Just had a look at some USA school web sites. Kids MUST have MMR to be
accepted and prove it too. In the US it seems that their founding fathers
idea of 'communitarianism', ie an individual is not a island and has some
responsibilities to the community which override individuals freedoms, is
taken seriously. Thus in the US the standard of driving is generally very
good and willful misusue of your freedom to drive, like drink-driving, is
punished severely. Informed consent to refuse anything is fine but when this
impacts on others, like reduced herd immunity, it can be seen as
anti-social. Even Anarchists do not hold that one can do anything one wants
if it hurts others who do not hold your view. Society has to have a shared
community view for it to function, that is the basis of law which we all
have to obey whether we agree with it or not. In this sense M Thatcher was
the ultimate sociopath as she held that there was no such thing as society,
simply groups of individuals coming together at times when it suited them.
Informed consent can mean that if u make a decision which society deems
unacceptable then there may be unpleasent consequences, oitherwise a persons
willfull actions have no consequences. And is it ethical for a parent to
refuse treatment to a child but the child may get the illness?


>From: Leon Geffen <[log in to unmask]>
>Reply-To: GP-UK <[log in to unmask]>
>To: [log in to unmask]
>Subject: Re: ethics of MMR
>Date: Mon, 23 Feb 2004 21:26:44 +0200
>
> > When a government (or one of its agencies)  tells us MMR is
> > safe why is that information any more reliable than when a
> > government tells us that Iraq posseses weapons of mass destruction?
>
>Peer review is not something that governments are particularly good at -
>they only have to worry about being reelected every 4-5 years, whilst
>the scientific community regularly reviews the work done by the members
>thereof. Governments haven't told us that MMR is safe, the overwhelming
>evidence to date by good scientists and doctors all around the world
>have. None of the anti MMR brigade have been able to show convincing
>(let alone plausible work to date) that MMR is harmful. What we do know
>is that the number of children with measles in the UK have increased
>since the MMR naysayers have had their tuppence worth has increased
>substantially.
>
>Science is able to admit its mistakes when new information comes to the
>fore. We in medicine try and practice according to the best evidence
>available at the moment, if that evidence is eventually shown to be
>incorrect, we acknowledge our errors and change our practice to reflect
>the best available evidence once again - it's an iterative process.
>
>I spose that if medical ethics are based on the following principles
>
>1) Patient autonomy
>2) Beneficence
>3) Non-maleficence
>
>then the parents have a right under the principle of autonomy to refuse
>treatment, whether they are right or wrong is not the issue. They are
>making an informed choice - albeit a stupid one in my mind not to
>vaccinate, but it's their right.
>
>How many parents of asthmatic chidren smoke? Do we send social services
>into the house and remove the children from their care? Do we refuse to
>give them bronchodilators etc.? The greater good of society would be far
>better served if no one smoked, yet we continue to tolerate their stupid
>behaviour. Why should we as GP's enforce the will of the state? Aren't
>we best served by maintaining our unique relationships with patients -
>even when they act contrary to "what we know is best for them"?
>Hopefully once patients realise that we are acting in their interests
>they will regain their trust in us and be willing to follow some of our
>advice. Only then will we be able to reclaim the high ground in managing
>our patients.
>
>Leon
>
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