Informed Consent

by sue on July 20, 2010

Investigate Before You Vaccinate

By Sue Claridge (taken from Chapters 1 and 2 of Investigate Before You Vaccinate, 3rd ed).

For most parents in New Zealand taking their new-born baby along to their six week well-child check is standard procedure. Among other things, the doctor will give the baby two shots containing vaccines for six diseases. Most parents do not question this medical intervention. The vast majority will have grown up with vaccines and, along with the rest of the community, regard vaccines as something akin to a modern medical miracle. They accept all the “advice” from doctors, nurses, Plunket, family and friends, that this is not just the best thing to do for their baby but the “only” thing to do.

Some parents now question the idea that their babies must be vaccinated to ensure good health. In fact, many parents believe that, in reality, vaccination may leave their children sick, disabled or damaged for life, or worse still, may kill their children. Increasing numbers of parents are choosing to investigate before they decide whether or not they will vaccinate their children.

Vaccination is not compulsory!

Vaccination is not immunisation!

As a result of their own research increasing numbers of parents believe that vaccines:

  • are not necessary;
  • are not effective; and
  • are not safe.

Speaking about the polio vaccination campaign in the 1950s, Dr Paul Meier said:

“It is hard to convince the public that something is good. Consequently, the best way to push forward a new program is to decide on what you think the best decision is and not question it thereafter, and further, not to raise questions before the public or expose the public to open discussion of the issues.” 1

These comments were further reinforced when the United States Food and Drug Administration (FDA) quietly rushed through rule changes lowering the polio vaccine testing standards:

“any possible doubts, whether or not wellfounded, about the safety of the vaccine cannot be allowed to exist in view of the need to assure that the vaccine will continue to be used to the maximum extent consistent with the nation’s public health objectives.” 2

This epitomises the attitude of the Medical Establishment to vaccination and many other medical treatments. They do not want the public to educate themselves about vaccination issues for they fear that the public may not like what they find.

However, your right to provide truly informed consent to vaccination or any other medical procedure or treatment is enshrined in New Zealand legislation.

“Consent is a fundamental concept in the provision of health care services, including immunisation.” So says the Immunisation Handbook3 (see below). The critical issue is whether or not that consent is informed. Health professionals in New Zealand have a legal obligation to obtain informed consent before any medical treatment or procedure, including vaccination. Informed consent can only be provided by a patient or caregiver (parent) when the patient or caregiver has considered all the information pertaining to the risks and benefits of the proposed treatment or procedure.

While health professionals in New Zealand may consider that they obtain informed consent, many parents are not given all the information that they need to make an informed decision. Some doctors have told IAS that they have been threatened with the loss of their contracts if they do not promote vaccination (Pers. comm.). In 2002, Dr Colin Tukuitonga, the Director of Public Health, said that he believed that midwives who did not promote “immunisation” were in breach of their contracts as lead maternity caregivers,4 despite their clear obligation to provide information on the risks as well as the benefits of vaccination.

There is pressure on health professionals to provide only information that is sanctioned by the Ministry of Health (MoH). However, “official” information is incomplete and it is recognised by New Zealand consumer advocacy and health organisations (other than the IAS) that further information is necessary in order for people to be able to make an informed decision.5

Dr Jane Orient, Executive Director of the Association of American Physicians and Surgeons (AAPS) says that “Physicians have a duty to present the risks and benefits as accurately as they can, including an honest appraisal of gaps in our knowledge.”6 The AAPS voted to oppose mandatory vaccination (in the United States) in November 2000 and stated that “safety testing of many vaccines is limited and the data are unavailable for independent scrutiny, so that mass vaccination is equivalent to human experimentation and subject to the Nuremberg Code, which requires voluntary informed consent.”7 (this author’s emphasis).

In an environment where there is often no-one prepared to accept responsibility when medicine goes badly wrong, when ultimately it is the children and their parents who pay the price no matter who is to blame, it is crucial that the people on the receiving end of medical treatment (or their parents or caregivers) are satisfied that it is in their best interests and that the benefits outweigh all of the risks. This is what informed consent is all about.

Excerpt from the Ministry of Health’s Immunisation Handbook, 2006.

Consent is a fundamental concept in the provision of health care services. It is based on ethical obligations, which are, in part, supported by legal provisions (e.g. Health and Disability Commissioners Act 1994, Code of Health and Disability Services Consumers’ Rights 1996 and Privacy Act 1991). Consent is a process whereby the individual and/or their representative (if the patient does not have the capacity to consent) are appropriately informed and willing and able to agree to what is being suggested without coercion. It also includes the right to be honestly and openly informed about one’s personal health matters. The right to agree to treatment carries with it the right to refuse treatment. Regardless of age, an individual must be able to understand:

  • that they have a choice
  • why they are being offered the treatment
  • what is involved in what they are being offered
  • the probable benefits, risks, side effects, failure rates and alternatives.

The essential elements of the informed consent process are effective communication, full information and freely given competent consent. The Code of Health and Disability Services Consumers’ Rights that represent these three elements are:

Right 5: Right to Effective Communication.

Right 6: Right to be Fully Informed.

Right 7: Right to Make an Informed Choice and Give Informed Consent.

For example, section 7(1) of the Code states that ‘No health and disability service can be provided to a consumer without his or her informed consent.’ Health professionals have legal obligations to obtain informed consent. Unless there are specific legal exceptions to the need for consent, the health professional who acts without consent potentially faces the prospect of a civil claim for exemplary damages, criminal prosecution for assault (sections 190 and 196, Crimes Act 1961), complaints to the Health and Disability Commissioner and professional disciplining.

The patient or parent/guardian needs to understand the risks and benefits of vaccination, including risks to the child and community, in order to give informed consent.3

“The patient who is armed with information, who wants to ask questions, sometimes difficult and awkward questions, should be seen as an asset in the process of care and not an impediment to it.”

Sir Liam Donaldson, Chief Medical Officer in the
Department of Health, UK, Second National Service Delivery
and Organisation Conference, 19th March 2003.

References

1. Intensive Immunization Programmes, 1962: Hearings before the Committee on Interstates and Foreign Commerce, House of Representatives, 87th Congress, 2nd Session on H.R. 10541, Washington D.C., US Government Printing Office.

2. No authors listed, 1984: US Federal Register, Volume 49, No 104, June 1, 1984, Page 23007, middle column.

3. Ministry of Health, 2006: Immunisation Handbook 2006, Wellington, Ministry of Health.

4. Angela Gregory, 2002: Midwives accused of threat to babies, The New Zealand Herald, 19 June, 2002.

5. Parents Centre, Pers. comm., June 2002; Maternity Services Consumer Council, Pers. comm., June 2002.

6. Orient, Jane, M.D., 2001; Letter to NBC in response to an episode of ER and a call to boycott the television series, AAPS, www.aasponline.com (accessed October 2001).

7. AAPS, 2000: AAPS Resolution Concerning Mandatory Vaccines, Ethical Medicine, AAPS Annual Meeting, October 25 – 28, 2000, www.aapsonline.org (accessed July 2002).

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{ 9 comments }

Sheldon Nesdale July 20, 2010 at 9:56 pm

My wife and I have decided not to vaccinate our son (now 1 year old). We feel pressure from various groups such as child care centres and Doctors, but we did the research and we stand by our decision. I am now immensely suspicious of the motives of the drug companies which fund radio ads such as those for the HPV vaccine.

scott July 20, 2010 at 10:58 pm

Hi Sheldon
We have 3 under 3 years old and any “vaccination” is a no go at all costs. The fact is there is no proof of effectiveness and significant evidence of the potential for harm. Frankly, I do not care what other people think of me in regard to taking a natural immunity approach. It is my job to protect my family. I do that by avoiding the injection of synthetic, potentially dangerous chemicals into their bodies, feeding them a high protein, low carbohydrate diet, supplementing them with appropriate vitamin D3 among other “natural” practices. VAX = NO GO. – Scott E

Geoff February 25, 2011 at 8:03 pm

E Scott may like to look at the story of Small Pox before he considers all vaccines to be bad.

Cheers

Geoff

Michelle March 8, 2011 at 7:03 am

Geoff, I’d say Scott looked at the story of the smallpox vaccine and that’s how he’s come to the conclusion that vaccines are not what they’re constantly sold to be!

Take a look here http://www.drcarley.com/Horrors_of_Vaccination_Exposed.pdf to find out the truth about the smallpox vaccine and the devastation it caused.

neo April 6, 2011 at 11:41 am

If vaccines are not effective, why do the vast majority of measles cases in developed countries occur in unvaccinated people?

Paul April 9, 2011 at 12:17 pm

Michelle, the book you linked above that was written in 1920 and includes references from medical studies from as far back as 1815 is interesting, it suggests there is a link between vaccinations and subsequent epidemics, in particular smallpox.

But due to its age, it does not have any information on how smallpox was subsequently eradicated, even in the presence of increased vaccination.

Has there been a follow up?

michelle April 12, 2011 at 6:40 am

Smallpox would have declined in the same way as all the other illnesses which were rife at that time, thanks to better hygiene, better living conditions, better diet and lifestyle.

Check out the chapter in that book about Leicester and how they managed smallpox outbreaks and how the illness declined despite the city never using the vaccine.

I also wouldn’t be too sure that small pox has actually been “eradicated” http://www.the-scientist.com/blog/display/57663/ seems to me that the name has just been changed, how convenient.

Annabell April 20, 2011 at 12:03 am

Makes me sick, the the fact that my 4 week old son got whooping cough and nearly died was because of the decline in people immunizing their children. I think some of you need to take a walk though a childrens hospital where there are kids that are really really sick, the loose limbs, that are brain damage and even die because of not vaccinating. I think people need to have a good look at the history books too because if the polio vaccine wasn’t introduced kids would have continued being damaged and dying a lot longer with out vaccination and yes it may have decined naturally but only after alot more kids where lost to it!!

Honestly you guys need to put the liturature up here that has proven wrong the link with autism. Fact is 15months is when the signs start showing and its something for parents to put blame to when grieving.

PLEASE people websites like this and google are not the places to get your research from not to vaccinate!!

Michelle May 4, 2011 at 12:57 am

Annabell, I’m sorry to hear that your baby was so sick at such a young age, I can imagine it must have been very stressful for you, however before you lay blame I really think you need to do a bit more research, I am happy to help you out there.

First something to consider is the fact that the rates of vaccination against whooping cough in this country and Australia, and USA (where they are having their biggest outbreaks of whooping cough since vaccination started…) are the highest they have ever been in the history of each country.

Please feel free to check out what I’m about to say, with either a medical text, or your doctor:

For a baby to show symptoms of whooping cough at four weeks of age, they have to have been exposed to whooping cough at or just after birth. Why? because this is how whooping cough is caught:

1) Exposure and a few days to incubate.

2) What seems like a mild cold for about a week, which then disappears. Everyone relaxes…

3) A few days later a cough starts, which seems like nothing, but steadily gets worse.

4) Diagnosis is usually made a couple of weeks into the coughing when the parents realise that this isn’t just a little inconvenient cough about to disappear, so this is when most parents go for help, and four weeks after exposure is about the usual time frame to diagnosis.

This information is recognised in the government handbook on pertussis: http://www.moh.govt.nz/moh.nsf/pagesmh/4617/$File/2006-06pertussis.pdf

So.. if your baby was DIAGNOSED with whooping cough at four weeks, then the first exposure of your baby to whooping cough was around the time of birth. If your baby was born in hospital, then that’s the place to catch whooping cough as this news item points out:

http://www.abc.net.au/news/stories/2010/10/18/3041031.htm

Now here’s a link for you, to an article on whooping cough in New Zealand written last year: http://www.nzma.org.nz/journal/123-1313/4080/

Study it please. Yes pertussis vaccination was available in 1945, and maximum uptake by 1955 when it was discontinued due to the polio, was 9% uptake. Big deal.

As Grant’s graph shows in the article, even as the numbers of vaccinations have increased, and the ages at which they have been administered have been brought closer and closer to birth, the rate of whooping cough has gone UP. In the 60′s it was 102/100,000 person years. Now it’s over 300/100,000. Given that around 93% of New Zealand children receive the primary whooping cough schedule, even if parents don’t give them all the others, most of the cases of whooping cough have been appropriately vaccinated against whooping cough. That is actually admitted in other medical articles elsewhere, and has been for some time. Maybe now you are aware of that, you will rethink the appropriateness and validity of your comments.

What is Grant’s “solutions”? Same old, same old. MORE pertussis vaccines, and more “timely” vaccinations. He can’t bring himself to admit that pertussis hits vaccinated children. The problem Cameron Grant has, is that there has never been a time in history when New Zealanders have had MORE pertussis vaccines, and been “MORE timely” than now, yet pertussis is now three times as common as it was before vaccines were introduced. He admits it’s increased, but dodges the fact that the vaccination is useless.

Note this comment though. “National (1992 and 2005) and regional (1996) estimates that used methods recommended by the World Health Organization provide the most accurate measure of immunisation coverage. Based upon these surveys the percentage of children fully immunised at age 2 years has increased from 60% in 1992 to 77% in 2005. ”

That is a false measure of pertussis vaccination rates, and he knows it, because over 90% of all babies are completely up to date on pertussis vaccine. The “two year old” marker is actually the marker for the additional vaccines, like MMR, prevnar etc… so what Grant is doing here, is fudging the data, to make it look like pertussis vaccination rates are a problem, when they are not.

He has no option than to do this, because to tell the truth would alert parents to the fact that worldwide, the pertussis vaccine is useless.

In 2010 “ Vaccination status was known for 551 (63.1%) cases notified during 2010 (Table 19). Of these, 247 (44.8%) cases were not vaccinated, (In other words, 55.4% were) including 11 cases aged less than six weeks and therefore not eligible for vaccination. A total of 151 (27.4%) cases had received three or more doses of pertussis vaccine. “ http://www.surv.esr.cri.nz/PDF_surveillance/AnnualRpt/AnnualSurv/2010/2010AnnualSurvRpt.pdf and http://www.surv.esr.cri.nz/PDF_surveillance/AnnualRpt/AnnualSurv/2010/2010AnnualSurvRptTables.pdf

Anyone who knows the medical literature, and medical history of pertussis, knows that the New Zealand whooping cough vaccine hasn’t made any difference to the historical course of, or progression of the disease in any age group whatsoever. Quite contrary to the Ministry of Health mantra on whooping cough, who gets infected, is a lottery depending on whether or not they’ve been exposed. Not everyone will be exposed all the time. But one thing is for sure. Anyone who gives birth in hospital, has a much higher chance of being exposed to it, than a person who delivers in a country maternity unit. Yet even they, if there is pertussis circulating in the community has a chance, since all the well wishers who may well be carrying pertussis and not know it, gather around to coo over, and potentially infect your baby.

The only people in denial about the realities surrounding pertussis, are the likes of Cameron Grant, and people who need a scapegoat for a useless vaccine, so blame the “unvaccinated”.

One of the biggest unrecognised sources of infection are vaccinated adolescents and adults, who as the literature shows, are unlikely to get diagnosed at all. Whooping cough isn’t the same in adults, as it is in children. In adults, whooping cough can manifest itself as a cold, then a persistent irritating but “nothing much” cough for a couple of weeks.

That is why in most countrie’s the Health Departments now say that where a family has a new baby, parents, grandparents, aunties, childworkers etc, should all be vaccinated to try to cocoon the baby, because in many instances, it’s the mother, or father, or grandparent who just thinks they have an innocent cold, who give the baby “whooping cough”.

However, as the American experience is showing – and relatively rapidly – this new approach isn’t working either. Here is USA vaccine coverage by state and by vaccine, from the CDC, 2008-09, upon kindergarden entry – click on the vaccine and you get a state breakdown. California for example had 168% coverage in 08-09 for pertussis, (!!) but had outbreaks anyway….

http://www2.cdc.gov/nip/schoolsurv/nationalAvg.asp

The key to understanding a problem, is to study the know information, the medical literature and medical history, and realise that not everything is as simple as you’d like people to imagine.

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