America’s Approach to Informed Consent (or Lack Thereof) When it Comes to Vaccination
Last week I helped grade exit exams at a local medical school. I was specifically grading the students on their patient interaction skills – how they spoke to the patient/actor, if they showed appropriate compassion, and if they obtained an important little something called informed consent.
What is informed consent?
For an individual to give informed consent, three things must be present:
- DISCLOSURE: The doctor must give the patient (or the patient’s guardian) the information necessary to make an autonomous decision.
- CAPACITY: The patient (or the patient’s guardian) must understand the information provided and also understand the consequences of whatever decision he or she makes.
- VOLUNTARINESS: The patient (or the patient’s guardian) has the right to freely decide what he or she thinks is best for without being pressured, coerced, manipulated, or threatened.
While the students demonstrated their newly minted skills, the world outside buzzed with controversy over the “vaccination issue.” I watched student after student get the actor-patient’s informed consent, and it dawned on me: informed consent – especially that part about voluntariness – almost never happens when it comes to vaccination. Remember, voluntariness is defined as the patient’s right to choose without being pressured or manipulated.
But in most medical practices, the conversation around vaccines goes something like this:
“Well, I see Jacob is 4 months old now, so it’s time to do the rotavirus vaccine. The nurse will be in to give him that shot.”
That is not informed consent. That’s bossing around a parent.
The doctor doesn’t mention that the biggest risk in not getting the shot is that your baby might develop rotavirus, which causes diarrhea. Although in developing countries dehydration from diarrhea can cause infant mortality, here in America a bottle of Pedialyte and in extreme cases some IV fluids at the nearby hospital are all that’s needed. The diarrhea usually resolves on its own in 3 to 7 days, and in some cases, the affected child has no symptoms whatsoever.
The doctor also doesn’t mention that a side effect of this vaccine is intussusception, a serious condition that causes an intestinal block that requires emergency surgery to correct. (Sounds a lot worse than diarrhea, doesn’t it?)
In other words: there is no disclosure.
In this case, let’s assume the parents spoke English and understood the doctor. But they don’t really know what rotavirus is, and the doctor didn’t explain what it was, other than saying it’s bad. So no capacity, really.
And there certainly is no voluntariness. The parents weren’t even asked if they wanted their child to get the vaccine.
I see this often in my practice, where I treat both healthy kiddos and those with vaccine injuries. The parents bring in their child’s vaccine record, and I ask, “How did you decide which shots to give?” I feel my blood boil as parent after parent tell me:
“Um, decide? We didn’t decide. We had no choice. The doctor just said we had to do it.”
That is not informed consent.
Don’t we have the right to make decisions about our health?
After California passed SB277, a bill that legally mandates all children be vaccinated per the CDC schedule, parents were understandably outraged. If you live in California, this means no more opting-out of vaccines; no more freedom of choice. Last I checked, us humans don’t like the government putting laws on our bodies. More and more families in California are choosing to home school their kids to get around the law, and others are moving out of state altogether.
But the bad news might bleed across state lines, as a handful of legislators (not to mention every pharmaceutical company) are pushing to pass similar laws in other states. The only loophole to the law in California is to have a doctor sign a medical exemption. Dr. Bob Sears, a pediatrician in Orange County, was signing such exemptions. He may soon lose his license to practice medicine. That has doctors in other states spooked. So more and more pediatricians are toeing the party line, even when their conscience tells them to do otherwise.
I’m pleased to say that the medical students nailed their exit examinations last week. They were polite, pleasant, and made contact with their patients. They explained their proposed game plans, outlined the rationale for those plans, talked their patients through the risks and benefits, and then asked the patient how he or she would like to proceed. They did great.
But my colleagues out in practice who support these mandatory vaccination laws? Need to go back to medical school.
Join me in protecting your medical freedom of choice.
Check out Oregonians for Medical Freedom, a grassroots coalition of parents, physicians, educators, and Oregonians from all walks of life who believe parents have a fundamental right to make informed medical decisions for their children.
This isn’t about being pro-vax or anti-vaxx. It’s about being allowed to make decisions about what is done to your body and to your child’s body. It’s about being able to ask questions about medical interventions without being bullied, ostracized, or having somebody call Child Protective Services (CPS). If laws about vaccines get passed, who is to say what other type of mandatory medical treatments will be imposed on us? Let’s keep medicine between doctors and patients, and may every patient have the right to informed consent.