Should Doctors be Allowed to Refuse Treatment if Parents Won’t Vaccinate?
by Jennifer Chait, 12/08/11
NPR recently broadcast an interesting discussion – Treating Families That Don’t Immunize. This NPR opinion piece asks the question: Is it okay, or even ethical for pediatricians to refuse routine care to families who refuse to vaccinate their children? The piece features commentary by New York Times Ethicist, Ariel Kaminer, who also recently posted this question to readers at The New York Times. The opinions are very interesting, especially if you read the reader comments on both. Many parents commented that a doctor dismissing a patient due to vaccine non-compliance isn’t fair. Yet, to play devil’s advocate, on the flip side, research shows that parents want their own freedom of choice when it comes to vaccine arrangements, such as many parents want to delay vaccines, have alternative schedules or not vaccinate altogether. It’s a little strange to want freedom of choice yourself, yet deny some doctors the same rights.

Image via Flickr User edenpictures
How many doctors turn patients away?
Currently it’s unclear just how many doctors actually turn away patients who won’t get vaccinated, but a recent national survey of pediatricians found that around 25% percent, always, often or sometimes will turn a child away if the child’s family refuses to vaccinate for basics such as polio and diphtheria. A MSNBC.com story points out that this is a seemingly growing trend. Some doctor’s offices have instituted policies that require all patients who want treatment to be immunized. This trend of dropping non-vaccinated patients is not supported by the American Academy of Pediatrics (AAP), an organization that does support universal immunization, but who also, according to the above story, says “Refusal to immunize should not be the only reason a doctor turns a family away.” However, the APP does offer doctors an out stating that:
“If, after discussion about the importance of vaccination and the risks of not vaccinating, the parent refuses, the pediatrician should document the discussion and have the parent sign a waiver affirming his/her decision not to vaccinate (i.e., AAP Refusal to Vaccinate Form). If the situation becomes such that you are no longer comfortable having the parent/patient in your practice, the AAP manual, “Medical Liability for Pediatricians”, Chapter 3, offers resources for risk communication and termination of the physician-patient relationship.“
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Let us not (ever) forget that it is the doctors who are providing us with a service, and not the other way around. We are the paying customers, we get freedom of choice – they don’t.