title: Physician Dismissal of Families Who Refuse Vaccination: An Ethical Assessment.
abstract: Thousands of U.S. parents choose to refuse or delay the administration of selected vaccines to their children each year, and some choose not to vaccinate their children at all. While most physicians continue to provide care to these families over time, using each visit as an opportunity to educate and encourage vaccination, an increasing number of physicians are choosing to dismiss these families from their practice unless they agree to vaccinate their children. This paper will examine this emerging trend along with the reasons given by those who advocate such an approach. I will argue that the strategy of refusing to allow families into a clinic unless they agree to vaccinate their children is misguided, and the arguments for doing so fail to stand up to close scrutiny. Such a strategy does not benefit the child or the health of the community, and may have a negative impact on both. Furthermore, some of the arguments in support of dismissal policies ignore the importance of professional obligation and appear to favor self-interest over the interest of the patient.
authors.affiliation: Professor of Pediatrics in the Department of Pediatrics at the University of Washington School of Medicine with adjunct appointments in the Department of Bioethics & Humanities and the Department of Health Services in the School of Public Health. He also serves as the Director of Education for the Treuman Katz Center for Pediatric Bioethics at Seattle Children's Research Institute. He received his M.D. at the University of North Carolina School of Medicine in Chapel Hill, North Carolina, and his M.P.H. at the University of Washington School of Public Health in Seattle, Washington.
authors.forename: Douglas S
authors.initials: DS
authors.lastname: Diekema
mesh_terms: D001291:Attitude of Health Personnel; D002648:Child; D003657:Decision Making; D005190:Family; D006801:Humans; D016365:Liability, Legal; D009014:Morals; D010290:Parents; D010684:Philosophy; D010820:Physicians / Q000941:ethics*; D057766:Policy; D011634:Public Health; D012306:Risk; D000072758:Vaccination Refusal / Q000941:ethics*