Non Medical Exemptions

When the children are incapable, nurses have moral responsibility to assist parents in decision making in the children's best interest. "Substituting an adult judgement of what is in a child’s best interest is not necessarily equivalent with the child’s best interest (Coyne and Harder, 2011)." Acting in a child’s best interest requires parents and health professionals to take children's view seriously and give priority consideration to the impact of their decisions on children (Canadian Coalition for the Rights of Children (CCRC). The adults have responsibilities towards their children to enable them in making decision but they do not have rights to make decision for their children (Lowden, 2002). Children should not be viewed as property. The first step in protecting the rights of children as outlined in the CRC is to view them as citizens (Van Daalen-Smith, 2010). When parents claim that the child belongs to them, they are establishing an ownership notion. Children should be respected as active contributor not as passive recipient of the health care (Maconochie and McNeill, 2010). Therefore, parental role in decision making for their children should be complementary not

Throughout the article, Hendrix evaluates the possible arguments of parents who turn down opportunities to vaccinate their children and later discusses methods to evoke better communication. For example, Hendrix states, “Some parents do invoke the herd immunity argument as a reason not to vaccinate, suggesting that it is unnecessary that they expose their child to the risk of side effects from vaccination if everyone else is vaccinated to a level that prevents the spread of illnesses” (2). While her stance calls for policymakers and health officials to consider the reasoning behind parental opposition to vaccinations, she also refutes

I would be sure to take in consideration the parents' choice of treatment, when acting as the patient's guidance consular, but the deciding factor is what values and treatment fits best with patient and not with what the parents decide. As the primary physician, I would make sure to allow the patient to discuss and make their decision in privacy with me. Giving the patient more autonomy without the persuasion form their parents. I am not saying as a physician that the parents do not have a say in what their son or daughter decides, but I would like to give the patient opportunity to think about their values and possible treatments without the over shadowing of their parents. I would like to allow the patient to make their decision in private after some guidance from me as a physician's stand point and

Although many people do not vaccinate for religious reasons, that does not mean they will be protected by their close communities and close relationships and religion. Many outbreaks are centraled in geographic areas and tight-knit communities that have many people that share the same values and beliefs. For example, in Texas, a megachurch voiced vaccination concerns and all believed that it was not safe to vaccinate (Silverman, 2013). They were convinced that the MMR vaccine did cause autism. There were many families that were part of the church that had a history of autism in their family, and did not want to chance it. So instead of asking for a different schedule of vaccines and not bundling the MMR, the families and others opted out of the MMR vaccine entirely (Silverman, 2013). A visitor came to the church, after being in Indonesia, and, unknowingly, was carrying measles. When people that had not been vaccinated were exposed, their bodies could not fight it off and a breakout of measles overtook the church (Silverman, 2013). After that incident, the church began holding seminars and conferences that explained the importance of vaccines and why vaccines are safe, for their members. (Silverman, 2013)

Wombwell, Eric, et al. "Religious Barriers to Measles Vaccination." Journal of Community Health, vol. 40, no. 3, June 2015, pp. 597-604. EBSCOhost,

Informed consent is the “process by which patients are informed of the possible outcomes, alternatives, and risks of treatments and are required to give their consent freely” (Burkhardt & Nathaniel, 2013, p. 528). Informed consent is a right given to the patient that provides an opportunity for the patient to actively participate in their own healthcare. But when it comes to the pediatric population, children are not guaranteed this right. While children are often allowed to voice their opinions during the informed consent process, this does not assure that the parents and healthcare professionals will take the children’s opinions into consideration. Parents are held accountable to provide the legal informed consent for their children and this can raise ethical and legal issues for nurses when they act as the patient advocates for the children in their care. This begs the question, ‘are children capable of participating in the decision making process of their own informed consent?’

Vaccination has been implemented into modern medicine throughout years to help prevent the spread of diseases, halting some completely. Though, in recent years, the resistance to vaccinations is growing and many affluent, well-educated communities now have high percentages of unvaccinated children (Allen). Guardians, concerned with their children’s health if they get vaccinated, are not realising the risk they are taking by denying their child proper medical care. With the amount of individuals deciding to refuse vaccinations, the possibility of deadly diseases that have been reduced or eliminated, such as, polio or chickenpox increases. However, this does not stop anti-vaccinators from choosing to opt out of getting the vaccines,

Immunization is the method whereby a person is made immune or impenetrable to a transmittable disease, usually by the supervision of a vaccine. Vaccines fuel the body's own immune system to guard the person against consequent contagion or disease. There is indication of an upsurge in vaccine refusal in the United States and of environmental gathering of refusals that results in epidemics. Epidemics of a vaccine-avoidable disease often starts amongst the people who rejected vaccination, spread promptly within unvaccinated inhabitants, and also spread to other subpopulations. The key motives for vaccine rejection in the United States are parental insights and apprehensions about vaccine protection and a low level of concern about the danger of many vaccine-preventable viruses. If immense benefits to humanity from vaccination are to be upheld, improved efforts will be desired to instruct the community about those advantages and to upturn public sureness in the systems we use to display and guarantee vaccine protection.

In relation to this, the mandating of vaccinations in specific jurisdictions is usually based on an assessment of the risks to the public health posed by certain infections and diseases. Whilst designing national immunization programs, ‘herd community’ is a concept often used as a basis for vaccines. This suggests that when vaccinated, you are immediately protected from the disease. What is more, it also serves in protecting others who are not vaccinated. This does not infer that everyone needs to be immunized in a given population in order to protect that population (Berger, 1999). As long as there is sufficient amount of children being immunized against each of these

Vaccinating children will prepare their immune systems, and themselves, for the unexpected, as there have been recent outbreaks of measles and whooping cough. These two vaccine-preventable diseases were thought to have been eradicated, and article “Anti-Vaccine Movement Is Giving Diseases a 2nd Life”, featured in USA Today, records that these diseases were spread to those who were not vaccinated through others traveling to the United States from a country where the diseases is still greatly present (Alcindor). Parents choosing not to supply their children with immunizations have the ability to begin the breakout of a serious disease, as they are not armed with an immunity to the disease, and have the potential to spread it to others who are not vaccinated. Providing children with vaccines not only benefits the individual, but the community as a whole. Some parents who follow the trend of not vaccinating depend on herd immunity, which is the term used by Haris, Hughbanks-Wheaton, Johnson, and Kubin, in an article featured in Teaching and Learning in Nursing, for the idea that immunizations rate found within a community are high, ranging from eighty to ninety-five percent (Harris et al. 126). Herd immunity presents parents who do not vaccinate their children with a false sense of security, as they believe this tactic is enough to protect their children, not seeing the necessity in immunizing with vaccines.

It is true that parents have a significant role in making the decision for their children, and the doctors have a duty to consider the parents’ opinion. However, parents’ wishes can be overridden if their point of view is detrimental to the health of the child. The doctors are also empowered to make the decision on the issue of ethical consideration when the parents’ choice seems harmful to the child’s health (McDougall, 2016). In this case, Mike’s decision is irrational, so the doctor should do what is right for the child. Given that the delay in treatment has led to the deterioration of the child 's health, it is not ethical for the doctor to let the child suffer due to lack of medical attention on the premise that the parent believes a miracle will heal him. Since religion believes that every life is important (“Principles of Medical Ethics,” 2017), the doctor should use his ethical consideration to do what is right for the child and override Mike’s decision to wait for the miracle to heal James.

Specifically, newly proposed legislation to a 60-year-old comprehensive immunization policy aimed at removing the exemption for firmly held religious beliefs is central to the debate. Secondly, there’s concern about legislation allowing parents to exclude their child(ren) from vaccination based on a personal objection. The current policy affording

The sociocultural influences that shaped perceptions of autism also shaped how families interpreted autism symptoms as something unrelated to a health concern (Mandell & Novak, 2005). The difference in diagnosis times and perceptions of autism can be tied to diverse cultural backgrounds (Ratto, Reznick, & Turner-Brown, 2016). Interestingly enough, Mandell and Novak also pointed out that certain minority groups were actually more hesitant than white families to accept a teacher’s advice about their child’s appeared symptoms (2005). This may have been due to the fact that the child’s symptoms may not have strayed from what that particular cultural group viewed as “normal” or did not conflict with the behaviors they most valued (2005).

The sociocultural influences that shaped perceptions of autism also shaped how families interpreted autism symptoms as something unrelated to a health concern (Mandell & Novak, 2005). The difference in diagnosis times and perceptions of autism can be tied to diverse cultural backgrounds (Ratto, Reznick, & Turner-Brown, 2016). Interestingly enough, Mandell and Novak also pointed out that certain minority groups were actually more hesitant than white families to accept a teacher’s advice about their child’s appeared symptoms (Mandell & Novak, 2005). This may have been due to the fact that the child’s symptoms may not have strayed from what that particular cultural group viewed as “normal” or did not conflict with the behaviors they most valued (Mandall & Novak, 2005).

Parents hesitant to vaccinate their children may seek exemptions from state vaccine mandates. Recent outbreaks of vaccine-preventable diseases in the United States have drawn attention to this epidemic. Vaccinations coverage may be increased by schools fully implementing State kindergarten vaccination laws, and by providers assessing children’s vaccination status at every clinic visit, and administering missed vaccine doses. While vaccine acceptance remains high in general, fear of vaccines has grown dramatically in many developed countries. In some communities, this fear has led to significantly increased rates of vaccine refusal which are associated with increases in illness and death from vaccine-preventable diseases, and large economic costs