Physicians can be put in difficult situations when parents refuse immunizations

LETTER — Posted March 1, 2004

Print  |   Email  |   Respond  |   Reprints  |   Like Facebook  |   Share Twitter  |   Tweet Linkedin

I read with interest the Ethics Forum reply by Erin Flanagan-Klygis, MD, on counseling patients who refuse immunizations for their children (Column, Jan. 5): While her advice to pediatricians was appropriate and accurate, I feel that three important points were not mentioned.

First, if a parent refuses immunizations, one of the most important and effective preventive measures in medicine, what else will they refuse? Will they follow your advice on a future recommendation for a life-saving procedure or medication? Will they refuse hospitalization for an illness that is serious? Where does a parent's right to choose medical care for their child versus the issue of child neglect (refusing a known, safe, intervention such as immunization) come into play?

Second, where does our liability fall with respect to "failure to immunize"? While polio is gone from the Americas, and one could make the argument to not immunize against this disease, the same doesn't hold for tetanus or Haemophilus diseases, which are not going to "go away."

I fear more liability from a family suing for failing to immunize than from any risk of a lawsuit from side effects of the vaccines themselves. Therefore, I would seriously consider discharging the patient from my practice, in contrast to Dr. Flanagan-Klygis' advice. While having the parents sign a waiver sounds nice, and may offer some protection for the physician, I'm sure that at some point this will be challenged by the clever plaintiff attorneys.

Third, it is amazing how quickly news travels. I have an acquaintance in practice who has a family who has refused immunizations. The word got around, and now more and more families who don't want their kids immunized are seeing him, because of his implied approval of this action.

I agree with the advice given: to be proactive, resourceful, flexible, respectful, and to have resolve. But there are other issues that need to be considered.

Albert G. Karam, MD, Dallas

Note: This item originally appeared at http://www.ama-assn.org/amednews/2004/03/01/edlt0301.htm.

Back to top



Read story

Confronting bias against obese patients

Medical educators are starting to raise awareness about how weight-related stigma can impair patient-physician communication and the treatment of obesity. Read story

Read story


American Medical News is ceasing publication after 55 years of serving physicians by keeping them informed of their rapidly changing profession. Read story

Read story

Policing medical practice employees after work

Doctors can try to regulate staff actions outside the office, but they must watch what they try to stamp out and how they do it. Read story

Read story

Diabetes prevention: Set on a course for lifestyle change

The YMCA's evidence-based program is helping prediabetic patients eat right, get active and lose weight. Read story

Read story

Medicaid's muddled preventive care picture

The health system reform law promises no-cost coverage of a lengthy list of screenings and other prevention services, but some beneficiaries still might miss out. Read story

Read story

How to get tax breaks for your medical practice

Federal, state and local governments offer doctors incentives because practices are recognized as economic engines. But physicians must know how and where to find them. Read story

Read story

Advance pay ACOs: A down payment on Medicare's future

Accountable care organizations that pay doctors up-front bring practice improvements, but it's unclear yet if program actuaries will see a return on investment. Read story

Read story

Physician liability: Your team, your legal risk

When health care team members drop the ball, it's often doctors who end up in court. How can physicians improve such care and avoid risks? Read story

  • Stay informed
  • Twitter
  • Facebook
  • RSS
  • LinkedIn