The International Academy of Biological Dentistry and Medicine respects and upholds the right of every individual to make their own health decisions – and decisions for their children’s medical and dental treatment – based on the fundamental ethical concept of informed consent.
Consequently, we also acknowledge the responsibility of physicians, dentists and other health care providers to educate their patients as to both the risks and benefits of any treatment being considered or recommended.
While we believe in the importance of public health as a social good, too often, measures cross the line and infringe upon the right of informed consent. Fluoridation is one such measure. Mandatory vaccination is another.
The Academy acknowledges that while there may be a role for vaccines in some instances, each individual retains the right to say yes or no to this intervention, and to what extent they wish to participate. This right does not infringe upon anyone else’s right to vaccinate their child or themselves. (While those in favor of mandatory vaccination often cite the concept of “herd immunity” to justify their position, epidemiological and other scientific data and research convey that this is a flawed concept at best.*)
Through the recent furor over measles cases traced to Disneyland, we have grown concerned by the bullying directed at parents, physicians and others who earnestly question – based on scientific inquiry, empirical evidence and principle – the wisdom of vaccination as it is currently practiced in this country; by the demonization of those who have chosen to vaccinate selectively or not at all; by the rush to introduce new legislation that would pit the right of informed consent against access to education and full participation in public life.
Though ostensibly expressed in the spirit of public health, the current rush to force vaccination may in some cases detract from health. For instance, parents may be afraid to seek medical care for a child in need because of their vaccination status or may not fully disclose that status for fear of forced vaccination or denial of treatment.
We have no doubt that those who express concern over unvaccinated or partially vaccinated children have good intentions and the well-being of families at heart – just as those who choose to not vaccinate fully do. We are confident that members of both groups are sincere and following their conscience.
Too often, vaccines are presented as a perfect intervention, with no side effects worth considering – though even the Institute of Medicine has indicated that there are significant gaps in the research on cumulative effects of vaccines as they are administered today.
Science is not an unchanging body of facts. It is a process of discovery, producing an ever evolving understanding of the world and the environment it exists within. Rigorously questioning what we already know is one of the primary ways knowledge expands.
This concept of informed consent is well defined in the AMA Code of Medical Ethics, which all would do well to respect in light of current vaccination battles:
The patient’s right of self-decision can be effectively exercised only if the patient possesses enough information to enable an informed choice. The patient should make his or her own determination about treatment. The physician’s obligation is to present the medical facts accurately to the patient or to the individual responsible for the patient’s care and to make recommendations for management in accordance with good medical practice.
Importantly, it is not the practitioner’s right to make the choice – let alone legislators or voters. It is the patient’s or, in the case of a child, his or her guardians’. As health care providers, we may not always agree with the choices patients make, but we honor their right to make them upon hearing all pertinent information about the proposed intervention, risks and benefits alike.
* A good summary of this issue is presented for general audiences here. A more detailed discussion with references is here.