Recalcitrant Parents versus Child Welfare Disease Inoculation

"In our view, exceptional circumstances where it may be appropriate for a physician to contact a child protection agency would be one where, due to the child's specific clinical circumstances and local presence of the disease in question, not getting vaccinated threatens the life or long-term health of the child."
Dr. Doug Bell, associate executive director, The Canadian Medical Protective Association (CMPA)

"Technically, if the right conditions existed, it may be legally appropriate for a physician to report a child."
"Generally there must be a serious threat -- and usually imminent -- to the health of the child."
Timothy Caulfield, Canada research chair in health, law and policy, University of Alberta

If passed, new legislation would require Ontario parents to attend an 'education session' if they want a vaccine exemption for their children.  CBC

"Regardless of circumstance, judges ultimately decide, based on a number of factors, whether apprehension is in the best interest of a child."
Zoe Cooper, Alberta Human Services

"One could reasonably argue vaccination for those children [at risk] is necessary medical treatment, because the parents have demonstrated an unwillingness to take a critically ill child to the doctor."
Juliet Guichon, bioethicist, University of Calgary

Joe Raedle/Getty Images Files -- Invoking child welfare in vaccination has some questioning state intervention

Vaccination rates against many diseases that afflict children and that can have long-term consequences for many, are by and large fairly high in Canada, ranging from 78 percent for pneumococcal to 91 percent for poliomyelitis. Still, a survey undertaken in 2013 discovered that 1.5 percent of Canadian children have never in their lives received any type of vaccination. Despite a UNICEF report of recent vintage on uptake rates of immunizations ranking Canada 28 out of 29 developed countries.

But the demographic of parents refusing to allow their children to be inoculated against many types of what are normally considered to be 'childhood' diseases is growing. British Columbia and Alberta have seen resurgences in measles lately, as an example. Surveys point out that one in five Canadians subscribe to the view, despite its scientific inaccuracy, that vaccines are the cause of autism. There is a five percent rate of parents who feel that homeopathy and chiropractic manipulation are capable of eliminating the requirement for inoculations, among other types of "alternative" remedies.

There is the notoriously tragic case in point of an 18-month-old child whose Alberta parents insisted on treating his illness with nutritional supplements. The parents were convinced that natural products inclusive of vinegar, onion powder, ginger, garlic and hot peppers would cure their son of his illness. They were informed by a nurse that the child might have meningitis, but this gave them little pause for rational thought and they continued to administer 'natural products', calling 911 only when the child stopped breathing.

The father had an investment in 'natural products' for he and his father operated an alternative health store in Prince George, British Columbia, promoting in particular a nutritional supplement they claim as an effective treatment for mental illness. "Healthy products for mind, body and soul", is how they promote their products. The parents were found guilty of the charge of "failing to provide the necessities of life" brought against them in the child's death, but were given slight sentences; the father four months in prison.

And nor did the parents regret their actions leading to their infant's death, expressing no remorse, but blaming paramedics in the ambulance taking their son to hospital, for causing the child's death. In the words of Justice Rodney Jerke of the Court of Queen's Bench of Alberta, the parents' failure to seek medical treatment "contributed significantly" to the risk to their son's life. A move is now going forward to revisit the sentence meted out to the father to reflect his "complete lack of remorse for his own inaction and an entrenchment of his refusal to seek medical attention when it becomes necessary for those in his care", wrote the judge of this man who has three other children in his care.

Although under Canadian law, no parent can be coerced to have a child vaccinated, measures can be taken under the right circumstances. As an example, when the Ottawa Children's Aid Society took steps when a father insisted on his right to treat his infant's leukemia with cannabis oil instead of chemotherapy. And the fact that Canadian judges uniformly rule that Jehovah's Witnesses have no right to deny life-saving blood transfusions to their ailing children. At this juncture, doctors are now being advised o report such parents to authorities if a child is at risk of serious harm.

According to Dalhousie University professor of pediatrics, circumstances could exist where "if you were the court, you would probably think seriously about" intervening when faced with vaccine refusal, explained Dr. Noni MacDonald. Children with their spleens surgically removed, she explained are at "incredible risk for a bunch of infections", including meningococcal disease. "If you were in the middle of a meningococccal outbreak, if they get it, they might die. These kids really need to be immunized."