Doctors exist to serve the well being of society, and the role is often considered to be more vocational than merely perfunctory. Aside from the many years of dedication and academic work that need to be invested into making a medical career possible, the role itself requires a great deal of commitment and communication skill in order to be performed successfully. Traditionally, doctors have been expected to treat patients without exception or a process of selection, and also regardless of their own beliefs or ethical values.
However, in recent times doctors have sought to take an increasingly hard line and moralistic attitude towards treating their patients, applying more stringent conditions to potential visitors. An example of this surrounds the controversial notion of vaccinating children against diseases, and a rising number of doctors are refusing to retain or treat patients who refrain from allowing their offspring to subject various vaccinations.While this action is supported in policy that allows doctors to retain a right to refuse treatment on individual moral grounds, the question remains as to whether this is appropriate in their role as ethical service providers.
Why Do Parents not Vaccinate Their Children?
The statistics are less than specific, but physicians themselves suggest that there is a growing number amongst them who adopt an unswerving policy to treating unvaccinated children. In fact, there are increasing instances where doctors have spent several months advising and educating parents in the benefits of individual vaccinations, only to refer them elsewhere when they continually refuse to let their children be immunised. While some physicians claim that this decision is taken predominantly to protect other children who are considered at an increased risk of illness, there is an undoubted sense of morality and individual selection being applied to their decision making processes.
Of course, there are different reasons why parents choose not to immunise their children against specific diseases. The most significant of these are based in medical concerns, especially as certain vaccinations have been linked through research to instances of aspergers, autism and other similar medical syndromes. As several instances have been reported globally through the media, parents have subsequently used this information to assist their own decision making processes, and conclude that the potential side effects of vaccinations far outweigh their benefits.
In addition, there have been several historical instances where religious or cultural beliefs have been cited as reasons and immunisation, especially in states where legislation is rather more forceful in imposing vaccination amongst children. This is often debated, but as many religions are ill defined and open to individual interpretation, it is possible that an individual can use their faith as a reason for avoiding vaccination for their children whether it is legitimate or merely a way of defeating an existing political system. Regardless of this, religion is often considered as one of the most influential factors in whether parents choose to immunise their children.
The Moral Implications
In terms of legislation, different policies exist within different states of the US, and each varies in their nature and approach to immunisation. Some, such as Mississipi for example, allow exemption from vaccination only for medical reasons, whereas Texas and Ohio also allow parents to opt out based on individual or ideological issues. The majority of the US falls in between these two extremes of interpretation, and allow exemptions based on reasons that surround religious or medical opinions only.
The fact that each state has a considered and independent policy towards vaccination is interesting, as it suggests that separate governing bodies have already addressed the situation and responded accordingly. It would therefore seem unnecessary for doctors to adopt their own policies concerning unvaccinated patients, as this could well result in the contradiction of an existing state law. Therefore, if a family have made a considered choice not to immunise their child and their reasoning is upheld by local legislation, then it seems entirely inappropriate for doctors to overrule this independently or on an adhoc basis.
That this action is supported by the American Academy of Pediatrics is something of a surprise, especially when you consider that they go further in suggesting that any physician can refuse an individual treatment for moral reasons or conscientiously object to undertaking certain medical procedures. This is somewhat at odds with the vocational nature of a doctors work, and sets a worrying precedent with regards to the freedom that medical operatives have in applying selective conditions to the patients that they treat. In this instance, though they may well have concerns of populating a waiting room with unvaccinated children, this is something that is surely a matter for collective state rule rather than an individual service provider or practitioner.
The Freedom of Choice in Society
Doctors are perhaps the ultimate example of a service provider, and subsist to provide expert knowledge and medical care to any citizen who requires it. If these waters of provision become muddied by individual conditions and moral considerations, then patients will be increasingly unsure as to whether they are entitled to treatment under specific physicians. Doctors, regardless of the weight that their opinions hold, have no legal or ethical right to refuse patients treatment on the basis of a single and inherently personal choice afforded to them by law.
However, they do have a right to protect themselves and other patients, and this is where certain physicians have a valid point with regards to immunisation. Though democracy allows the freedom of choice, it also does so to individuals who may not have the necessary knowledge or common sense with which to make particular decision, and there is then a valid argument that governments or relevant experts should take a stand to educate and guide members of society. In this context, doctors could be considered as taking strong but necessary steps to coercing parents into the right course of action to serve their children and others appropriately.
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