Informed Consent and Public Health
The Case of Childhood Vaccination
Informed consent, which is primarily aimed at encouraging individual patients and subjects of scientific research to make autonomous decisions, and public health measures, such as compulsory vaccination against infectious diseases, the successfulness of which implies harmonized administration of vaccines to a broad population, seem to be irreconcilable opposites at first glance. This paper deals with investigating whether these opposites can reconcile or whether informed consent can be applied in the field of public health. The first part of the paper provides a short overview of the main features of informed consent and its relevance in treating individual patients. The second part of the paper tackles the issue of immunization. If not provided with consent of their patients or having a legal obligation, physicians are believed to interfere with the bodily integrity of other people when conducting vaccination and their act can be deemed as an assault and entail non-pecuniary damage compensation. Herd immunity as a “public good” can only be achieved if all people are equally subject to public health measures. At this point, the key question is if informed consent and appertaining freedom of decision-making represent a threat to the accomplishment of this public health goal.
This question should truly be answered since vaccination may, though rarely, bring to medical complications, which may then lead to high treatment costs, loss of income and extremely rare, to death. The purpose of this paper is to demonstrate that disclosure of the risks and benefits of immunization within the framework of public health programmes could contribute to putting the fundamental bioethical postulates into practice: establishing and fostering mutual trust between physicians and their patients, which can, in the end, contribute to a higher immunization rate of a population Keywords: informed consent, compulsory vaccination, trust, public health policies, public good.
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