There is nothing worse that being afraid that you, the responsible person, can harm a child or a vulnerably elderly relative by making the wrong decision on their behalf.

That fear has been raised to unprecedented levels over the subject of vaccine safety, with influential entertainers taking on the role of warning the public about the alleged dangers of childhood immunizations. They believe, although there is scientific proof to the contrary, that these immunizations cause autism.

Based on anecdotal information, it would seem that the alleged autism-vaccination link has added into general wariness of all vaccines, including the new one for the H1N1 pandemic flu. Although the Medpage Today story below does not touch upon this subject, it is clear that fears about what’s in pandemic flu vaccine and how fast it has been produced (”rushed” is the code word), mirror the childhood vaccination fears. Is that coincidence? No, at least one influential entertainer has put out statements against pandemic flu, too.

Back to the pediatricians.

Right now the American Academy of Pediatrics is meeting here in Washington, D.C. Medpage Today’s reporting from the meeting serves up some interesting information about a breach in the doctor-patient’s own decision-maker relationship.

Some pediatricians have decided that they have to take a stand on this issue even if that means “firing” parents, giving them written notice and 30 days to find another physician for their children.

It is not that they are unsympathetic to parents’ fears, so effectively fueled by famous names and the natural fears parents have about the child’s safety.

This is not a “control” issue but an ethical one.

The doctors believe it is right to protect children with vaccinations. It is their ethical obligation to protect their young patients.

• Some parents do not believe vaccinations are safe or necessary, no matter how much information is offered.

• One excellent book recommended by one of the experts quoted below is, “Autism’s False Prophets: Bad Science, Risky Medicine, and the Search for a Cure,” by Paul Offit, M.D.

• “Fight fire with fire. The antivaccine movement plays on parents’ sympathies by telling heartbreaking stories about deaths and illnesses in children. Marshall (see below) said he’s not above telling his own story about the child he encountered during his first rotation who was dying from Haemophilus influenzae type b, the leading cause of bacterial meningitis among children before a vaccine was developed,” says one presenter.

When all of these steps have been taken, if there still is not a meeting of minds between parent and physician, it is time for a change, some of these doctors say.

Parents have been over-sold on the risks. They seldom see the benefits of vaccinations.

This clearly is an issue which usually-gentle pediatricians have decided calls for a battle plan.

Medpage Today

“If parents refuse to vaccinate their children, it’s ethical and legal to dismiss the child as a patient, a pediatrician told attendees of the American Academy of Pediatrics meeting here.

“In the middle of treatment, you can’t just say, I’m done,” Gary Marshall, MD, of the University of Louisville (Ky.) School of Medicine, said during a session that addressed parental concerns about vaccinations and how pediatricians can respond.

“But if it becomes obvious that you and the family will never see eye to eye on a specific issue, there’s no reason not to “fire” them, providing you follow the steps necessary to avoid charges of abandonment. Those include providing written notice that you will no longer treat their children and giving them a set time frame — at least 30 days — to find another physician. (Emphasis added)

“Tampa pediatrician Marcy Baker, MD, said she has stopped seeing children because parents refuse to vaccinate them, and knows her colleagues are doing the same. (Emphasis added)

“We’ll work with them a little, but if they refuse to have the child vaccinated, we’ll discharge them,” she told MedPage Today after Marshall’s presentation.”

Source: Medpage Today, October 22, 2009

Source: Meeting presention, American Academy of Pediatrics, October 21, 2009, Washington, D.C.