A 2-week-old infant is brought to the pediatrician for the first time by his parents. His mother received regular prenatal care and the child was born at home under the guidance of a midwife and a doula. The child appears well. The parents tell you they do not plan to have their child receive any vaccines. After a discussion regarding the risks and benefits of vaccines, the parents are still adamant in their wishes to forgo. Which of the following is the most appropriate course of action?
- Call child protective services
- Refuse to continue to care for the child
- Seek a court order to deliver the vaccines against the wishes of the parents
- Give any scheduled vaccines during that visit against the will of the parents
- Document the visit, specifically the detailing of risks and benefits and the parents’ refusal of treatment
Parents have the right to refuse most treatments for their children, including vaccines. The physician should document that he or she recommended vaccines to the parents, their risks and benefits, and that the parents continued to refuse.
Consent for medical treatment is almost always required when treating minors. While parents do not have the right to refuse life-saving or limb-saving treatment for their children, they can refuse routine vaccinations.
Kimmel discusses the challenges of treating patients whose parents refuse vaccines. He notes that physicians should acknowledge that while vaccines are not always 100% effective and do very rarely have serious adverse effects, the benefits of immunization almost always exceed the potential risks.
Illustration A depicts the states that allow for different types of exemptions for children who do not meet the vaccine requirements for attending public school.