Division of Infectious Diseases, Department of Pediatrics, Nemours Children's Hospital, Orlando, Florida.
Department of Pediatrics, University of Central Florida College of Medicine, Orlando, Florida.
Pediatrics. 2016 Oct;138(4). doi: 10.1542/peds.2016-1597. Epub 2016 Sep 2.
One of the most divisive issues in pediatrics today concerns the proper response by pediatricians to parents who refuse routine childhood immunizations for their children. Many pediatricians refuse to care for such families. Others continue to provide care and continue to try to convince parents that the benefits of immunizations far outweigh the risks. Two of the most powerful arguments in favor of dismissing such parents are as follows: (1) their refusal suggests such lack of trust in the physicians' recommendations that it undermines the basis for a meaningful physician-patient-parent relationship; and (2) unimmunized children present an unacceptable risk to other children in the physicians' waiting rooms. This article examines those arguments.
如今,儿科学领域最具争议的问题之一是儿科医生应如何回应拒绝为孩子进行常规儿童免疫接种的家长。许多儿科医生拒绝为这类家庭提供医疗服务。而另一些医生则继续提供医疗服务,并继续试图说服家长,免疫接种的好处远远超过风险。支持解雇这些家长的两个最有力的论据如下:(1)他们的拒绝表明对医生建议缺乏信任,从而破坏了有意义的医患家长关系的基础;(2)未免疫接种的儿童会给医生候诊室中的其他儿童带来不可接受的风险。本文将对这些论点进行探讨。