Medical ethics and broadening the context of debate

McMillan, John

doi:10.1136/medethics-2020-106094

Cited by 1 publication

(4 citation statements)

References 10 publications

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“…Fifteen papers from this sample present arguments that vaccine refusal is justi ed based on respect for parental autonomy, rights, or liberties (21,23,25,31,32,35,36,39,68,71,75,80,94,100,121). Some argue that vaccine refusal is justi ed on the basis of preserving legal rights (31,80) or expression of religious freedom (23).…”

Section: Descriptive Analysis Of Contentmentioning

confidence: 99%

“…that in a low-incidence (and therefore low-risk) setting mandates cannot be justi ed (45, 87,104)-most make their arguments from autonomy, informed consent, and personal liberty and do not weigh these against the potential for harm (12,16,61,82,89,107,114). One author argues that even if mandates improve vaccination rates, they damage trust with parents and make refusers more steadfast in their decision (121), so are not sustainable. Finally, some authors present middle-ground positions that-in their vieware more autonomy-or liberty-preserving, including persuasion (121) or weakly enforced mandates (71), or argue that policy responses should take the least coercive approach that is feasible and effective to balance the needs of the individual with public health (117).…”

Section: 'Response' Arguments: Claims Regarding the Ability Of Differ...mentioning

confidence: 99%

“…One author argues that even if mandates improve vaccination rates, they damage trust with parents and make refusers more steadfast in their decision (121), so are not sustainable. Finally, some authors present middle-ground positions that-in their vieware more autonomy-or liberty-preserving, including persuasion (121) or weakly enforced mandates (71), or argue that policy responses should take the least coercive approach that is feasible and effective to balance the needs of the individual with public health (117).…”

Section: 'Response' Arguments: Claims Regarding the Ability Of Differ...mentioning

confidence: 99%

“…For example, authors disagree on the effect of both nudges and conscientious objection policies on parental autonomy or liberty. With respect to nudges, some argue they are autonomy-preserving because they steer parents in a certain direction while allowing choice (106), do not override or challenge the strong views of deeply opposed opponents (42,44) and uphold informed consent (121). Some supporters of nudging weigh multiple normative considerations, arguing that nudges that appeal to social responsibilities in a medical practice setting are justi ed because they appropriately balance parental autonomy against the practitioner's responsibility to promote trust and collective bene ts (3,80).…”

Section: 'Response' Arguments: Claims Regarding the Ability Of Differ...mentioning

confidence: 99%

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Vaccine Refusal and What to Do About It: a Systematic Review of the Ethical Literature

Wiley

Christou-Ergos

Degeling

et al. 2023

Preprint

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Background: Parental refusal of routine childhood vaccination remains an ethically contested area. This systematic review sought to explore and characterise the normative arguments made about parental refusal of routine vaccination, with the aim of providing researchers, practitioners, and policymakers with a synthesis of current normative literature. Methods: Nine databases covering health and ethics research were searched, and 121 publications identified for the period Jan 1998 to Mar 2022. For articles, source journals were categorised according to Australian Standard Field of Research codes, and normative content was analysed using a framework analytical approach. Results: Most of the articles were published in biomedical journals (34%), bioethics journals (21%), and journals that carry both classifications (20%). Two central questions dominated the literature: 1) Whether vaccine refusal is justifiable (which we labelled ‘refusal arguments’); and 2) Whether strategies for dealing with those who reject vaccines are justifiable (‘response arguments’). Refusal arguments relied on principlism, religious frameworks, the rights and obligations of parents, the rights of children, the medico-legal best interests of the child standard, and the potential to cause harm to others. Response arguments were broadly divided into arguments about policy, arguments about how individual physicians should practice regarding vaccine rejectors, and both legal precedents and ethical arguments for vaccinating children against a parent’s will. Policy arguments considered the normative significance of coercion, non-medical or conscientious objections, and possible reciprocal social efforts to offset vaccine refusal. Individual physician practice arguments covered nudging and coercive practices, patient dismissal, and the ethical and professional obligations of physicians. Most of the legal precedents discussed were from the American setting, with some from the United Kingdom. Conclusions: This review provides a comprehensive picture of the scope and substance of normative arguments about vaccine refusal and responses to vaccine refusal. It can serve as a platform for future research to extend the current normative literature, better understand the role of cultural context in normative judgements about vaccination, and more comprehensively translate the nuance of ethical arguments into practice and policy.

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Section: Descriptive Analysis Of Contentmentioning

confidence: 99%

Section: 'Response' Arguments: Claims Regarding the Ability Of Differ...mentioning

confidence: 99%

Section: 'Response' Arguments: Claims Regarding the Ability Of Differ...mentioning

confidence: 99%

Section: 'Response' Arguments: Claims Regarding the Ability Of Differ...mentioning

confidence: 99%

See 2 more Smart Citations

Vaccine Refusal and What to Do About It: a Systematic Review of the Ethical Literature

Wiley

Christou-Ergos

Degeling

et al. 2023

Preprint

View full text Add to dashboard Cite

show abstract

Medical ethics and broadening the context of debate

Cited by 1 publication

References 10 publications

Vaccine Refusal and What to Do About It: a Systematic Review of the Ethical Literature

Vaccine Refusal and What to Do About It: a Systematic Review of the Ethical Literature

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