Should Doctors be Allowed to Refuse Treatment if Parents Won’t Vaccinate? - Page 4 - Mothering Forums

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#91 of 105 Old 10-11-2012, 09:41 PM
 
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Originally Posted by MamaMunchkin View Post

By the way, in countries with universal health care - are there publicly-funded physicians?  How does it work?

In Australia most doctors are paid by a mixture of private and public funding although there are still the odd few who are fully govt funded. The way it works is that if you are low income or getting some type of govt pension then you have a health care card which means you pay nothing at the doctors and your Dr bills the govt. Anyone who is elegible for a Medicare card ( all Australian citizens) will get subsidised visits. So you pay out of pocket and then get a partial refund from the govt (sometimes this is processed at the Drs surgery or you can go to a Medicare office and get cash back or do it by mail). The amount you get back is a set amount and it is up to the Dr how much they charge above that. My GP charges about $65 for a standard visit and I get about $38 back. There are variations too - some antenatal visits are bulk-billed (ie govt pays for it all and I don't hand over any money) as are some follow-up visits for certain things. Many GPs will bulk-bill children under 5yo for all visits. My GP bulk-bills all children under 12yo. Some GPs will bulk-bill other health care providers although that seems to be getting rarer.

Specialists are a bit different. You can see specialists through the public system but the waiting lists may be long and you don't get to choose who you see. You can opt to see a private specialist and either pay out of pocket (usually a partial Medicare rebate) or, if you have private health insurance you will get most of your money back through them and Medicare depending on your level of private cover.

For example, I had my tonsils out privately. I paid $200 for the initial ENT consult, $400 excess for my hospital stay ( if we chose to pay for a higher level of private cover then I wouldn't have had to pay that) and, I think, about $400 for the anaesthetic fee. The ENT's fee for the actual surgery plus one follow-up visit in hospital and one follow-up visit in his rooms was about $1200 and was completely covered by my insurance + Medicare, I didn't pay for any of that. I could have had it done publically and it wouldn't have cost me a cent but the waiting list would have been much longer and I couldn't have chosen my surgeon.

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#92 of 105 Old 10-11-2012, 09:54 PM
 
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To answer the original question, no, I don't think doctors should have the right to terminate a patient based on vaccine refusal. I've seen the phrase "non-compliance with advice" a number of times on this thread. That idea blows the notion of informed consent/informed refusal out of the water. One of the basic principle of informed consent, in this country at least, is that if you refuse a particular treatment then the HCPs are not responsible for the outcome but not will it jeopardise the rest of your care. So, for example, if a patient has a wound and we say "ok, we think the best thing to do is wash it out, stitch it up, give you a course of X antibiotic and get you to come back every two days for review and redressing." If the pt says "I want the wound care but I refuse the antibiotics" then we still have to provide the best wound care. We also have to ensure that the pt understands what the potential risks of no antibiotics are and that they can change their mind at any point.

For doctors to start saying "you have to do what I recommend or I won't treat you anymore" is coercion and manipulation and has nothing to do with informed consent.

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#93 of 105 Old 10-12-2012, 06:25 AM
 
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Katelove, in Australia, is the ability to receive government-funded or government-subsidized health are, (or any other social service), contingent on vaccination status?

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#94 of 105 Old 10-12-2012, 06:39 AM
 
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Homeschooling laws are based on truancy laws in WA, and compulsory attendance laws apply, technically anyway.  Just nitpicking.

Really?  They passed a law here that you need a doctor's signature for public school exemptions?  I am so out of the loop....  that sucks.

ETA:  That's an interesting argument.  I'll have to mull that one over......
Not all preventative care practices are private practices.  Many are run by hospitals.  And yes, private hospitals.  There are many issues swirling around that, like our area hospitals and clinics under the umbrella of Providence, a private, Catholic entity (couldn't think of a better word--sorry!)  The other, a non-religious hospital, also runs clinics.  Our county hospital (publicly funded) has clinics.  My girls' HCP is a private practice.

I get it on the homeschooling front. innocent.gif I was just trying to pre-empt somebody saying, "Well, you could always homeschool." Forgive the rant, but it drives me crazy when vaccine skeptics say that in response to laws that attack exemptions. The fundamental right to informed consent should be available to every family, not just homeschooling ones. greensad.gif Anyway, I digress.

I'm arguing that whether they're in private practice or receive public funding, all doctors in WA and CA should be legally required to accept families regardless of vax status. These states have *forced* these families into paid, contractual relationships, and it hardly seems just to fore someone into a "service" that providers simply won't provide. If we're forced to go to school, teachers have to teach us even if we disagree with them philosophically or religiously. If we're forced to go to the doctor, doctors should have to treat us, (or in this case, provide the Bad Mommy/Bad Daddy consult), even if we disagree with them philosophically or religiously.

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#95 of 105 Old 10-12-2012, 03:22 PM
 
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Katelove, in Australia, is the ability to receive government-funded or government-subsidized health are, (or any other social service), contingent on vaccination status?

No. There is a "parenting payment" which is paid when your child is about 2yo if they have been fully vaccinated or if they weren't vaxxed you have to submit a CO form instead. But everyone can get it.

There are no health services contingent on vax status.
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#96 of 105 Old 10-13-2012, 03:40 AM
 
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No. There is a "parenting payment" which is paid when your child is about 2yo if they have been fully vaccinated or if they weren't vaxxed you have to submit a CO form instead. But everyone can get it.
There are no health services contingent on vax status.

 

It's not even technically a "parenting payment." It's the Family Tax Benefit. Hmm. We're a family. We pay taxes. We should qualify without having to submit a CO form. To me, tax benefits and vaccination status should NOT be equated. What does my kids' vaccination status have to do with getting a family tax rebate? I don't see any requirements for adults to submit proof of boosters to receive tax benefits. 

 

Sorry, just a sticking point for me, as a new-ish resident of Australia who didn't have anything similar in my home country.

 

http://immunise.health.gov.au/internet/immunise/publishing.nsf/Content/faq-related-payments


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#97 of 105 Old 10-13-2012, 07:23 AM
 
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If they put that kind of energy into getting people to quit smoking, imagine the health benefits!  


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#98 of 105 Old 10-14-2012, 12:35 AM
 
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If they put that kind of energy into getting people to quit smoking, imagine the health benefits!  

 

Yeah, because over here anyway, the government is essentially saying, "Look, if you want this tax benefit, you have to do what we consider healthy." So, why not ask all people to submit a letter from their GPs attesting that they are non-smokers and that their kids live in a smoke-free home in order to receive said tax benefits also. I mean, if the government is so concerned about our health and is doing the carrot and stick routine. winky.gif

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#99 of 105 Old 10-14-2012, 10:15 AM
 
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Increasingly more insurance companies in the US have started giving price discounts to people who don't smoke and who complete a questionnaire or a workshop or something on healthy/preventative lifestyle habits. My employer and my husband's employer both do. 

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#100 of 105 Old 10-14-2012, 10:28 AM
 
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To be fair, there are doctors that fire patients who wont quit smoking and who arent making strides to lose weight.

 

http://commonhealth.wbur.org/2012/08/mass-doctor-wont-accept-new-patients-who-are-obese

 

And I have no article for it, but I know my grandmother went through three separate oncologists who basically told her there was no point in treating her if she was going to keep smoking (she had lung cancer). 


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#101 of 105 Old 10-14-2012, 04:04 PM
 
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To be fair, there are doctors that fire patients who wont quit smoking and who arent making strides to lose weight.

 

http://commonhealth.wbur.org/2012/08/mass-doctor-wont-accept-new-patients-who-are-obese

 

 

 

While I am not sure I agree with firing smokers and overweight people, smoking and weight do heavily affect most organs and life expectancy.  

 

Not-vaccinating does not. 

 

Most VPD's, whether due to herd immunity or simple disease decline for one reason or another, are very rare.

http://www.cdc.gov/vaccines/pubs/pinkbook/downloads/appendices/G/cases&deaths.pdf

 

In the cases where things are not rare (CP, pertussis, influenza come to mind) the vaccine is not overly effective.


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#102 of 105 Old 10-14-2012, 04:27 PM
 
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Well, with weight loss and smoking, context is everything. The analogy with vaxes isn't entirely fitting because while vaxing is a quick occurrence, weight loss and smoking cessation require rigorous behavior modification, lifestyle changes, and sometimes even psychotherapy. If a client flat-out refuses to try, that's one thing. But if a doctor just says, "Lose weight before your next appointment or you can't come back,"....that's quite another!

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#103 of 105 Old 10-14-2012, 05:47 PM
 
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Yes, I do think a doctor should be able to terminate relationships for whatever reason s/he chooses (as long as it does not violate federal anti-discrimination law).  I do not think it is the right thing to do, but I think it is a right.  Nobody should be legally obligated to continue a professional relationship.

 

I write this as an overweight woman who operates a (very) small business.  I see both sides.

 

I think it would be absolutely foolish for a doctor to make a huge long list of reasons for termination.  A whole lot of folks would probably decide to go elsewhere, even if they met the criteria to stay.

 

But we do not have the right to demand treatment from the doctor (or any other businessperson) of our choice, at our convenience, on our own terms.  We just don't.


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#104 of 105 Old 10-14-2012, 07:35 PM
 
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Yes, I do think a doctor should be able to terminate relationships for whatever reason s/he chooses (as long as it does not violate federal anti-discrimination law).  I do not think it is the right thing to do, but I think it is a right.  Nobody should be legally obligated to continue a professional relationship.

 

I write this as an overweight woman who operates a (very) small business.  I see both sides.

 

I think it would be absolutely foolish for a doctor to make a huge long list of reasons for termination.  A whole lot of folks would probably decide to go elsewhere, even if they met the criteria to stay.

 

But we do not have the right to demand treatment from the doctor (or any other businessperson) of our choice, at our convenience, on our own terms.  We just don't.

But then, at what point do parents NOT have the right to obtain medical treatment for their unvaccinated child from a pediatrician--particularly one who has seen the child since birth-- rather than being forced to seek treatment (and pay much higher rates ) at the ER?

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#105 of 105 Old 10-14-2012, 08:53 PM
 
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But we do not have the right to demand treatment from the doctor (or any other businessperson) of our choice, at our convenience, on our own terms.  We just don't.

I think we have the right to *refuse* treatment for any reason, at any time without penalty from the HCP.

I do agree that doctors and other HCPs are not obligated to *provide* a treatment which they do not feel is in the patient's best interest. For example, if I walk into a surgeon's rooms and request that s/he remove my appendix when there is no evidence of appendicitis and no other compelling reason such as I am about to spend a year in Antarctica or something. But refusing to provide a treatment is not the same thing as refusing to continue seeing a patient who has refused a particular recommendation.

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