The King’s New Clothes

Blunden, Bill

doi:10.1007/978-1-4302-0755-9_6

Cited by 1 publication

(1 citation statement)

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“…Those justifying vaccine refusal in certain circumstances argue that in settings where there is a high level of herd immunity, the risk posed by an unvaccinated child is not great enough to override respect for parental autonomy (62,65,94,98), and that the bene ts of community protection do not justify the individual risk posed by the vaccine and borne by the child who is already protected through herd immunity (72, 96,97,17,93,108). Perspectives of non-vaccinators echo these ideas by asserting that some diseases are not harmful enough to proscribe vaccine refusal (14) and that vaccine injury contributes to and justi es refusal (16).…”

Section: Consequences For Others and The Childmentioning

confidence: 99%

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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