diseases by nearly 100%. So how could anyone question the wisdom "even imperative" of immunizing all children?
Aside from unsubstantiated claims of government and pharmaceutical industry conspiracies, members of a growing anti-immunization movement cite a variety of plausible arguments to defend their position. Among them are:
All doctors have an obligation to provide their patients (and their families) with the facts, as they understand them. In certain situations, doctors may even have the moral authority to go further and persuade their patients to accept the predominant point of view. However, doctors tread on ethically thin ice when they turn away children whose parents remain unconvinced. Such children, one could argue, need their pediatricians more, not less.
Q: Many pediatric practices refuse to see patients whose parents choose not to immunize. How do you feel about this practice? How would you recommend we handle dealing with these patients?
A: The majority of doctors are zealous advocates of universal immunizations. They are understandably baffled, therefore, when a parent refuses to immunize a child. After all, immunizations were responsible for eradicating two of the most feared diseases of the twentieth century "small pox polio" and have reduced the incidence of seven other major infectious diseases by nearly 100%. So how could anyone question the wisdom "even imperative" of immunizing all children?
Aside from unsubstantiated claims of government and pharmaceutical industry conspiracies, members of a growing anti-immunization movement cite a variety of plausible arguments to defend their position. Among them are:
- The reduction in infectious disease rates can be attributed to improved standards of living, not medical interventions such as immunizations.
- While vaccinations may have been beneficial in the past, the dramatic reduction in infectious disease rates means they are no longer needed. When is the last time a parent, or doctor for that matter, saw a case of diphtheria or rubella?
- The risks associated with universal immunizations do not outweigh their benefits. This is particularly true of the potential for poorly understood adverse consequences over the long term, such as the rising incidence of asthma and other immunologic conditions.
- Any mandatory medical treatment is an unacceptable infringement on personal liberties. The government cannot compel a person to accept a potentially harmful intervention no matter what the benefits may be to society.
All doctors have an obligation to provide their patients (and their families) with the facts, as they understand them. In certain situations, doctors may even have the moral authority to go further and persuade their patients to accept the predominant point of view. However, doctors tread on ethically thin ice when they turn away children whose parents remain unconvinced. Such children, one could argue, need their pediatricians more, not less.