As more families refuse vaccinations, pediatricians often find themselves put in a complicated situation: treat or dismiss.

Treating unvaccinated patients carries the risk for spreading sickness to others but dismissing those patients can place that burden on other pediatricians.

As dismissal rates increase, the American Academy of Pediatrics (AAP) has adjusted its position on this issue to address the growing trend. The organization states that it is now acceptable for clinicians to turn away families who continue to refuse vaccines.

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However, an unvaccinated child must be treated somewhere. The risk for spreading a sickness is not stopped but is transferred to patients in a different waiting room.

Authors of the viewpoint article — a response to the AAP position paper that was published in JAMA — point out that “dismissing vaccine-refusing families does not address the fundamental problem of vaccine refusal.”

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“There’s no easy answer here,” said Mark Navin, assistant professor of Philosophy at Oakland University and co-author of the JAMA article. “I’m very sympathetic to difficulties that pediatricians face, but we think this current recommendation [from the AAP] is not ethically justified.”

By refusing these patients, Navin says, these doctors are not fulfilling the goal of committing to the health of their communities. Rather, physicians who dismiss unvaccinated families are seemingly putting their own practice before public health efforts.


Deem MJ, Navin, MC, Lantos JD. Considering whether the dismissal of vaccine-refusing families is fair to other clinicians [published online April 30, 2018]. JAMA Pediatr. doi:10.1001/jamapediatrics.2018.0259