Patient Autonomy Versus Public Safety

injectionGovernor Jerry Brown signed Senate Bill 277 into law this week requiring school children to be vaccinated to enter public or private school.  Disappointingly, I hear some Sacramento area physicians elated at the signing.  I believe this to be dangerously close to a violation of the principle of patient autonomy.  The principle of patient autonomy is a pillar of medical bioethics.  It means allowing patients to make their own decisions regarding the use of healthcare.  It is not to be superseded by the principle of beneficence, or the principle of doing what is best for the patient’s health.  I believe requiring vaccines is in the best interest of the health of the children of the state of California.  I also believe that this act also comes terribly close to violating the autonomy of those children’s families.  Some argue that the families have complete freedom to choose to not vaccinate, but taking away the right to attend school would be counted by many as coercion.


Kara SchoolThat is not to say that I am completely innocent of similar action.  We direct families to seek medical care from another provider if they intend to not vaccinate their children as we advise.  I see finding another doctor in town a much easier task than educating children without being allowed to go to ANY school.  My preference would be to be able to convey my understanding of the benefit of vaccination compared to the danger of disease, but Hank Green provides an excellent explanation of why this task is difficult and sometimes impossible.  Hopefully people will be open to considering if their trusted source of information may not be accurate and looking deeper into the evidence as they reassess their position on vaccination.

Mark Vaughan, M.D. is the Medical Director and founding member of the Auburn Medical Group, an independent Family Medicine practice in Auburn, California. He speaks on general medical topics on the Auburn Medical Group YouTube Channel. His handle for Twitter and Instagram is @doctorvaughan.

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