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'Anti-vaxxers' in the waiting room

June 25, 2014
by Terry L. Stawar, Ed.D. CPRP
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Like climate change and other scientific issues, vaccinations have become politicized as an issue of ideology and personal freedom. The primary risk from opting-out falls to the unvaccinated child. In some cases charges of child abuse or medical neglect have even been raised,  as in Pennsylvania a few years ago, when a measles outbreak killed nine unvaccinated children from two religious communities   opposing  immunizations.

According to Dorit Rubinstein Reiss, a law professor at the University of California, parents who reject   prevailing scientific evidence that indicates the risk of not vaccinating is much greater than vaccinating, may be “seen as violating a child’s right to health and life." Reiss says that while courts acknowledge the state’s right to protect children,  they have been less apt to address the dangers of non-vaccination,  without clear legislative direction. Occasionally courts have overrule parental vaccination decisions, but usually this has been when divorced parents disagree about immunizations. Reiss seems skeptical of the successful employment  of criminal statues to prosecute parents who don’t immunize their children, even when it results in harm to the child.

The anti-vaxxer issue has even shown up in a television show. In a Season 10 episode of Law & Order: Special Victims Unit entitled “Selfish,” parents were prosecuted because they decided to not vaccinate their own child and this resulted in someone else's vulnerable child dying. In an article entitled “Endangering the Herd,” Slate Magazine writer Jed Lipinski cites the work of Arthur Caplan from New York University Medical School. Caplan argues that opting a child out of vaccines should not offer  protection for parents from liability for the consequences that that choice has for others, such as  infants or other at-risk individuals getting harmed. In other words, parents who choose not to vaccinate their children theoretically could be held legally responsible if their child infects someone else. Does this legal liability, however, transfer over to organizations that knowingly allow unvaccinated children to be in close proximity to potentially vulnerable individuals in their facilities?

In a recent survey 85% of pediatricians reported encountering a parent who refused or delayed immunizations for their child.  Also more than half have worked with parents who refused all vaccines. Around the country some of these pediatricians are now declining  to treat children, whose parents refuse vaccinations. Harry Miller, a pediatrician in Clifton Park, N.Y., works at a practice that stopped treating unvaccinated children about a year ago. He says “Exposing that small percent who don’t vaccinate to those who do is a disservice.”

Getting over the fear

The American Academy of Pediatrics suggests a less drastic approach and says in their policy statement. “Over time, parents may be willing to reconsider previous vaccine refusals.” They see the physician’s role as one of addressing parental concerns and providing education about vaccines. But they also say, “However, when a substantial level of distrust develops, significant differences in the philosophy of care emerge, or poor quality of communication persists, the pediatrician may encourage the family to find another physician or practice.”

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Terry Stawar

President/CEO (LifeSpring, Inc.)

Terry Stawar

@tstawar

planetterry.wordpress.com

Terry L. Stawar, EdD, is President and CEO of LifeSpring Health Systems, a community behavioral...

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