Brabin Loretta, Roberts Stephen A, Kitchener Henry C
Academic Unit of Obstetrics & Gynaecology, Research floor, St, Mary's Hospital, Whitworth Park, Manchester, M13 0JH, UK.
BMC Public Health. 2007 Feb 9;7:20. doi: 10.1186/1471-2458-7-20.
The first vaccine to prevent human papillomavirus (HPV) and cervical cancer has been licensed, and in future, vaccination may be routinely offered to 10-14 year old girls. HPV is a sexually transmitted virus and some parents may refuse consent for vaccination. Under-16s in the UK have a right to confidential sexual health care without parental consent. We investigated parents' views on making available HPV vaccination to adolescent minors at sexual health clinics without parental consent.
This was a semi-qualitative analysis of views of parents of 11-12 year old school children collected as part of a population-based survey of parental attitudes to HPV vaccination in Manchester. Parents were firstly asked if they agreed that a well-informed child should be able to request vaccination at a sexual health clinic without parental consent, and secondly, to provide a reason for this answer. Ethical perspectives on adolescent autonomy provided the framework for descriptive analysis.
307 parents answered the question, and of these, 244 (80%) explained their views. Parents with views consistent with support for adolescent autonomy (n = 99) wanted to encourage responsible behaviour, protect children from ill-informed or bigoted parents, and respected confidentiality and individual rights. In contrast, 97 parents insisted on being involved in decision-making. They emphasised adult responsibility for a child's health and guidance, erosion of parental rights, and respect for cultural and moral values. Other parents (n = 48) wanted clearer legal definitions governing parental rights and responsibilities or hoped for joint decision-making. Parents resistant to adolescent autonomy would be less likely to consent to future HPV vaccination, (67%) than parents supporting this principle (89%; p < 0.001).
In the UK, the principle of adolescent autonomy is recognised and logically should include the right to HPV vaccination, but this may concern parents who would otherwise approve vaccination.
预防人乳头瘤病毒（HPV）和宫颈癌的首款疫苗已获许可，未来可能会常规性地为10至14岁女孩接种。HPV是一种性传播病毒，一些家长可能会拒绝同意接种疫苗。在英国，16岁以下青少年有权在未经父母同意的情况下获得保密性健康护理。我们调查了家长对于在性健康诊所为青少年未成年人提供未经父母同意的HPV疫苗接种的看法。
这是一项对11至12岁在校儿童家长看法的半定性分析，该调查是曼彻斯特一项基于人群的家长对HPV疫苗接种态度调查的一部分。首先询问家长是否同意一个充分了解情况的孩子应该能够在未经父母同意的情况下在性健康诊所要求接种疫苗，其次，请他们给出这样回答的理由。关于青少年自主权的伦理观点为描述性分析提供了框架。
307位家长回答了这个问题，其中244位（80%）解释了他们的看法。观点与支持青少年自主权一致的家长（n = 99）希望鼓励负责任的行为，保护孩子免受消息不灵通或偏执的家长的影响，并尊重保密性和个人权利。相比之下，97位家长坚持要参与决策。他们强调成年人对孩子健康和指导的责任、父母权利的削弱以及对文化和道德价值观的尊重。其他家长（n = 48）希望有更明确的关于父母权利和责任的法律定义，或者希望共同决策。抵制青少年自主权的家长未来同意HPV疫苗接种的可能性（67%）低于支持这一原则的家长（89%；p < 0.001）。
在英国，青少年自主权原则得到认可，从逻辑上讲应该包括HPV疫苗接种权，但这可能会让原本会同意接种疫苗的家长感到担忧。
