I used to be dead-set against the idea of letting Jehovah's Witnesses and Christian Scientists deny their children conventional treatment for life-threatening illnesses. It still makes me angry to know that there are mothers and fathers out there who love their god more than their sons and daughters. And yet...
And yet, there is a case to be made for letting parents determine the fate of their children. The libertarian argument against the state forcing a course of treatment on a child against their parents' wishes is a compelling one. This meditation on the dilemma in Reason magazine hits the nail on the head:
It's easy to be a fair-weather libertarian and oppose an interventionist government when supporting personal freedom has no high, visible, immediate costs. But freedom, as they say, isn't free, and must be defended even when such costs are involved. That means opposing government surveillance that can foil terrorist plots, or restrictions on free speech even when the speech causes profound anguish--such as the picketing of military funerals by antigay preacher Fred Phelps and his followers, who claim that the deaths of US soldiers in Iraq are God's punishment for America's tolerance of gays.
As some who is, no pun intended, dead-set against the Bush administrations attempts to monitor Americans' private communications and its associated denials of Constitutional and common-law rights to liberty and privacy, I have a hard time finding the flaw in that argument.
I recognize there's a difference between letting someone spew hate-filled epithets and pursuing a course of action that culminates in the death of a child. Of course it's a tragedy when a boy or girl dies for no other reason than the parents have more faith in New Age quackery, pseudo-science or faith itself than the accumulated wisdom of modern medicine. The Reason essay was inspired by the story of 16-year-old Starchild Abraham Cherrix, who, in addition to being saddled with that name, has cancer of the lymph nodes. After a first round of chemotherapy failed to eradicate the tumors, the parents shipped him off to Mexico for a discredited alternative course of herbs and organic produce called the Hoxsey method. The county objected and the lawyers are now in on the action.
The simple answer would be the conventional MDs know best; actions that would deny life-saving treatment constitute child abuse. And in this case, that's probably true, more or less.
But in other cases, it's not so cut and dried. We're not talking about an Abrahamic right to sacrifice your child according to the whims of Yahweh. It's about selecting from an array of medical options, some based on sound science, others less so. We all know conventional, "western" medicine isn't without its flaws. Pharmaceutical firms are regularly caught cooking the books and selling products that at best are no better than placebos or, at worst, can kill. Doctors far too often behave more like pushers of dubious drugs than caring care-providers. If the parents in question have had any prior bad experiences with the medical community, it's not so hard to understand why their faith might be misplaced.
At risk of reducing this issue to a statistical distraction, the vast majority of North American parents, when confronted with a potentially fatal disease, follow the advice of their AMA- or CMA-certified physicians. Only a very few dare seek out alternatives that offer nothing more than false hope. Perhaps one of the costs of the freedom we enjoy is the occasional life of the child of misguided parents. It would be nice if there was a way to respect parental authority and save every sick child that could be saved. But unless I've overlooked something, there isn't.
In my own circle of family and friends, there is a mother who refuses to vaccinate her daughter thanks to baseless scare stories she has come across in her (largely fundamentalist Christian) sources of advice and information. To me, that's damn irresponsible. Just a few weeks ago, the BBC reported that the "numbers of measles cases in the UK have risen to their highest level in nearly 20 years" and "the south east's health agency blames low uptake of the MMR vaccine. It comes as a doctor who linked MMR with autism faces possible misconduct charges." But I strongly suspect that I would be considered way out of line if I tried to tell the vaccine-averse mother how to care for her daughter.
In theory, Hillary Clinton is right: it does take a village to raise a child. Pre-agricultural societies may well have operated that way. But that was then. This is now, and I'm not sure I want to live in a society that denies me the right to do what I think is best for my family. And I guess it's only fair to grant even JWs, Christian Scientists (although I really, really hate the oxymoronic combination of those two words), and anyone else who doesn't trust the medical establishment, the right to do the same.
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I'll get the aside out of the way first. The problem with parents who don't vaccinate their children is not only that they endanger their own child but that, by reducing herd immunity, they also endanger others as well. Even if one concedes them that right as regards their own children, they clearly do not have any right to increase risk for others.
That actually does bring me to my main point. Fancy that. For the moment, let's factor out the separable age-of-consent issues by assuming that the 16-year-old child himself is incapable of giving consent - as might be the case if he had entered a coma without (unlike Terri Shiavo) any prior statement of intent, for example. Most of your remaining argument seems to be based on an assumption that the parents and only the parents have the right to decide what's best for a child. Why? Do they own their children? Are they the only ones with a stake in the outcomes? There's a whole realm of cases in which all but those who really do consider children to be property would agree that the child's interests dictate intervention by the state. Why is this not one of those cases? Such things are always judgement calls, but isn't the science in this case solid enough to conclude that the parents have failed in their duty to provide responsible care?
Interesting post, but I confess I am confused by your phrase "...follow the advice of their AMA- or CMA-certified physicians...". The AMA doesn't certify anybody; it is essentially a right-leaning professional lobbying organization. Many physicians, including myself, are not members, and many others belong only because it is a requirement of their state or local medical association. Certification is a function of professional boards under the auspices of the ACGME (in the US) and state licensing bureaus.
Good point. I should have used "approved" or "associated" rather than "certified."
About the vaccination issue: the dilemma I faced as a parent was that I saw evidence that vaccination harms some children in some way, large or small. Even if researchers want to dispute that with me, one thing's sure: no one ever promises you specifically that your child won't be harmed. Physicians take no responsibility for what may follow a vaccination. Neither do schools and health authorities who issue threats if the child is not vaccinated. Their duty is to all children, not to mine in particular.
My loyalty is to my child.
So - why are my children vaccinated? They are vaccinated because one day while I was dithering it struck me that all the "progressive" people I was hanging out with were not vaccinating their children either. I had lost the protection of the herd. I was intentionally surrounding my child with people who could absolutely infect him. Furthermore, by relying on other people to be "stupid" enough to vaccinate their children, I was committing an immoral act. I was actively wishing something less for those children than I would want for my own. No family is an island. You are part of the main.
Have my children suffered direct reactions from vaccinations? Yeah, but nothing awful. Do I suspect vaccination of being behind some illnesses? Yeah. But you know what? Polio is a really terrible disease. Measles keeps you in the house for months with the blinds drawn. There's all kinds of bad out there, in orders of magnitude.
My one moment of amusement was when I met a parent who wanted to keep my child away from his, because his child wasn't vaccinated. The implication was that mine could infect him. Well actually his child was perfectly safe with mine. Possibly not with someone else's.
It's hard to construct a general rule. Maybe it's OK for parents to reject conventional cancer treatment for their child when it's clear that conventional treatment has a very small chance of doing anything other than prolonging the agony. Is it OK for parents to reject conventional treatment for a child suffering from appendicitis? What about a child bitten by a rabid animal?
First of all, yours is not a libertarian argument. Libertarians would hold that the child is autonomous.
Parents as a general rule do not know best. While some of them are the most emotionally involved with their children, in general the range of experience and knowledge of partents is limited so why do you assume that parents know best?
i am the "mother who refuses to have her daughter vaccinated." let me tell you why. it is not because of fundamentalist christian views. where did that come from, james? it comes more from a scientific view point. i worked as a pharmacy technician for close to 10 years, so i was surrounded by medical and pharmaceutical information.
when i was pregnant i researched the pros and cons of immunizations. if other people would also research they would find that the diseases that vaccines supposedly protect against were already on the decline when vaccinations became "mandatory" (shots are not mandatory for public school enrollment) due to more sanitary living environments and healthier habits. also, most of the diseases are not life threatening. did any of us die from chicken pox? most of these diseases are now easily treatable due to modern medicine. and another thing, even if one is vaccinated, he is not guaranteed not to get the disease anyway. how many people have gotten the flu after having gotten the vaccination? also, as these vaccines wear off as we get older the chance of getting sick still exists. and measles and the like are far worse in an adult than in a child. a child's immune system is stronger than an adults.
now, what can a vaccination negatively due to a child? SIDS, autism, ADD &ADHD are a few major side effects. a babies blood-brain barrier is not capable of filtering the garbage from vaccines, especially when they are given in combination as in MMR & DTP. if you look at the studies an alarming number of SIDS deaths occur directly following a vaccination. ask the mother of an autistic child when he became autistic. you may be surprised to find out that it came after the 2 year old DTP shot. the rise in autism has increased 1000% since the vaccine was heavily used starting in the early 90's. TIME magazine recently had a good article about autism.
if you do choose vaccinations for your child consider waiting to start the regime until 2 years of age and ask for single shots instead of the MMR variety that contains 3.
not to vaccinate is my educated decision. for more information i suggest reading WHAT YOUR DOCTOR MAY NOT TELL YOU ABOUT CHILDREN'S VACCINATIONS written by stephanie cave, M.D.,F.A.A.F.P.
love to little star.