Wood-Harper Janice
School of Community Health Sciences and Social Care, University of Salford, Greater Manchester, M6 6PU, UK.
Nurs Ethics. 2005 Jan;12(1):43-58. doi: 10.1191/0969733005ne757oa.
The recent decrease in public confidence in the measles, mumps and rubella vaccine has important implications for individuals and public health. This article presents moral arguments relating to conflicts between individual autonomy and collective responsibilities in vaccination decisions with a view to informing and advising health professionals and improving the effectiveness of education policies in avoiding resurgence of endemic measles. Lower population immunity, due to falling uptake, is hastening the need for greater public awareness of the consequences for the population. Vaccination refusals go hand in hand with responsibilities owed to future generations and society in not knowingly contributing to preventable harms. Issues such as parents' rights are considered and balanced against: collective responsibilities for public health; permissibility of 'free-riding'; conflicting duties of health professionals; and possible enforcement of vaccination. It is suggested that the arguments may form a persuasive tool for the practice of health professionals involved in informing and supporting parents' vaccination decisions.
近期公众对麻疹、腮腺炎和风疹疫苗的信心下降,这对个人和公共卫生具有重要影响。本文提出了与疫苗接种决策中个人自主权和集体责任之间冲突相关的道德论据,旨在为卫生专业人员提供信息和建议,并提高教育政策在避免地方性麻疹卷土重来方面的有效性。由于疫苗接种率下降导致人群免疫力降低,这加速了提高公众对其对人群后果认识的必要性。拒绝接种疫苗与对后代和社会应尽的责任密切相关,即不能在明知的情况下造成可预防的危害。文中考虑了诸如父母权利等问题,并与以下方面进行权衡:公共卫生的集体责任;“搭便车”的可允许性;卫生专业人员相互冲突的职责;以及可能的疫苗接种强制规定。有人认为,这些论据可能会成为一种有说服力的工具,帮助参与为父母的疫苗接种决策提供信息和支持的卫生专业人员开展工作。