Infant vaccination: a conflict of ethical imperatives?

Pywell, Stephanie M (2005). Infant vaccination: a conflict of ethical imperatives? In: Garwood-Gowers, Austen; Tingle, John and Wheat, Kay eds. Contemporary Issues in Healthcare Law and Ethics. Butterworth-Heinemann Ltd, pp. 213–232.


The mass vaccination of infants raises several issues of interest to medical ethicists. At an individual level it involves invasive clinical intervention on healthy patients who are too young to express their own views. At a societal level it concerns measures that most people view as being for the good of every member of the population. The purpose of this chapter is to consider the ethical conflict which arises, at least in theory, between the states duty to protect the health of its citizens and all patients’ rights to have their autonomy respected and their individual health regarded by their doctors as being above all other considerations.

The arguments draw, in part, on doctoral research conducted between 1997 and 20011. Because infant vaccination policy is formulated for the welfare of society as a whole, one objective of the research was to ascertain the effects of this policy on individuals. Two surveys involving written questionnaires were conducted: one was given to parents of young children who, it was expected, would have had a ‘normal’ experience of vaccination; the other was sent parents who believed their children had been harmed by vaccines. Both questionnaires received appropriate ethical approval. They are discussed more fully under the heading ‘Empirical Studies’.

It is recognized that the theoretical issues discussed in this chapter should not necessarily be determinative of public health policy and practice, but it is suggested that changes could be made which would achieve a better balance between the conflict described above.

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