It is interesting that since my letter was published in the March issue of the ARCHIVES, I have received several letters from colleagues gently and not so gently reminding me of the ideal of informed consent. My approach to the issue of childhood immunization does not circumvent this; it merely means I do not have to do what the parent decides. I, too, have a choice.
Having watched medical philosophical thinking change from the physician as authority figure whose judgment was not to be questioned to the advisor-counselor who presents rational risk-vs-benefit arguments to patients, I have been disappointed that so few of my peers fail to question the assumptions in their education. Black and white philosophical positions make decision making easier, but are more often wrong than right. Here one position assumes all humans are incapable of making rational decisions, and the other that they are totally rational, well-educated beings and peers. Neither is realistic.
Jessee RA. Delusions. Arch Pediatr Adolesc Med. 2000;154(1):89. doi:
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