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The Pediatric Forum
April 2006

Dismissing Families: A Critical Issue

Author Affiliations

Copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.2006

Arch Pediatr Adolesc Med. 2006;160(4):452-453. doi:10.1001/archpedi.160.4.452-b

As a former practicing family physician providing care to pediatric and adolescent patients, I applaud the ARCHIVES' efforts to bring attention to this critical issue.

In my former practice I, too, dismissed families from my practice for refusing childhood immunizations. Following the lead of a pediatrician mentor of mine, I would exhaust all efforts to provide cogent arguments to support the proven safety and effectiveness of these most successful preventive regimens. When these arguments failed, I advised these well-meaning but misguided parents that they were asking me to “voluntarily contribute to the death of their child from a disease we could prevent”; an ethical breach they could not ask of me. Most understood, and although it seldom changed their preconceptions, it at least provided a conceptual basis to interpret the decision to terminate the patient-physician relationship.

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