Ethics and Law: Should Parents Have a Right to Refuse Vaccination and Immunization of Their Children?

This paper investigates the reasons because of which parents refuse to provide vaccination to their child, concerns of parents related to immunization safety, and also their source of information. It also highlights the rights of children’s to get vaccination and best standards of health.

Running Head: Ethics and law 1
Ethics and Law

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Executive Summary:
Number of controversies arose in relation to immunization safety and these controversies results
in the refusal made by the parents in context of vaccination of their children’s. This paper mainly
investigates the reasons because of which parents refuse to provide vaccination to their child,
concerns of parents related to immunization safety, and also their source of information. This
paper also highlights the rights of children’s to get vaccination and best standards of health.
Whether vaccination is voluntary or compulsory, this question includes difficult ethical
perspectives and best interest of the child. It must be noted that the most important measure
which prevent the infectious diseases is the vaccination and immunization. It is very important
for boosting the immunity system of the human body by motivating the body to generate
antibodies for fighting with different diseases. Vaccination is considered as deferral of weakened
live or it finishes the microorganisms which are administered for the purpose of boosting
immunity.

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Contents
Executive Summary:....................................................................................................................................2
Introduction:...............................................................................................................................................4
Ethical perspective related to medical practice:..........................................................................................5
Utilitarianism theory................................................................................................................................5
Deontology theory:..................................................................................................................................5
Virtue Ethics:...........................................................................................................................................5
Basic Principles of Medical ethics:...........................................................................................................6
Autonomy:...........................................................................................................................................6
Non-Maleficence:................................................................................................................................6
Beneficence:........................................................................................................................................6
Justice:.................................................................................................................................................7
Legal perspective related to medical practice:............................................................................................7
Parent’s right related to their children’s vaccination:.................................................................................8
A child’s right to health services:.................................................................................................................9
Solutions and guidelines adopted to resolve this issue:............................................................................10
Conclusion:................................................................................................................................................10
References:................................................................................................................................................11

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Introduction:
This section defines the meaning and importance of vaccination and immunization for the
children’s and human body. It also states the different aspects of vaccination and immunization
in children’s from medical point of view. This part further includes the structure of the paper.
Vaccines play most important role in reducing the infection among the population, as they are
considered as important weapon for fighting against the diseases such as because of the
vaccination programs various diseases are eliminated and it is difficult to find these diseases in
the children like smallpox, polio palsy, diphtheria complications, or death and brain damage
from measles. This can be understood through example, 1 in every 200 polio infections result in
irreversible paralysis, and from these paralyzed children’s almost 5-10% are died when their
breathing muscles become immobilized. There is no medicine for polio, and it can only be
prevented (World Health Organization, 2013). One more example is there, diphtheria
vaccinations is very important for patients because even with treatment, almost 1 out of 10
diphtheria patients dies because of the airway blockage, myocarditis, or severe pneumonia with
respiratory failure (World Health Organization, 2014). It must be noted that the most important
measure which prevent the infectious diseases is the vaccination and immunization. It is very
important for boosting the immunity system of the human body by motivating the body to
generate antibodies for fighting with different diseases. Vaccination is considered as deferral of
weakened live or it finishes the microorganisms which are administered for the purpose of
boosting immunity. Immunization movement of the childhood witnessed highly success from
last few years (Pollard, 2007). However, public shows their concerns over the safety and
accuracy of the vaccines and ask number of questions in this context.
Vaccination protects the children from serious illness and it is more important in case of
children’s, as vaccine protect the children’s from different diseases such as paralysis of limbs,
hearing loss, convulsions, brain damage, and death. It is the right of every child to get best
standard of health and vaccinations so that they get protection from various infectious diseases.
However, in some cases parents refuse to get their children’s vaccinated because of different
believes they hold (Vaccine Information, n.d.). This paper discusses the question “Should
parents have a right to refuse vaccination and immunization of their children? Discuss this
position from an ethical and legal perspective”. Structure of this report includes ethical & legal

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perspective related to medical practice, Parent’s right related to their children’s vaccination,
child’s right to health services, and solutions and guidelines adopted to resolve this issue. Lastly,
paper is concluded with brief conclusion which highlights all the key points of this report.
Ethical perspective related to medical practice:
Medical ethics is considered as a framework of moral principles which apply ethical values and
standards in context of medical practice. Medical ethics is mainly based on the values and
standards that medical professionals must follow while practicing and used as guide in those
cases which result in confusion. These values also include the respect for autonomy, non-
maleficence, beneficence, and justice (Furler & Palmer, 2010). These values allowed the medical
practitioners and care providers to create a treatment plan and ensure best services to their
patients and community. This section defines the ethical values and ethical standards conducted
in the medical practice, and it also correlate the different ethical theories with the practices
conducted in medical profession such as Utilitarianism, Deontology, virtue ethics, autonomy,
Non-Maleficence, Beneficence, and justice. This section also states the ethical code of conduct
for medical practitioners and basic principles of medical ethics. As stated by Bayer (2007), ethics
are considered as set of principles, rules, values or ideologies guiding which mainly provide the
guidance to the particular group of people. Medical ethics includes the application of moral
values and codes to the practice of medical by the professionals of medical field. Ethics in
context of medical field guide the medical practitioners in context of legal and ethical issues
which they encounter while performing their duties (BMA, 2018). Medical profession is
considered as the most honest profession and various authorities set the ethical code of conduct
for medical professionals. In case of children’s and young people, following are the basic
principles set by the UK:
 If it is possible then parents or guardians of the children or young people must be
informed fully about the care and treatment get by the children or young people.
 Health professionals must act as the advocates of the children or young people.
 Health professionals must provide their professional advice to the parents and guardians
of the children and young people, and in case children’s have their views and wishes then

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it must be taken into account while providing care and treatment for promoting the
welfare of children and young people.
 Professional must be the individual who provide consents to treatment when they are
competent to do so.
 Must take decisions with the consent of the other family members, especially parents of
the children and young people.
 Must remain the information of the patient confidential unless some exceptional reasons
are present which required to breach the confidentiality.
Various theories of ethics deal with the medical profession and relationship between them are
stated below:
Utilitarianism theory:
This theory is normative in nature and considers the right and wrong on the basis of the
consequences of the action, which means if consequences of the action are better as compared
to bad then action is good. This theory does not consider the intention of the person who is
conducted the action, but it only analyze the result of the action conducted by the person which
means if result of the action is more good as compared to the bad then such action is right and if
result of the action is more bad as compared to good then such action is wrong. It is necessary to
understand that basic principle related to public health is utilitarianism (Holland , 2007). This
happen because the main aim of ensuring public health is the advantage it provided to the people
by ensuring protection and promotion of their general health and happiness.
Deontology theory:
This theory mainly focuses on the rightness and wrongness of the action itself, instead of
rightness and wrongness of the consequence of the action. As stead by kant, action is considered
as right action if obliged the moral rules (Bredeson, 2012). In this author focus on the duty of the
person which means if person fulfills the duty then such person is conducting right action and if
person does not fulfill the right action then such action is wrong, and result of the fulfillment of
duty does not considered. This theory is considered as the ethics of duty in which morality of the
action depends on the nature of the action. Decision related to the deontology considered as
appropriate theory from individual point of view but it does not produce good results for the

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society. It must be noted that relationship between doctor and patient is by nature, and this
tradition is recognized by the medical teaching practice and whenever this theory is breached it is
considered as the medical negligence arises (Mandal, ponnambath, Parija, 2016).
Virtue Ethics:
Virtue ethics is considered as the approach to ethics that mainly consider the character of
individual as the most important factor of the ethical thinking, instead of the acts themselves or
their results. This theory based on the temperament of the person (Brenkert & Beauchamp,
2010). Virtue ethics is considered as important source of public health as it is mainly used for the
purpose of justifying the initiatives taken by the health policies (Holland, 2007).
Basic Principles of Medical ethics:
There are number of authors who stated that ethical nature in context of medical practices is
completely against the principles defined by Non-maleficence, Autonomy, Justice and
Beneficence (Beauchamp & Childress, 2013). All these factors mainly introduce the framework
for purpose of defining principles of medical ethics.
Autonomy:
Autonomy is considered as the ability to determine self-rules which are completely free from the
limitations or interference of other person. This factor stated that person follow its own rules no
matter whether he/she is aware about the consequences of their decisions or not. In context of
children’s health they are not able take their own decisions because of the lack of capability on
the grounds of their age. It must be noted that adults are capable to take their own decisions
related to healthcare and their children’s health. In number of cases, it is considered that the
parents stand in the best position to determine the rights of their child’s. In some cases conflicts
between what a physicians would consider in the best interest of the child and what parents
believes (Parsapoor, Parsapoor & Razaei, 2014).
Non-Maleficence:
Essence related to this principle is that any person cannot cause harm to the patients
intentionally, which means duty is imposed on medical practitioners to ensure that they never use
any such treatment which injured their patients purposefully (Dickenson, 2010). This principle is
included in the code of conduct of medical practitioners. The duy of doctors related to this

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principle does not stop at the duty of of not causing any harm to the patients but also under duty
not to impose any risks of potential harm to the patient. However, these rights are not abssolute
in nature and is subject to the balance of harm and also the benefits of the treatment in question
(Sundean, 2013).
Beneficence:
This principle defines the action of mercy, kindness, humanity. In other words, acting in such
manner which results in good for others and it is considered as the moral duty of the person to
act in the best interest of another person. This principle provides guidance to the person to
achieve the interest of other person and in lieu of medical practice achieve best health for their
patients. This principle imposed duty on all the medical practitioners to do right thing for their
patients and act in the best interest of their patients. This challenge lies in balancing the rights of
the patients for the purpose of making their own decisions and remain autonomous, and
obligations of the medical practitioners to perform their duties (UCSF, n.d.).
Justice:
As per this principle, equals must be treated equal and unequal must be treated unequally. It must
be noted that it is very difficult and there is no criteria to determine whether two individuals are
equal or unequal. In context of medical profession, there must be equal treatment for all the
patients. In other words, distribution of resources in context of healthcare must be similar
(Alzheimer Europe, n.d.).
Legal perspective related to medical practice:
Vaccination of children is considered as the prophylactic intervention in the healthy children, and
this is considered as biggest reason of parents to oppose the vaccination of their children.
Vaccination of children’s in UK is not compulsory and this provision has documented side
effects. Although parents have duty to act in the best interest of their children, and it is seemed
that they repeat their autonomy if they made choice not to vaccinate. In general situations,
vaccinate is not enforced if both the parents agreed. However, Court possesses the power to
intervene if parents do not agree. From the point of view of medical practitioners, in these cases
favoring the vaccination are considered as offset potential, emotional and parenting factors.
Generally, parents oppose the vaccination in context of negative effects of the vaccination. It is

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necessary to establish the assessment of competence for the purpose of ensuring the potential risk
of both non-vaccination and vaccination in terms of child’s health (wearmouth, 2014). Following
are the Acts which define the legal provisions related to the child’s vaccination and
immunization:
 1840 Act- This Act defines provision related to the variolation, illegal, and providing
optional vaccination without any charge.
 1853 Act- this act made the provisions related to compulsory vaccination for all the
children’s in the first three months of their life.
 1867 Act- this Act extend the age of vaccination up to 14 months.
 1896 Act- in this Royal Commission issue the report and recommended that vaccination
ensure protection against the smallpox and this report end the penalties in context of non-
compliance.
 1898 Act- this act remove the penalty in case of non-compliance and provide power to
the parents to get exemption if they believe that vaccination is not effective for their
children (Minisry of Ethics, n.d.).
Government of UK takes various actions in promoting the vaccination and immunization of
Children’s for the purpose of ensuring protection to the children’s from infectious diseases. UK
adopt the concept of working together to safeguard the children’s, and with this intention
government provide national framework within which all the local and national agencies and
professionals agree to work together in their own ways for the purpose of safeguarding and
promote the welfare of their children. This can be understood through example, concept of
working together to safeguard the children’s, was introduced by the government and in this
government of UK intends to provide national framework within which all the local and national
agencies and professionals agree to work together in their own ways for the purpose of
safeguarding and promote the welfare of their children such as section 10 of the Children Act
2004 states that each local authority must make necessary arrangements for the purpose of
promoting the co-operation between the authority and their relevant partners, and also with the
other bodies for working with the children in the area which fall under the authority of local
bodies (Children Act 2004). Arrangements made by local bodies must be of such nature as they
ensure the children’s well-being in the area of authority. Arrangements made by local bodies

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must be of such nature as they ensure the children’s well-being in the area of authority. This
section defines the legal guidelines related to the medical practice, and it also states the relevant
act and related provisions for the children’s health and rights. This part also defines the
vaccination and immunization management in UK.
Parent’s right related to their children’s vaccination:
Almost 3 decades ago, WHO prescribed the option of vaccination and immunization for the
purpose of controlling the diseases among the students such as tuberculosis, diphtheria,
whooping cough, polio, tetanus, and measles (WHO, 2005). As per this prescription of the
WHO, at least 95% of the children in the world should be vaccinated. This part of the paper
defines the right of the parents on their children’s, and what rights parents have in context of
private life and family (UNICEF, 2017). As stated above, parents possess the power to refuse the
vaccination of their child. However, court also possesses power to intervene in this right of
parents. In case law C v A (A Minor) [2011] EWHC 4033 (Fam), Court stated that concerned
children must receive immunization against the wish of other mother because it was appropriate
to age and also in context of medical practitioner recommendation. In context of mother’s right
under Article 8 of the ECHR, it is necessary to balance this right against article 24 of the United
Nations Convention on the Rights of the Child which provide right to the child to get highest
attainable standard of health. This article also imposes obligations on parties and state to ensure
complete implementation of this right which also includes taking necessary measures to deal
with the diseases.
It must be noted that there is immense decrease in the number of vaccinated children’s because
of the strong anti-vaccination lobby, lack of doctor’s responsibility, and lack of awareness
among the parents in this context. Immunization is considered as the most important and most
effective measure of preventing diseases at primary stage. If children’s get the vaccination at
initial stage then it is very helpful to prevent the infectious diseases, complications, hospital
treatment and deaths (English, 2017; NHS, n.d.).

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A child’s right to health services:
Article 24 of the United Nations Convention on the Rights of the Child provide right to the child
to get highest attainable standard of health. As per this Article, Children’s have right to get good
quality of healthcare and also the best possible healthcare such as safe water for drinking,
nutritious food, a clean and safe environment, and information to help them stay healthy. In other
words, vaccination is the basic right of children because it helps the children’s to fight against
the infectious diseases (UNICEF, 2018). In UK, vaccination and immunization is optional, but
generally health visitors appointed by government visits the once home for the purpose of giving
advice on the issues related to the vaccination. In actual, the Vaccination Act of 1853, had made
the vaccination mandatory for the children’s below than 3 months in context of smallpox, and
those parents who fail to comply with this mandatory requirement were subject to fine and
imprisonment. In this context, government also made amendment in the period of 1867, and as
per this amendment children’s below 14 months must get vaccination on mandatory basis and
also include penalties in case of non-compliance. Subsequently, on more amendment is made
under the law and as per this amendment parents must get right to object the vaccination of their
children’s if they feel that vaccination is not safe for their children (vaccination Act 1853). This
happens because of the distrust of the public in the intervention made by the government on the
children’s healthcare.
In UK, vaccination and immunization is optional, but generally health visitors appointed by
government visits the once home for the purpose of giving advice on the issues related to the
vaccination. This happens because of the distrust of the public in the intervention made by the
government on the children’s healthcare. This section defines the rights provided by government
and other regulatory bodies to the children’s in context of health services. In this we discuss
whether children’s have right related to the higher standard of health.
From ethical point of view also, children’s hold right to get best healthcare services. Compulsory
vaccination includes the principles of the utilitarianism and deontology theory which mainly
promotes the goods and happiness of the society as a whole. Additionally, it also reflect the
element of beneficence and justice to the society by conducting their actions in such manner as it
ensures best interest of the children in the society. However, issue related to the compulsion
vaccination in context of ethics is that it breach the provisions related to the autonomy or self-

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determination. As stated above, children’s are not able to decide their good and bad and not able
to give their consent about vaccination, and at this time responsibilities of the parent’s come to
play. While exercising their autonomy, parents can decide whether their children need
vaccination or not. But this right of parent’s seems breach of right provided to child (Barbacariu,
2014).
Solutions and guidelines adopted to resolve this issue:
This part of the paper provides different solutions from ethical and legal perspective to resolve
this issue such as government must initiate programs under which health official aware the
parents about the importance of vaccines for their children’s health (Bower, Gask, May, Mead
2001), programs which ensure that each and every child in the UK get vaccination for preventing
the infectious diseases, government must introduce framework which ensure mandatory
vaccination for different diseases.
There are number of measures which can be used by the government for the purpose of resolving
the conflict between child right to get best health care and parent right to refuse the vaccination
of their child:
 Government can initiate awareness programs which help the parents to understand the
importance of vaccination and take more informed decision in context of their child
health. It must be noted that medical representatives are appointed for this program who
visit number of parents and teach them about the good and bad outcomes of the
vaccination and immunization.
 Government must introduce some strict laws which ensure compulsion vaccination and
relief should only provide in some particular cases where parents have justified reason to
refuse the vaccination (Bower, Gask, May, Mead 2001).
 Government can also take help from the schools where vaccination education programs
can be arranged for ensuring the healthcare rights of child.
Conclusion:
Conclusion includes all the ethical and legal perspectives related to the medical practice which
are discussed in the file. In other words, it includes both key points of this paper and also

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necessary recommendations for the readers. This paper discusses the rights of the parents in the
healthcare decisions of their children and also the rights of the government to interfere in the
healthcare matter of children’s reside in UK. This paper mainly describes the rights of the
children’s in lieu of getting highest standard of health care services. It also states the different
aspects of vaccination and immunization in children’s from medical point of view. After
considering the above facts, it can be said that most important measure which prevent the
infectious diseases is the vaccination and immunization. It is very important for boosting the
immunity system of the human body by motivating the body to generate antibodies for fighting
with different diseases. However, in some cases parents refuse the vaccination because of their
different believes and this give rise to different issues. Vaccination protects the children from
serious illness and it is more important in case of children’s, as vaccine protect the children’s
from different diseases such as paralysis of limbs, hearing loss, convulsions, brain damage, and
death. It is the right of every child to get best standard of health and vaccinations so that they get
protection from various infectious diseases. Right to get vaccination is the right of every children
and balance between these conflicts is necessary. It can be sad that both legal and ethical
perspectives give rights to children to get best healthcare services. Compulsory vaccination
includes the principles of the utilitarianism and deontology theory which mainly promotes the
goods and happiness of the society as a whole. It also reflects the element of beneficence and
justice to the society by conducting their actions in such manner as it ensures best interest of the
children in the society.
The main aim of ensuring public health is the advantage it provided to the people by ensuring
protection and promotion of their general health and happiness. It must be noted that relationship
between doctor and patient is by nature, and this tradition is recognized by the medical teaching
practice and whenever this theory is breached it is considered as the medical negligence arises.

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