WSJ has an article about the increasing number of pediatricians who fire their patients who refuse to vaccinate:
Pediatricians fed up with parents who refuse to vaccinate their children out of concern it can cause autism or other problems increasingly are “firing” such families from their practices, raising questions about a doctor’s responsibility to these patients.
Medical associations don’t recommend such patient bans, but the practice appears to be growing, according to vaccine researchers.
In a study of Connecticut pediatricians published last year, some 30% of 133 doctors said they had asked a family to leave their practice for vaccine refusal, and a recent survey of 909 Midwestern pediatricians found that 21% reported discharging families for the same reason.
By comparison, in 2001 and 2006 about 6% of physicians said they “routinely” stopped working with families due to parents’ continued vaccine refusal and 16% “sometimes” dismissed them, according to surveys conducted then by the American Academy of Pediatrics.
“There’s more noise among pediatricians, more people willing to argue that it’s OK to do this versus 10 years ago,” said Douglas Diekema, a professor of pediatrics at the University of Washington in Seattle. Dr. Diekema wrote the AAP’s policy on working with vaccine refusers, which recommends providers address the issue at repeated visits, but respect parents’ wishes unless it puts a child at risk of significant harm.
This is an interesting ethical question as there are several issues at play. Since the pediatrician is the child’s doctor, is it wrong to fire the family from the practice just because the parent is misinformed? Or is it a worse practice to tolerate parental medical foolishness and expose other patients in the practice to vaccine-preventable disease? Since vaccination is one of the most important roles of the pediatrician during well-child visits, is there any point at all in having regular pediatrician visits if you refuse vaccination?
My initial feeling is that these pediatricians are justified in refusing to care for patients who refuse vaccination. The debate on vaccination is over. The vaccines work. The vaccines are safe. They do not cause autism. Prevention of diseases like measles, mumps, rubella, pertussis, tetanus, meningitis, diptheria, chicken pox, HPV, polio, etc., is as important for individual patient’s benefit as well as prevention of transmission of these diseases in society and parents who refuse vaccination are bad for their children and bad for everyone else.
However, I’m still torn because it’s not the kid’s fault his parents reject western medicine and disease prevention. Does this further endanger the individual child as the child will no longer receive screening for childhood disease that is another highly important component of pediatric care?
In the end, a repeated point the pediatricians make in this article is that if the patients reject vaccination, they will reject most of the pediatricians recommendations. At which point, why even see a pediatrician? Why see a doctor if you don’t believe in medicine? Go see a quack instead. But then this brings me back to how it’s the child that is the one who is harmed by the rejection by mainstream pediatricians. What if this drives the parents further into the arms of quacks? How does that benefit the child?