When is it Permissable to Dismiss a Family Who Refuses Vaccinces? Legal, Ethical and Public Health Perspectives

Although immunization is one of the most important health inter- ventions of the 20th century, cases of infectious disease continue to occur. There are parents who refuse immunization for their children, creating a dilemma for the primary care physician who must consider the best interest of the individual child as well as that of the commu- nity. Some physicians, when faced with parents who refuse immuniza- tion on behalf of their children, choose to dismiss these families from their practice. Given the existing shortage of primary care physicians across Canada, this decision to dismiss families based on vaccine refusal has far-reaching implications. The present article explores this issue in the Canadian context from a legal, ethical and public health perspective.