Tuesday, April 21, 2009

Vaccination as a Choice: Right to Refuse Vaccination

Vaccinations have no doubt been one of the most influential and invaluable tools created in modern medicine. Since it’s discovery and creation, this medical marvel has nearly eradicated smallpox, decreased epidemics, and largely protected against common colds and even chickenpox. However with its success has also come great controversy. One component of the larger debate is whether certain vaccinations should be state mandated or whether it should be a choice left to the parents. Keeping ones autonomy is a central issue in many bioethical debates and is no different with this one. Many parents and non-parents alike feel that personal autonomy is more important than obligation to the public and government and should be taken into consideration and respected.
In a public survey that was posted on the website NaturalNews.com, 98% of the participants stated parents should have the right to refuse vaccinations for their children. Though even with considerable statistics like this, an increasing number of states in our country have been fighting to make a number of childhood vaccinations mandatory to enter school. One of the arguments for supporters of mandating child vaccinations is that you are doing your child a disservice. Some even go as far as calling it abuse or neglect if a parent chooses not to get their child vaccinated. Although this view is expressed by a larger number of people, it has weaknesses. A parent is responsible for their child’s well-being and have an obligation and right to raise them how they see fit. For some, not vaccinating their children is the right way to go about this. A parent is considered the primary decision maker for the child until that child is legally an adult, which opponents of this are not taking into consideration. Mandating child vaccinations goes against parental rights and lets an outside source make medical decisions that directly affect the child. It can never be considered neglect or abuse when parents are making a conscious, informed, and well thought out decision to, in their eyes, protect their child and also protect their rights. For example, if a patient refuses treatment in a hospital even though it might greatly help them later in life, it would be against the law to continue treating them. This is no different from a parent refusing to immunize their child even though it might help them later in life.
This leads into a main argument in favor of vaccination as a choice: parents should be able to choose what is put inside of their child’s body and what kind of medical treatment is performed on them. An article I found online at the Association of American Physicians and Surgeons (AAPS), provides an example of this argument. L.R. Huntoon, M.D., Ph.D, spoke to a group at the YWCA and titled this Vaccinations: Public good vs. Individual Rights. Huntoon stated that he wanted to address one question, which was “who should decide what to put in your body?” Huntoon began the discussion with telling a fictional story: “The story begins with the FDA which has a little known advisory committee known as the ACNF - Advisory Committee for Nutritional Food. And their mission is to promote the most nutritional diet in the interest of the public good. After a period of study and deliberations, they came up with Recommended Daily Amounts of each type of food to include at least 3 servings of meat per day, preferably Big Macs, Whoppers and Chicken Dinners. They've called this optimal diet FAD which stands for Federally Approved Diet. They have published their FAD diet and other recommendations in a special government report. Before long, your state legislators took note of this official government report and acting in what they felt was the public's best interest, they passed a law, which made the FAD diet mandatory. And, just to make sure that all citizens follow this government approved diet, the law mandates that neither you nor your children can attend school (including college) unless you eat the government's FAD diet…. So, one day during a class discussion on nutrition your daughter or granddaughter happens to mention that she and her family are.....VEGETARIANS. Well, within a few days her parents receive a very threatening letter from school officials, which makes it clear that the little girl will be expelled from school unless her parents start feeding her the FAD diet. School officials also make it clear that if her parents are particularly stubborn in refusing to comply with the government-mandated FAD diet, that Child Protective Services will be called and they will likely take the little girl away from her parents based on "NUTRITIONAL NEGLECT" of a child. Well, being vegetarians, a very bright and independent thinking group of people, the parents said "Hey, wait a minute.... this is the United States of America, not communist China. Government has no right to tell me what I put into my body or into my child's body." Although this story is completely fictional, it does however represent the very real position we are at today with government-mandated vaccinations. And even though no one could ever compare the effectiveness and health benefits of vaccines to fast food, the point is made and supported. The government can not intervene in any other part of parenting a child so why this? Especially because it is a medical procedure that is pervasive and directly affects the child.
Most parents who decide against vaccination are not doing it solely to do it, but because of legitimate reasons and concerns they have learned about. Religion is a central theme in debates surrounding not only personal, educational and public issues but bioethical issues as well. A person’s religion needs to be taken into account in this particular situation of vaccination as a choice as it has been in other areas of medical practice. For example, Christian Science is one religion where members refuse medical treatment of any kind, which would include vaccination. They choose the practice of faith healing to treat members of the religion. However some states do not take this into account or consider it a good enough reason. A factor of not vaccinating that is actually supported by states and the CDC is not vaccinating based on medical grounds. The CDC website gives a list of common child vaccinations and when not to get children vaccinated. For example, they state “people should not get hepatitis B vaccine if they have ever had a life-threatening allergic reaction to baker's yeast.” For the MMR vaccine “Some people should check with their doctor about whether they should get MMR vaccine, including anyone who:
* Has HIV/AIDS, or another disease that affects the immune system
* Is being treated with drugs that affect the immune system, such as steroids,
for 2 weeks or longer.
* Has any kind of cancer
* Is taking cancer treatment with x-rays or drugs
* Has ever had a low platelet count (a blood disorder)”

In relation to this parents may also decide against vaccination because of negative side effects and previous cases they have seen. The CDC warns that the DPT vaccine may cause negative side effects because of the Pertussis component in it. Which is exactly what happened to Amy Roehl. After receiving this vaccine she had convulsions and a high fever. After this experience her mother decided not to continue with any other vaccinations except for her Hepatitis B shot. Another case supporting this particular argument is presented in a documentary titled Vaccine Nation. It includes the story of Alan Yurko who in February of 1999, was sentenced to life plus ten years with no chance of parole for child abuse and aggravated murder in the death of this ten-week old son. The medical diagnosis of the baby’s death was shaken baby syndrome. The doctor making the documentary as well as other medical professionals believe a majority of SBS cases to be attributed to a delayed vaccine reaction. Cases like this have affected the views of the public and now want to be more informed before vaccinating children. A last argument is the choice not to get vaccinated for personal reasons. Many people don’t realize how some vaccines are made. For example the influenza vaccine is made with animal products and eggs. Other vaccines are make with monkey and chick kidney cells. And others are made with calf serum and protein. Because of the use of animals as means PETA is a large opponent against vaccination. The Institute for Vaccine Safety has a map of which states accept religious, medical, and personal belief exemptions for child vaccinations:

If parents are choosing not to get their children vaccinated for various reasons based on medical, religious, or philosophical grounds, denying the parents this right would be very ethically unsound and morally wrong. Parents have been threatened with fines and even jail time in states such as New York and Maryland. Children who haven’t been vaccinated have been expelled from schools across the nation. And it has even gone so far that Child Protective Services was called and threatened to take children away if the parents did not comply with state mandations.

Is this a case of keeping ones autonomy and not letting the government or institutions rule what is being put in their own bodies? Or are objectors to the practice neglecting their children’s well being and denying them the best heath possible? Parents not vaccinating their child cannot be considered neglect. They are taking every aspect of their lives into account and consideration and then making an educated and informed choice they feel is best for their child. The government should not be able to take this important parental right away and to do so would be ethically wrong for many reasons.




  1. Are/were Maryland and New York the only states that threaten with jail time and fines if parents don't comply? I think it is a mush bigger situation and affecting children more if they are taken away from parents than if parents decide not to vaccinate. I can't believe personal autonomy is being challenged this hard after so many cases in bioethics have ruled to keep autonomy and respect it.

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  3. How is it even rational for kids to miss over a month of school for not getting the chickenpox vaccine instead of missing a week for just getting chickenpox?

    I also really like how that guy said "we can do this the easy way or we can do this the hard way"... I really don't think threatening people is a great way to earn their trust or support.