Vaccination: Is There a Place for Penalties for Non-compliance?
Vaccination: Is There a Place for Penalties for Non-compliance?
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DOI：
10.1007/s40258-019-00460-z
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发表时间：
2019-06-01
影响因子：
3.6
通讯作者：
Wilson, James
中科院分区：
文献类型：
--
作者：
Chantler, Tracey;Karafillakis, Emilie;Wilson, James
欧洲为控制麻疹疫情而采取的惩罚性措施引发了辩论和公众对惩罚和排除非免疫程序的道德理由的抗议。本文提出了一个与强制性疫苗接种政策相关的伦理框架，我们用它来分析三个案例研究：强制性政策，通过罚款来执行;政策，需要接种疫苗提供社会商品;和社区主导的政策，社区自己决定如何执行疫苗接种的遵守。我们报告当代，正在进行的和过去的措施，已被用来增加疫苗接种，考虑他们的理由和相关的公众反应，阐述社会文化和背景的影响，并讨论强制接种疫苗的伦理理由。我们主张采取一种衡量的方法，保护基本人权，以证据为基础的信息和医疗咨询，以支持健康决策，同时提高人们对免疫接种在保护更广泛社区中的作用的认识。我们认为，需要更加重视免疫接种，将其作为促进社会公益、减少伤害和保护弱势群体的一种手段。
The introduction of punitive measures to control outbreaks of measles in Europe has sparked debate and public protest about the ethical justification of penalties and exclusionary processes for non-immunisation. This article advances an ethics framework related to compulsory vaccination policies, which we use to analyse three case studies: of mandatory policies that are enforced by fines; of policies that require vaccination for the provision of social goods; and of community-led policies in which communities themselves decide how to enforce vaccination compliance. We report on contemporary, ongoing and past measures that have been used to increase vaccine uptake, consider their rationale and the related public responses, elaborate on socio-cultural and contextual influences, and discuss the ethical justification for mandatory vaccination. We argue for a measured approach that protects fundamental human rights to evidence-based information and medical counsel to support health decision making and that simultaneously raises awareness about the role of immunisation in protecting the wider community. We think more emphasis needs to be placed on immunisation as a means of promoting social good, reducing harm and protecting vulnerable groups.